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I can't negotiate that CMS website very well to give references but it is my

understanding that if you rent space in a pool it must be solely used for your

clients at the time. If there are two pools in the same room it would be OK to

have exclusive use of that one while the other is being used for another

purpose.

Bettye -Saleh, PT

Easter Seals TriCounties

Ventura, CA

________________________________

From: PTManager on behalf of kpalma892

Sent: Wed 1/31/2007 14:11

To: PTManager

Subject: pool therapy

Does anyone know where I can reference in Medicare Manuals any clause

that prohibits the use of a fitness pool being used for both our

clients and those in the fitness center. At one of our off-sites we

lease pool time from the fitness center we are in thebuilding with.

While we have a portion of the pool for limited time; club members can

use the rest of the pool. I was reading in the APTA website a clause

in CMS manuals stating we can only use those pools if we are alone in

the pool with our patients. Is this true or only for private practice

facilities? We are part of an outpatient hospital setting.

thanks Kim

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I did more research and the clause re. this issue falls specifically

under the PT services rendered in a private practice setting. I'm not

sure if it would apply to OP hospital settings - anyone have any

references?

Kimberley R. Palma

Office Manager - ECHN Rehabilitation Services

Tel: x5579

Fax:

_____

From: PTManager [mailto:PTManager ] On

Behalf Of BettyeSaleh

Sent: Wednesday, January 31, 2007 8:09 PM

To: PTManager

Subject: RE: pool therapy

I can't negotiate that CMS website very well to give references but it

is my understanding that if you rent space in a pool it must be solely

used for your clients at the time. If there are two pools in the same

room it would be OK to have exclusive use of that one while the other is

being used for another purpose.

Bettye -Saleh, PT

Easter Seals TriCounties

Ventura, CA

________________________________

From: PTManager <mailto:PTManager%40yahoogroups.com> on

behalf of kpalma892

Sent: Wed 1/31/2007 14:11

To: PTManager <mailto:PTManager%40yahoogroups.com>

Subject: pool therapy

Does anyone know where I can reference in Medicare Manuals any clause

that prohibits the use of a fitness pool being used for both our

clients and those in the fitness center. At one of our off-sites we

lease pool time from the fitness center we are in thebuilding with.

While we have a portion of the pool for limited time; club members can

use the rest of the pool. I was reading in the APTA website a clause

in CMS manuals stating we can only use those pools if we are alone in

the pool with our patients. Is this true or only for private practice

facilities? We are part of an outpatient hospital setting.

thanks Kim

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Share on other sites

If using a private/community pool and billing Medicare the following

applies: (From Medicare Benefit Policy Manual: Pub 100-02, Chapter 15,

Section 230.4 )

" Services should be furnished in the therapist's or group's office or in the

patient's home. The office is defined as the location(s) where the practice

is operated, in the state(s) where the therapist (and practice, if

applicable) is legally authorized to furnish services, during the hours that

the therapist engages in the practice at that location. If services are

furnished in a private practice office space, that space shall be owned,

leased, or rented by the practice and used for the exclusive purpose of

operating the practice. For example, a therapist in private practice may

furnish aquatic therapy in a community center pool. As required in other

settings (such as rehabilitation agencies and CORFs), the practice would

have to rent or lease the pool for those hours, and the use of the pool

during that time would have to be restricted to the therapist's patients, in

order to recognize the pool as part of the therapist's own practice office

during those hours. "

Pub 100-02 is readily available online at the Medicare website, and it is an

Internet Only Manual. It is found on the CMS website - Medicare Section -

Under the section on Regulation & Guidance. I would include the link, but

yahoo always seem to truncate them on this list.

Beckley

Bloomingdale Consulting Group, Inc

BloomingdaleConsulting.com <http://www.bloomingdaleconsulting.com/>

(fax)

_____

From: PTManager [mailto:PTManager ] On Behalf

Of BettyeSaleh

Sent: Wednesday, January 31, 2007 8:09 PM

To: PTManager

Subject: RE: pool therapy

I can't negotiate that CMS website very well to give references but it is my

understanding that if you rent space in a pool it must be solely used for

your clients at the time. If there are two pools in the same room it would

be OK to have exclusive use of that one while the other is being used for

another purpose.

Bettye -Saleh, PT

Easter Seals TriCounties

Ventura, CA

________________________________

From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com on

behalf of kpalma892

Sent: Wed 1/31/2007 14:11

To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

Subject: pool therapy

Does anyone know where I can reference in Medicare Manuals any clause

that prohibits the use of a fitness pool being used for both our

clients and those in the fitness center. At one of our off-sites we

lease pool time from the fitness center we are in thebuilding with.

