No, but be sure to include this information in your documentation and plan of treatment. You still need the physician's order to cover you for the first seven days. There are some supportive treatment clients who have been in the program for years and a lot of progress is not expected. Our goal is to keep them from backsliding. You need to document what you are doing to keep the client stable.
Documentation is the key.
Good documentation is needed related to what you are doing to encourage them to participate. Medicare requires that you document the reason why the client missed the session. The facility physician can admit with standing admission orders. A court order is an example of a non-physician referral. A family member may not refer a patient.