1. (a) General requirements.

   1. (1)

      1. (A) “Rehabilitation hospital” means a hospital or a distinct part of a hospital as designated in 20 CAR § 43-102, definitions, that:

2. (i) Is used for the primary purpose of providing rehabilitative services as so defined; and

   1. (ii) Shall comply with 20 CAR §§ 43-101 – 43-137.

      1. (B) Each hospital or unit shall have the capability of providing or arranging for emergency services twenty-four (24) hours per day, seven (7) days per week.

   2. (2)

      1. (A) Any comprehensive physical rehabilitative program shall provide through the use of qualified professional personnel, at a minimum, the following clinical services:

         1. (i) Physical therapy;
         2. (ii) Occupational therapy;
         3. (iii) Speech therapy; and
         4. (iv) Social services or psychological services.
      2. (B) Note. May be provided under contract or arrangement on an as-needed basis.
   3. (3) A physician qualified by training, experience, and knowledge of rehabilitative medicine shall be appointed as the medical director.

   4. (4)

      1. (A) Nursing services shall be under the direct supervision of a registered nurse who:

         1. (i) Has a master’s degree; or
         2. (ii) Is qualified by education and experience in rehabilitative nursing.
      2. (B) If the registered nurse does not have the required credentials, a master’s degree-prepared registered nurse shall be available as a consultant.
      3. (C) The number of registered nurses, licensed practical nurses, and other nursing personnel shall be adequate to formulate and carry out the nursing components of the individual treatment plan for each patient.

      4. (D) There shall be a registered nurse on duty twenty-four (24) hours per day, seven (7) days per week, to:

         1. (i) Plan, assign, supervise, and evaluate nursing care; and
         2. (ii) Provide for the delivery of nursing care to patients.

   5. (5)

      1. (A) A physician licensed in the State of Arkansas shall be responsible for each patient's general medical condition as needed.
      2. (B) Medical services shall be available twenty-four (24) hours per day, seven (7) days per week as needed.
      3. (C) Upon admission there shall be written orders for the immediate care of the patient.

   6. (6)

      1. (A) Policies and procedures shall be developed.
      2. (B) The manual shall have evidence of ongoing review and/or revision.

      3. (C) The first page of the manual shall have the:

         1. (i) Annual review date; and
         2. (ii) Signature of the department supervisor and/or person or persons conducting the review.

   7. (7)

      1. (A) Clinically relevant educational programs shall be conducted on a regularly scheduled basis of not fewer than twelve (12) per year.

      2. (B) There shall be evidence of:

         1. (i) Program dates;
         2. (ii) Attendance; and
         3. (iii) Subject matter.

   8. (8)

      1. (A) Regular staff meetings shall be held at least monthly.
      2. (B) Dated minutes of each meeting shall be kept in writing.
   9. (9) There shall be an ongoing QA/PI program.

3. (b) Special medical record requirements.

   1. (1) Refer also to 20 CAR § 43-113, Health Information Services.

   2. (2) The medical record shall include:

      1. (A) Reason for:

         1. (i) Referral to physical rehabilitation services; or
         2. (ii) Admission to the comprehensive physical rehabilitation program;

      2. (B) History and physical examination including patient's:

         1. (i) Clinical condition;
         2. (ii) Functional strengths and limitations;
         3. (iii) Indications and contraindications for specific physical rehabilitative services; and
         4. (iv) Prognosis;

      3. (C) Goals of treatment and the treatment plan, including:

         1. (i) Any problem that may affect the outcome of physical rehabilitation services; and
         2. (ii) Criteria for the discontinuation of services;

      4. (D)

         1. (i) Interdisciplinary treatment plans to include:
4. (a) (a) Measurable goals of treatment; and

5. (b) (b) Criteria for discharge.

   1. (ii) The plan shall include ongoing assessments as required by the patient's medical condition.

      1. (iii) Documentation of patient and family in the:
6. (a) (a) Development of the treatment plan;

7. (b) (b) Resolution of problems; and

   1. (c) (c) Rehabilitation potential;

      1. (E) A discharge summary that includes recommendations for further care; and

      2. (F)

         1. (i) Patient evaluation procedures, including treatment plan for each patient based on the functional assessment and evaluation.
         2. (ii) The initial treatment plan shall be developed within twenty-four (24) hours, and a comprehensive individualized plan:
8. (a) (a) Developed no later than one (1) week after admission; and

9. (b) (b) Updated at least monthly.

   1. (iii) The plan shall state the rehabilitative problem, goals, and required therapeutic services, as well as:
10. (a) (a) Prognosis;

11. (b) (b) Anticipated length of stay; and

    1. (c) (c) Discharge disposition.

       1. (c) Physical environment. The rehabilitation facility shall comply with 20 CAR § 43-141, physical environment.

          1. (d) Physical facilities. The rehabilitation facility shall comply with 20 CAR § 43-175, physical facilities — rehabilitation facilities.

Codification Notes: “QA/PI” means quality assurance/performance improvement.