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§485.715 Condition of Participation: Speech Pathology Services

If speech pathology services are offered, the organization provides an adequate program of speech pathology and has an adequate number of qualified personnel and the equipment necessary to carry out its program and to fulfill its objectives.
Interpretive Guidelines §485.715

A – General
Speech-language pathology services are those services (examples are provided below) that are provided within the scope of practice of speech-language pathologists and are necessary for the diagnosis and treatment of speech and language disorders.
The speech pathology services provided should be such that patients accepted for treatment are able to receive services as medically indicated. The equipment used by speech-language pathologists may vary from organization to organization, depending upon the types of patients that each organization accepts for service. Equipment must be available that is necessary for the patient’s treatment.
Review personnel rosters and patient census to determine that the organization provides sufficient qualified personnel to adequately serve the patients it accepts for services.

B – Major Sources of Information
Plans of care, and speech pathology evaluations and progress notes;

  • Patient care policies;
  • Personnel records—job descriptions, employee qualifications, and current licensure information; and
  • Clinical records.

I-151
(Rev. 83, Issued: 03-15-13, Effective: 03-15-13, Implementation: 03-15-13)

§485.715(a) Standard: Adequate Program

The organization is considered to have an adequate outpatient speech pathology program if it can provide the diagnostic and treatment services to effectively treat speech disorders.
Interpretive Guidelines §485.715(a)

A – General
In order for the organization to have an adequate speech-language pathology program, it must have available qualified speech-language pathologists (refer to § 484.4 for the requirements), and the necessary equipment to diagnose and treat the patients that it accepts for services. Speech-language pathology services are aimed at improving a patient’s communication, cognitive and linguistic skills, and hearing and swallowing abilities.
Clinical services provided by speech-language pathologists may include, but are not limited to, the following:

  • Dysphagia (swallowing) evaluation and treatment;
  • Selecting, fitting, and establishing effective use of prosthetic/adaptive devices for communication and swallowing;
  • Using instrumentation such as video fluoroscopy and computer technology to observe, collect data, and measure parameters of communication and swallowing;
  • Voice therapy to remediate disorders in vocal quality and volume;
  • Language therapy to improve comprehension and expression; and
  • Cognitive retraining.

Review the patient’s clinical record to ascertain what type of equipment, if any, is used for the patient and if that equipment is available on the day of the survey.

B. Major Sources of Information

  • Patient care policies and procedures;
  • Clinical records; and
  • Staff interviews and observations of therapies.

I-152
(Rev. 83, Issued: 03-15-13, Effective: 03-15-13, Implementation: 03-15-13)

§485.715(c) Standard: Personnel Qualified to Provide Speech Pathology Services

Speech pathology services are given or supervised by a qualified speech pathologist and the number of qualified speech pathologists is adequate for the volume and diversity of speech pathology services offered. At least one qualified speech pathologist is present at all times when speech pathology services are furnished.
Interpretive Guidelines §485.715(c)

A – General
A qualified speech-language pathologist meets the requirements found in § 484.4.
Adequate service cannot be determined based upon the mere proportion of the staff to patient ratio. Qualified staff must possess the knowledge and skills required for the treatment of the various patients’ diagnoses.
Surveyors should verify through record review, observation, and interview:

  • That patient evaluations or reevaluations are being performed by or under the supervision of a SLP a speech-language pathologist;
  • That a qualified speech-language pathologist is providing speech-language pathology services; and
  • That the clinical record notes and/or observations show that the plan of care is being followed.

B – Major Sources of Information

  • Personnel records for licensure, certification, or registration;
  • Policies and procedures regarding patient care;
  • Observations and interviews; and
  • Clinical record review (plans of care and progress notes).

I-67
(Rev. 83, Issued: 03-15-13, Effective: 03-15-13, Implementation: 03-15-13)

§485.717(a) Standard: Qualifications of Staff

The agency’s therapy services are furnished by qualified individuals as direct services and/or services provided under contract.
Interpretive Guidelines § 485.717(a)

A – General
All individuals who furnish therapy services in a rehabilitation agency must meet the qualifications of § 484.4; and have the required license, registration or certification as required by national certification organizations, State practice acts, and Federal, State and local laws.
The licenses must be for the States in which the services are being provided.

B – Major Sources of Information

  • Personnel records containing current licenses and/or certificates of registration or certification;
  • State licensure laws for health care providers; and
  • State practice acts.

I-69
(Rev. 83, Issued: 03-15-13, Effective: 03-15-13, Implementation: 03-15-13)

§485.717(b) Standard: Arrangements for services

If services are provided under contract, the contract must specify the term of the contract, the manner of termination or renewal and provide that the agency retains responsibility for the control and supervision of the services.
Interpretive Guidelines §485.717(b)

A – General
For guidelines, refer to I-80, §485.719(a).

I-79
(Rev .83, Issued: 03-15-13, Effective: 03-15-13, Implementation: 03-15-13