Progress/Supervisory Visits

Key Points

• LifeCare requests that Progress/Supervisory Visits be scheduled every 3  weeks and that these visits be added to the EMR so all staff are aware of the appointment and compliance with this requirement.

• Check the number of visits in POC and the end date of the certification period to determine whether re-certification is needed.

• A Supervisory Visit does not need to replace an assistant's therapy visit, but can be an "additional visit" that week.

Regulatory Guidelines/Overview

Supervision and Progress Reports are related, but separate services that warrant definition. 

Supervision applies to the assistant providing care. When care is provided in an off-site setting, regulations require a supervisory visit every 30 days.  For supervision of the assistant, Medicare also requires ongoing “general supervision,” meaning the Supervising Therapist must be available to the Assistant via telecommunication at all times when patient care is being rendered.

In contrast, a Progress Report is a document required by Medicare to assess patient progress and document the medical necessity for continued therapy.   A Progress Report is required, without exception, every 10 therapy visits, which gives an assistant/patient 8 "therapy only" visits.  Medicare requires the “active participation” of the clinician (supervising therapist) in the patient’s care, which is proven by  “providing a billable treatment every 10 visits.”

What To Include

The day beginning the first reporting period is the first day of the episode of treatment regardless of whether the service provided on that day is an evaluation or treatment. The next treatment day begins the next reporting period. The Progress Report shall contain: 

● Date that the report was written; 

● Signature and professional identification of the qualified professional who wrote the report; 

● Reports of the patient’s subjective statements if relevant; 

● Objective description of changes in the patient’s status relative to each goal currently being addressed in treatment. 

● Assessment of improvement, extent of progress (or lack thereof) toward each goal; 

● Plans for continuing treatment and/or treatment plan revisions.