Guideline text:
(Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

§482.62(g)(2) The number of qualified therapists, support personnel, and consultants must be adequate to provide comprehensive therapeutic activities consistent with each patient's active treatment program.

## Interpretive Guidelines §482.62(g)(2)

Qualified staff should complete their respective discipline assessments for use in multidisciplinary treatment planning. Specific role(s) and modalities to be implemented by rehabilitative staff must be determined by goals set in the patient's treatment plan.

Qualified therapists who provide clinical services and administrative staff should utilize established monitoring and evaluation mechanisms to conduct consistent timely review of the quality and appropriateness of therapeutic and rehabilitative services delivered to patients.

## Survey Procedures §482.62(g)(2)

Is there evidence that sampled patients and staff are familiar with the goals and staff interventions described in the patient's treatment plan? Are these observed interventions being carried out? What is the patient's response? Are these interventions and activities of sufficient frequency and intensity to achieve maximum therapeutic benefit?

What are the qualifications, experience, duties and responsibilities of the Therapeutic Activities Director and discipline supervisor(s)?

How is the program organized?

Did the patients in the sample have a need for any therapeutic activities? Were their needs met?

Did any of the patients in the sample indicate a need for therapeutic activities, but none were considered?

What kinds of services are provided to the patient population?

Are activity areas/sites accessible and available to meet the patient's individual needs? Are the facilities and resources adequate to enable implementation of goals set in the patient's treatment plan?

Does the program utilize available community resources to provide opportunities for socialization, leisure, and therapeutic and/or rehabilitation activities for patients who can participate outside the hospital setting?

Are current activity schedules clearly posted for patient and staff reference and use? Are the scheduled activities related to the particular patient area and specific treatment needs of patients?

Are patient needs met consistently at all times including evenings and weekends?

If a large number of patients are assigned to the same therapeutic activity, do patients have individualized goals within their treatment plans?

Why have therapeutic activities staff been deployed in the manner they have?

## Transmittals Issued for this Appendix

| Rev #    | Issue Date   | Subject                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   | Impl Date   | CR#   |
|----------|--------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------|-------|
| R220SOMA | 04/19/2024   | Revisions to State Operations Manual (SOM) Appendix A-Hospitals                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           | 04/19/2024  | N/A   |
| R216SOMA | 07/21/2023   | Revision to State Operations Manual (SOM) Appendix A- Hospitals                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           | 07/21/2023  | N/A   |
| R200SOMA | 02/21/2020   | Revisions to the State Operations Manual (SOM) Appendix A - Hospitals, Appendix AA - Psychiatric Hospitals, Appendix B - Home Health Agency, Appendix D - Portable X-Ray, Appendix G - Rural Health Clinics/Federally Qualified Health Centers, Appendix H- End Stage Renal Disease Facilities (ESRD), Appendix K - Comprehensive Outpatient Rehabilitation Facility, Appendix L - Ambulatory Surgical Centers, Appendix M-Hospice, Appendix U - Religious Nonmedical Healthcare Institutions, AppendixW- Critical Access Hospitals (CAHs), Appendix X - Organ Transplant Program and Appendix Z - Emergency Preparedness | 02/21/2020  | N/A   |
| R183SOMA | 10/12/2018   | Revisions to Medicare State Operations Manual (SOM) Table of Contents, Medicare SOM Appendix, SOM Appendix A - Survey Protocol, Regulations and Interpretive Guidelines for Hospitals, SOM Appendix T- Regulations and Interpretive Guidelines for Swing Beds in Hospitals, SOM Appendix W- Survey Protocol, Regulations and Interpretive Guidelines for Critical Access Hospitals (CAHs) and Swing-Beds in CAHs.                                                                                                                                                                                                         | 10/12/2018  | N/A   |
| R176SOMA | 12/29/2017   | Revisions to State Operations Manual (SOM) Appendix A - Survey Protocol, Regulations and Interpretive Guidelines for Hospitals                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            | 12/29/2017  | N/A   |
| R172SOMA | 11/17/2017   | Revision to State Operations Manual (SOM) Appendix A - Survey Protocol, Regulations and Interpretive Guidelines for Hospitals                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             | 11/17/2017  | N/A   |
| R170SOM  | 09/08/2017   | Revisions to the State Operations Manual (SOM) Appendix A - Survey Protocol, Regulations and Interpretive Guidelines for Hospitals- Rescinded and Replaced Transmittal #172                                                                                                                                                                                                                                                                                                                                                                                                                                               | 09/08/2017  | N/A   |