While we have a portion of the pool for limited time; club members can

use the rest of the pool. I was reading in the APTA website a clause

in CMS manuals stating we can only use those pools if we are alone in

the pool with our patients. Is this true or only for private practice

facilities? We are part of an outpatient hospital setting.

thanks Kim

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Share on other sites

It goes a bit further in our experience: is correct, for a hospital or

private practice, the pool must be leased for exclusive use during the time the

patients will be using it. Implied--and enforced in our state--is the fact that

the pool is then part of the licensed hospital facility, and the state and/or

JCAHO will inspect the leased space and make sure that it meets the physical and

life/safety requirements of a hospital facility. Most of the pool facilities in

our area would not meet the standards of those inspections; even " simple " things

like signage requirements become major hurdles.

Bob Perlson

Director, Rehabilitation Services

Asante Health System

781 Black Oak Dr. Ste 101

Medford Oregon

pool therapy

Does anyone know where I can reference in Medicare Manuals any clause

that prohibits the use of a fitness pool being used for both our

clients and those in the fitness center. At one of our off-sites we

lease pool time from the fitness center we are in thebuilding with.

While we have a portion of the pool for limited time; club members can

use the rest of the pool. I was reading in the APTA website a clause

in CMS manuals stating we can only use those pools if we are alone in

the pool with our patients. Is this true or only for private practice

facilities? We are part of an outpatient hospital setting.

thanks Kim

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Share on other sites

,

Was interested in your response. I had heard that the facility also

had to be Medicare approved. Is that correct? (as it relates to a

free standing fitness facility). Thank you DJ

C. Julius PT, MA

Service Delivery Leader, Ambulatory Rehab Services

St. ph Mercy Hospital

Michigan Orthopedic Center

5315 Elliott Drive, Suite 203

Ypsilanti, MI. 48197

Telephone

Pager

e-mail juliusd@...

This e-mail is intended for the use of the individual or entity to

which it

is addressed and may contain information that is patient protected

health

information, privileged, confidential and/or exempt by law from

disclosure.

If the reader of this message and its attachments is not the intended

recipient, any further dissemination, distribution or copying of the

communication is strictly prohibited. If you have received this

communication and attachments in error, please notify the sender noted

immediately. After the notification, please delete the message and

all

attachments. Thank you for your anticipated cooperation.

>>> nancy@... 1/31/2007 9:42 PM >>>

If using a private/community pool and billing Medicare the following

applies: (From Medicare Benefit Policy Manual: Pub 100-02, Chapter 15,

Section 230.4 )

" Services should be furnished in the therapist's or group's office or

in the

patient's home. The office is defined as the location(s) where the

practice

is operated, in the state(s) where the therapist (and practice, if

applicable) is legally authorized to furnish services, during the hours

that

the therapist engages in the practice at that location. If services

are

furnished in a private practice office space, that space shall be

owned,

leased, or rented by the practice and used for the exclusive purpose

of

operating the practice. For example, a therapist in private practice

may

furnish aquatic therapy in a community center pool. As required in

other

settings (such as rehabilitation agencies and CORFs), the practice

would

have to rent or lease the pool for those hours, and the use of the

pool

during that time would have to be restricted to the therapist's

patients, in

order to recognize the pool as part of the therapist's own practice

office

during those hours. "

Pub 100-02 is readily available online at the Medicare website, and it

is an

Internet Only Manual. It is found on the CMS website - Medicare

Section -

Under the section on Regulation & Guidance. I would include the link,

but

yahoo always seem to truncate them on this list.

Beckley

Bloomingdale Consulting Group, Inc

BloomingdaleConsulting.com <http://www.bloomingdaleconsulting.com/>

(fax)

_____

From: PTManager [mailto:PTManager ] On

Behalf

Of BettyeSaleh

Sent: Wednesday, January 31, 2007 8:09 PM

To: PTManager

Subject: RE: pool therapy

I can't negotiate that CMS website very well to give references but it

is my

understanding that if you rent space in a pool it must be solely used

for

your clients at the time. If there are two pools in the same room it

would

be OK to have exclusive use of that one while the other is being used

for

another purpose.

Bettye -Saleh, PT

Easter Seals TriCounties

Ventura, CA

________________________________

From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

on

behalf of kpalma892

Sent: Wed 1/31/2007 14:11

To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

Subject: pool therapy

Does anyone know where I can reference in Medicare Manuals any clause

that prohibits the use of a fitness pool being used for both our

clients and those in the fitness center. At one of our off-sites we

lease pool time from the fitness center we are in thebuilding with.

