Each patient shall receive an initial physical/occupational therapy evaluation prior to the provision of services. During that initial evaluation and ongoing, the following shall be addressed and documented:
- Treatment goals and plans in accordance with the diagnosis and prognosis, as well as the patient and family’s considerations, aiming those goals toward preventing or reducing disability or pain and restoring lost function.
- Therapeutic interventions that focus on posture, strength, locomotion, endurance, cardiopulmonary function, balance, coordination, joint mobility, flexibility, pain, and functional abilities in daily living skills. The application of modalities that include heat, cold, air, water, sound, electricity, massage, mobilization, and therapeutic exercise with or without assistive devices.
- Assessment and training in gait and cognition including, as necessary, the use of assistive devices.
- Patient and family education as appropriate.
- Physical/occupational therapy staff shall monitor the extent to which the services provided have met the goals relative to all examinations including improvement of the identified physical and cognitive dysfunction and the degree of pain reduction