| R151SOM   | 11/20/2015   | Revisions to State Operations Manual (SOM), Appendix A -Survey Protocol, Regulations and Interpretive Guidelines for Hospitals                                                                       | 11/20/2015   | N/A   |
|-----------|--------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------|-------|
| R149SOM   | 10/09/2015   | State Operations Manual (SOM) for All Types of Providers and Suppliers Subject to Certification                                                                                                      | 10/09/2015   | N/A   |
| R141SOM   | 07/10/2015   | Revisions to the State Operations Manual (SOM), Appendix A - Survey Protocol, Regulations and Interpretive Guidelines for Hospitals                                                                  | 07/10/2015   | N/A   |
| R137SOM   | 04/01/2015   | Revisions to State Operations Manual (SOM) Appendices A, G, L and T related to Hospitals, Rural Health Clinics, Ambulatory Surgical Centers and Swing Beds                                           | 03/27/2015   | N/A   |
| R122SOM   | 09/26/2014   | Revisions to State Operations Manual (SOM), Appendix A - Survey Protocol, Regulations and Interpretive Guidelines for Hospitals                                                                      | 09/26/2104   | N/A   |
| R116SOM   | 06/06/2014   | Revised State Operations Manual (SOM) Hospital Appendix A, Survey Protocol, Regulations and Interpretive Guidelines for Hospitals                                                                    | 06/06/2014   | N/A   |
| R105SOM   | 03/21/2014   | Revised Appendix A, Interpretive Guidelines for Hospitals, Condition of Participation: Quality Assessment and Performance Improvement                                                                | 03/21/2014   | N/A   |
| R103SOM   | 02/14/2014   | Revised State Operations Manual (SOM) Hospital Appendix A                                                                                                                                            | 02/14/2014   | N/A   |
| R99SOM    | 01/31/2014   | Revised State Operations Manual (SOM) Appendices A, I, L, andW                                                                                                                                       | 01/31/2014   | N/A   |
| R95SOM    | 12/12/2013   | Revised Appendix A, Interpretive Guidelines for Hospitals, Appendix L, Interpretive Guidelines for Ambulatory Surgical Centers and Appendix W, Interpretive Guidelines for Critical Access Hospitals | 06/07/2013   | N/A   |
| R89SOM    | 08/30/2013   | Revised State Operations Manual (SOM) Appendices A, I, L, and W-Rescinded and replaced by Transmittal 99                                                                                             | 08/30/2013   | N/A   |
| R87SOM    | 07/19/2013   | Revised Appendix A, Interpretive Guidelines for Hospitals, Condition of Participation: Discharge Planning                                                                                            | 07/19/2013   | N/A   |

| R84SOM   | 06/07/2013   | Revised Appendix A, Interpretive Guidelines for Hospitals, Appendix L, Interpretive Guidelines for Ambulatory Surgical Centers and Appendix W, Interpretive Guidelines for Critical Access Hospitals - Rescinded and replaced by Transmittal 95   | 06/07/2013   | N/A   |
|----------|--------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------|-------|
| R81SOM   | 03/23/2012   | Revisions to State Operations Manual (SOM), Appendix A, Hospitals                                                                                                                                                                                 | 03/23/2012   | N/A   |
| R78SOM   | 12/22/2011   | Revised Appendix A, Interpretive Guidelines for Hospitals and Appendix W, Interpretive Guidelines for Critical Access Hospitals(CAH)                                                                                                              | 12/22/2011   | N/A   |
| R77SOM   | 12/22/2011   | Revised Appendix A, 'Interpretive Guidelines for Hospitals'                                                                                                                                                                                       | 12/22/2011   | N/A   |
| R75SOM   | 12/02/2011   | Revised Appendix A, Interpretive Guidelines for Hospitals and Appendix W, Interpretive Guidelines for Critical Access Hospitals(CAH)                                                                                                              | 12/02/2011   | N/A   |
| R74SOM   | 12/02/2011   | Revised Appendix A, 'Interpretive Guidelines for Hospitals'                                                                                                                                                                                       | 12/02/2011   | N/A   |
| R72SOM   | 11/18/2011   | Revised Appendix A: Conditions of Participation and Interpretive Guidelines for Hospitals                                                                                                                                                         | 11/18/2011   | N/A   |
| R59SOM   | 05/21/2010   | Clarification of the Interpretive Guidelines for the Anesthesia Services Condition of Participation                                                                                                                                               | 05/21/2010   | N/A   |
| R47SOM   | 06/05/2009   | Revised Appendix A, 'Interpretive Guidelines for Hospitals'                                                                                                                                                                                       | 06/05/2009   | N/A   |
| R37SOM   | 10/17/2008   | Revised Appendix A, 'Interpretive Guidelines for Hospitals'                                                                                                                                                                                       | 10/17/2008   | N/A   |
| R01SOM   | 05/21/2004   | Initial Release of Pub. 100-07                                                                                                                                                                                                                    | N/A          | N/A   |

Structured rule (JSON):
{"intent_tags": ["quality", "compliance"], "logic_config": {"required_artifact": "adequate number of qualified therapists, support personnel, and consultants"}, "rule_type": "existence", "scope_tags": ["clinical", "facility", "legal"]}