Form Cms-437- Psychiatric Unit Criteria Worksheet Page 8

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TAG
REGULATION
GUIDANCE
YES NO
EXPLANATORY STATEMENT
A1186
(4) Psychological Services. The unit must provide
Are the patients in need of psychological therapy or
or have available psychological services to meet the
testing receiving those services in a timely manner,
needs of the inpatients. The services must be furnished
and with sufficient intensity?
in accordance with acceptable standards of practice,
service objectives, and established policies and
procedures.
A1187
(5) Social Services. There must be a director of social
Does the social services director periodically audit
services who monitors and evaluates the quality and
the quality of social work services?
appropriateness of social services furnished.
A1188
The services must be furnished in accordance with
accepted standards of practice and established policies and
procedures.
A1189
Social service staff responsibilities must include, but are not
limited to, participating in discharge planning, arranging for
follow-up care, and developing mechanisms for exchange of
appropriate information with sources outside the hospital.
A1190
(6) Therapeutic Activities. The unit must provide a
therapeutic activities program.
A1191
(i) The program must be appropriate to the needs
Has the unit ensured consistent availability and
and interests of inpatients and be directed toward
provision of individualized therapeutic activities
restoring and maintaining optimal levels of physical
and rehabilitative services based on patient’s
and psychological functioning.
needs?
A1192
(ii) The number of qualified therapists, support
Are there clearly defined monitoring and evaluation
personnel, and consultants must be adequate to
mechanisms to conduct consistent and timely
provide comprehensive therapeutic activities
review of the quality and appropriateness of
consistent with each inpatient’s active treatment
therapeutic and rehabilitative services?
program.
According to the Paperwork Reduction of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for
this information collection is 0938-0358. The time required to complete this information collection is estimated to average 15 minutes per response, including the time to review instructions, search
existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for
improving this form, please write to: CMS, Attn: PRA Reports Clearance Officer, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Form CMS-437 (04/06)
8

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