While we have a portion of the pool for limited time; club members can

use the rest of the pool. I was reading in the APTA website a clause

in CMS manuals stating we can only use those pools if we are alone in

the pool with our patients. Is this true or only for private practice

facilities? We are part of an outpatient hospital setting.

thanks Kim

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Share on other sites

Thanks Bob - I will echo that. One of my clients (rehab agency) in Florida

added a therapy pool to her new clinic recently, and the State was involved

in the entire process from construction on forward. In Florida there are

differentiating rules for pools that are therapy pools including location.

When I ran wheelchair sports programs in Oklahoma and Florida, we used

community pools during 'open time' for wheelchair sports training and

recreation, and during 'closed' time for therapy related activities that

were billed, regardless of the payor.

Beckley

Bloomingdale Consulting Group, Inc

******************************************

BloomingdaleConsulting.com <http://www.bloomingdaleconsulting.com/>

(fax)

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Perlson, Bob

Sent: Thursday, February 01, 2007 8:08 AM

To: PTManager

Subject: RE: pool therapy

It goes a bit further in our experience: is correct, for a hospital or

private practice, the pool must be leased for exclusive use during the time

the patients will be using it. Implied--and enforced in our state--is the

fact that the pool is then part of the licensed hospital facility, and the

state and/or JCAHO will inspect the leased space and make sure that it meets

the physical and life/safety requirements of a hospital facility. Most of

the pool facilities in our area would not meet the standards of those

inspections; even " simple " things like signage requirements become major

hurdles.

Bob Perlson

Director, Rehabilitation Services

Asante Health System

781 Black Oak Dr. Ste 101

Medford Oregon

pool therapy

Does anyone know where I can reference in Medicare Manuals any clause

that prohibits the use of a fitness pool being used for both our

clients and those in the fitness center. At one of our off-sites we

lease pool time from the fitness center we are in thebuilding with.

While we have a portion of the pool for limited time; club members can

use the rest of the pool. I was reading in the APTA website a clause

in CMS manuals stating we can only use those pools if we are alone in

the pool with our patients. Is this true or only for private practice

facilities? We are part of an outpatient hospital setting.

thanks Kim

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Share on other sites

I am not aware of Medicare (CMS) requiring " Medicare approval " of a

community pool. I have worked with many clinics getting ready for survey

and certification as a CORF or Rehab Agency around the county, and many

states have additional health regulations, code regulations, architectural

regulations, etc that govern therapy clinics, and those vary depending on

the type of Medicare certification you are trying to achieve. For example

in California, a CORF requires compliance with different building code

regulations than a Rehab Agency, in Alabama an architectural/building code

review and inspection is required, etc.

Since private practice clinics (PTPP/OTPP) are not surveyed by the State

Agency as a requirement of Medicare Certification, some of these items may

not be required for private practice. That is why it is important to review

all the facility regulations pertinent to your State, Medicare certification

category, Therapy Licensing Board (such as in Texas ), Medicare Contractor

(carrier or FI), Certificate of Need requirements etc.

Beckley

Bloomingdale Consulting Group, Inc

BloomingdaleConsulting.com <http://www.bloomingdaleconsulting.com/>

(fax)

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Doug Julius

Sent: Thursday, February 01, 2007 9:35 AM

To: PTManager

Subject: RE: pool therapy

,

Was interested in your response. I had heard that the facility also

had to be Medicare approved. Is that correct? (as it relates to a

free standing fitness facility). Thank you DJ

C. Julius PT, MA

Service Delivery Leader, Ambulatory Rehab Services

St. ph Mercy Hospital

Michigan Orthopedic Center

5315 Elliott Drive, Suite 203

Ypsilanti, MI. 48197

Telephone

Pager

e-mail juliusd@trinity- <mailto:juliusd%40trinity-health.org> health.org

This e-mail is intended for the use of the individual or entity to

which it

is addressed and may contain information that is patient protected

health

information, privileged, confidential and/or exempt by law from

disclosure.

If the reader of this message and its attachments is not the intended

recipient, any further dissemination, distribution or copying of the

communication is strictly prohibited. If you have received this

communication and attachments in error, please notify the sender noted

immediately. After the notification, please delete the message and

all

attachments. Thank you for your anticipated cooperation.

>>> nancy@bloomingdalec <mailto:nancy%40bloomingdaleconsulting.com>

onsulting.com 1/31/2007 9:42 PM >>>

If using a private/community pool and billing Medicare the following

applies: (From Medicare Benefit Policy Manual: Pub 100-02, Chapter 15,

Section 230.4 )

" Services should be furnished in the therapist's or group's office or

in the

patient's home. The office is defined as the location(s) where the

practice

is operated, in the state(s) where the therapist (and practice, if

applicable) is legally authorized to furnish services, during the hours

that

the therapist engages in the practice at that location. If services

are

furnished in a private practice office space, that space shall be

owned,

leased, or rented by the practice and used for the exclusive purpose

of

operating the practice. For example, a therapist in private practice

may

furnish aquatic therapy in a community center pool. As required in

other

settings (such as rehabilitation agencies and CORFs), the practice

would

have to rent or lease the pool for those hours, and the use of the

pool

during that time would have to be restricted to the therapist's

patients, in

order to recognize the pool as part of the therapist's own practice

office

during those hours. "

Pub 100-02 is readily available online at the Medicare website, and it

is an

Internet Only Manual. It is found on the CMS website - Medicare

Section -

Under the section on Regulation & Guidance. I would include the link,

but

yahoo always seem to truncate them on this list.

