Page 17 - Rehab 2020

b. Understand difference between restorative and maintenance.
i. Restorative – improve/return function
ii. Compensatory/Adaptive – improve function by modifying task through
adaptive equipment, modifying the environment, and/or modifying the task.
iii. Maintenance – CMS Definition - “Maintenance therapy, when the
specialized knowledge and judgment of a qualified therapist is required to
design and establish a maintenance program based on an initial evaluation
and periodic reassessment of the patient’s needs, and consistent with the
patient’s capacity and tolerance.
For example, a patient diagnosed with Parkinson’s disease who has not
been under a rehabilitation regimen may require the services of a
qualified therapist to determine what type of exercises will contribute the
most to the maintenance of his present level of functioning.”
iv. Maintenance therapy is
a. Designing and setting up a maintenance program
b. Instructing patient, family and Home Health Aides in the
program (not Home Health Aide only)
c. Infrequently re-evaluating the program and/or the patient
d. REQUIRES the specialized knowledge, skill and judgment of
the therapist (PT, OT, SLP)
v. Creating a therapy program to:
a. Maintain current functional level
b. Decrease amount of assistance needed from caregivers at
current functional level
c. Increase safety at current functional level
d. Identify needed assistive devices/aids to maintain current
functional level
e. Instruct caregivers in proper participation with current
functioning
vi. Maintenance therapy would:
a. Be determined with the MD – both therapist and MD need
to agree that there is no expectation of improvement in
condition (no restorative therapy needs) and that agreement
should be documented in a COC note.
b. Documentation would show skilled maintenance and use the
Maintenance purpose of visit code.

VNSNY CRITERIA FOR ADMISSION

1. Patient resides within the service area: 5 boroughs of NYC, Nassau, Suffolk, and
Westchester counties.
2. Patient is under the care of a physician overseeing the plan of care
3. Patient is able and willing to participate and cooperate in carrying out the plan of care; if the
patient is unable, a mutual care agreement is needed – a form signed by a family member or
caregiver assuming responsibility for participation in the plan of care and ensuring the
patient’s safety in the home in the absence of VNSNY personnel.

9