Form Cms-671 - Ltc Facility Application For Medicare/medicaid Page 5
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6GENERAL INSTRUCTIONS AND DEFINITIONS
(use with CMS-671 Long Term Care Facility Application for Medicare and Medicaid)
Director of Nursing - Professional registered nurse(s)
Dietary Services - All activities related to the provision of a
administratively responsible for managing and supervising
nourishing, palatable, well-balanced diet that meets the daily
nursing services within the facility. Do not additionally reflect
nutritional and special dietary needs of each resident.
these hours in any other category.
Dietitian - A person(s), employed full, part-time or on a
Nurses with Administrative Duties - Nurses (RN, LPN,
consultant basis, who is either registered by the Commission
LVN) who, as either a facility employee or contractor, perform
of Dietetic Registration of the American Dietetic Association,
the Resident Assessment Instrument function in the facility
or is qualified to be a dietitian on the basis of experience in
and do not perform direct care functions. Also include other
identification of dietary needs, planning and implementation of
nurses whose principal duties are spent conducting
dietary programs.
administrative functions. For example, the Assistant Director
of Nursing is conducting educational/in-service, or other duties
Food Service Workers - Persons (excluding the dietitian) who
which are not considered to be direct care giving. Facilities
carry out the functions of the dietary service (e.g., prepare and
with an RN waiver who do not have an RN as DON report all
cook food, serve food, wash dishes). Includes the food
administrative nursing hours in this category.
services supervisor.
Registered Nurses - Those persons licensed to practice as
Therapeutic Services - Services, other than medical and
registered nurses in the State where the facility is located.
nursing, provided by professionals or their assistants, to
Includes geriatric nurse practitioners and clinical nurse
enhance the residents' functional abilities and/or quality of life.
specialists who primarily perform nursing, not
physician-delegated tasks. Do not include Registered Nurses'
Occupational Therapists - Persons licensed/registered as
hours reported elsewhere.
occupational therapists according to State law in the State in
which the facility is located. Include OTs who spend less than
Licensed Practical/Vocational Nurses - Those persons
50 percent of their time as activities therapists.
licensed to practice as licensed practical/vocational nurses in
the State where the facility is located. Do not include those
Occupational Therapy Assistants - Person(s) who, in accord
hours of LPN/LVNs reported elsewhere.
with State law, have licenses/certification and specialized
training to assist a licensed/certified/registered Occupational
Certified Nurse Aides - Individuals who have completed a
Therapist (OT) to carry out the OT's comprehensive plan of
State approved training and competency evaluation program,
care, without the direct supervision of the therapist. Include
or competency evaluation program approved by the State, or
OT Assistants who spend less than 50 percent of their time as
have been determined competent as provided in 483.150(a)
Activities Therapists.
and (3) and who are providing nursing or nursing-related
services to residents. Do not include volunteers.
Occupational Therapy Aides - Person(s) who have
specialized training to assist an OT to carry out the OT's
Nurse Aides in Training - Individuals who are in the first 4
comprehensive plan of care under the direct supervision of the
months of employment and who are receiving training in a
therapist, in accord with State law.
State approved Nurse Aide training and competency
evaluation program and are providing nursing or
Physical Therapists - Persons licensed/registered as physical
nursing-related services for which they have been trained and
therapists, according to State law where the facility is located.
are under the supervision of a licensed or registered nurse. Do
not include volunteers.
Physical Therapy Assistants - Person(s) who, in accord with
State law, have licenses/certification and specialized training to
Medication Aides/Technicians - Individuals, other than a
assist a licensed/certified/registered Physical Therapist (PT) to
licensed professional, who fulfill the State requirement for
carry out the PT's comprehensive plan of care, without the
approval to administer medications to residents.
direct supervision of the PT.
Pharmacists - The licensed pharmacist(s) who a facility is
Physical Therapy Aides - Person(s) who have specialized
required to use for various purposes, including providing
training to assist a PT to carry out the PT's comprehensive
consultation on pharmacy services, establishing a system of
plan of care under the direct supervision of the therapist, in
records of controlled drugs, overseeing records and
accord with State law.
reconciling controlled drugs, and/or performing a monthly
drug regimen review for each resident.
Speech-Language Pathologists - Persons licensed/registered,
according to State law where the facility is located, to provide
speech therapy and related services (e.g., teaching a resident to
swallow).
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