Cal. Code Regs. Tit. 22, § 51213 - Rehabilitation Center

(a) A rehabilitation center shall be certified by the Department as meeting the requirements of this section, shall be approved by the Department and shall meet the requirements of either (b) or (c) and all the other provisions of this section.

(b) Such rehabilitation center shall be a hospital, which meets the standards for participation set forth in Section 51207 and which is currently participating in the program and which was an organized outpatient department, and which

(1) Has an organized rehabilitation service, and

(2) Has as chief of the rehabilitation service a physician who has the necessary training and experience to assure proper patient assessment and care.

(c) If it is not a hospital which meets the requirements of (b) above, the rehabilitation center shall be an organized outpatient clinic. Each such rehabilitation center shall have an organized rehabilitation service and shall provide sufficient professional supervision to assure that the extended treatment plan of the attending physician will be properly carried out.

(d) The rehabilitation center shall provide two or more of the following services:

(1) Physical therapy

(2) Occupational therapy

(3) Speech therapy

(4) Audiology

(e) The rehabilitation center shall meet the standards set forth in Section 51209 or 51211.1 when providing physical therapy and occupational therapy, and employ personnel who meet the definitions set forth in Section 51079 when providing physical therapy, Section 51083 when providing occupational therapy, Section 51095 when providing speech therapy and Section 51097 when providing audiology services.

(f) The rehabilitation center shall establish and maintain a record of diagnosis, condition, treatment plan, services provided, and functional results on each patient treated. Such medical records shall include the following:

(1) The extended treatment plan required pursuant to the provisions of Section 51314(a).

(2) Patient identification, including Social Security number.

(3) A medical history, including a recent physical examination.

(4) Attending physician's orders.

(5) A complete record of all services rendered by the rehabilitation center.

(6) Progress notes.

(7) Copies of laboratory and radiology reports as they relate to conditions treated by the rehabilitation center.

(8) Medication records.

(g) Each such rehabilitation center shall have written policies that provide for:

(1) Arrangements with Medi-Cal providers to provide laboratory, x-ray, and other ancillary services on an as needed basis.

(2) A utilization review plan that includes:

(A) The organization and composition of a utilization review committee, which shall include at least one physician and which shall be responsible for the utilization review functions.

(B) The frequency of meetings which shall be not less than monthly.

(C) A selection of cases for review on a random sample basis of not less than one case in every ten.

(D) A summary of the number and types of cases reviewed, and the findings on each.

(E) The actions to be taken by the rehabilitation center based on the findings and recommendations of the utilization review committee.

(3) Notification of the utilization review committee of all new patients for whom the rehabilitation center assumes responsibility for treatment. The utilization review committee shall also be provided with a monthly updated list of all rehabilitation center patients.

(4) The medical records of each patient to be available from the rehabilitation center for the use of the utilization review committee.

(5) The names and office or facility locations of consultants who are available to provide consultation on an individual case basis to the rehabilitation center, on request, for those professional services provided by the rehabilitation center.

Notes

Cal. Code Regs. Tit. 22, § 51213

1. Amendment of subsections (c) and (e) filed 9-27-72; designated effective 11-1-72 (Register 72, No. 40). For prior history, see Register 72, No. 31.
2. Amendment of subsection (a) filed 1-18-74; effective thirtieth day thereafter (Register 74, No. 3).
3. Change without regulatory effect adding NOTE (Register 86, No. 49).

Note: Authority cited: Sections 10725 and 14124.5, Welfare and Institutions Code. Reference: Sections 14019.5, 14059, 14110 and 14132, Welfare and Institutions Code.

1. Amendment of subsections (c) and (e) filed 9-27-72; designated effective 11-1-72 (Register 72, No. 40). For prior history, see Register 72, No. 31.
2. Amendment of subsection (a) filed 1-18-74; effective thirtieth day thereafter (Register 74, No. 3).
3. Change without regulatory effect adding NOTE (Register 86, No. 49).