Clarification on the Role of Aides in Maintenance Therapy

The Centers for Medicare and Medicaid Services (CMS) have issued Change Request 8458 to clarify the role of aides in delivering maintenance therapy in the context of the recent changes stemming from the Jimmo vs. Sebelius settlement.   

Previous CMS guidance had incorrectly indicated that skilled physical therapy services in the Skilled Nursing Facility (SNF) setting must, “…require the skills of a qualified therapist (not an assistant) for the performance of a safe and effective maintenance program.” The regulations, however, do not specify that an assistant cannot perform maintenance services in the SNF setting, unlike the home health and outpatient regulations which specifically make this distinction.  This Change Request corrects that particular language to eliminate the phrase “not an assistant.”

Therefore, assistants or aides can provide Medicare covered maintenance services in the skilled nursing facility, but not in the home health or hospital outpatient department.

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827