Beckley

Bloomingdale Consulting Group, Inc

BloomingdaleConsulting.com <http://www.blooming

<http://www.bloomingdaleconsulting.com/> daleconsulting.com/>

(fax)

_____

From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

[mailto:PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com] On

Behalf

Of BettyeSaleh

Sent: Wednesday, January 31, 2007 8:09 PM

To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

Subject: RE: pool therapy

I can't negotiate that CMS website very well to give references but it

is my

understanding that if you rent space in a pool it must be solely used

for

your clients at the time. If there are two pools in the same room it

would

be OK to have exclusive use of that one while the other is being used

for

another purpose.

Bettye -Saleh, PT

Easter Seals TriCounties

Ventura, CA

________________________________

From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

on

behalf of kpalma892

Sent: Wed 1/31/2007 14:11

To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

Subject: pool therapy

Does anyone know where I can reference in Medicare Manuals any clause

that prohibits the use of a fitness pool being used for both our

clients and those in the fitness center. At one of our off-sites we

lease pool time from the fitness center we are in thebuilding with.

While we have a portion of the pool for limited time; club members can

use the rest of the pool. I was reading in the APTA website a clause

in CMS manuals stating we can only use those pools if we are alone in

the pool with our patients. Is this true or only for private practice

facilities? We are part of an outpatient hospital setting.

thanks Kim

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Share on other sites

I spoke w/our intermediary - EMPIRE (for Connecticut).

This policy pertains only to PT's practicing in a private practice

setting (as noted in the manual)

It does not apply to PT services rendered by a hospital outpatient dept.

Kimberley R. Palma

Office Manager - ECHN Rehabilitation Services

Tel: x5579

Fax:

_____

From: PTManager [mailto:PTManager ] On

Behalf Of Doug Julius

Sent: Thursday, February 01, 2007 9:35 AM

To: PTManager

Subject: RE: pool therapy

,

Was interested in your response. I had heard that the facility also

had to be Medicare approved. Is that correct? (as it relates to a

free standing fitness facility). Thank you DJ

C. Julius PT, MA

Service Delivery Leader, Ambulatory Rehab Services

St. ph Mercy Hospital

Michigan Orthopedic Center

5315 Elliott Drive, Suite 203

Ypsilanti, MI. 48197

Telephone

Pager

e-mail juliusd@... <mailto:juliusd%40trinity-health.org>

This e-mail is intended for the use of the individual or entity to

which it

is addressed and may contain information that is patient protected

health

information, privileged, confidential and/or exempt by law from

disclosure.

If the reader of this message and its attachments is not the intended

recipient, any further dissemination, distribution or copying of the

communication is strictly prohibited. If you have received this

communication and attachments in error, please notify the sender noted

immediately. After the notification, please delete the message and

all

attachments. Thank you for your anticipated cooperation.

>>> nancy@...

<mailto:nancy%40bloomingdaleconsulting.com> 1/31/2007 9:42 PM >>>

If using a private/community pool and billing Medicare the following

applies: (From Medicare Benefit Policy Manual: Pub 100-02, Chapter 15,

Section 230.4 )

" Services should be furnished in the therapist's or group's office or

in the

patient's home. The office is defined as the location(s) where the

practice

is operated, in the state(s) where the therapist (and practice, if

applicable) is legally authorized to furnish services, during the hours

that

the therapist engages in the practice at that location. If services

are

furnished in a private practice office space, that space shall be

owned,

leased, or rented by the practice and used for the exclusive purpose

of

operating the practice. For example, a therapist in private practice

may

furnish aquatic therapy in a community center pool. As required in

other

settings (such as rehabilitation agencies and CORFs), the practice

would

have to rent or lease the pool for those hours, and the use of the

pool

during that time would have to be restricted to the therapist's

patients, in

order to recognize the pool as part of the therapist's own practice

office

during those hours. "

Pub 100-02 is readily available online at the Medicare website, and it

is an

Internet Only Manual. It is found on the CMS website - Medicare

Section -

Under the section on Regulation & Guidance. I would include the link,

but

yahoo always seem to truncate them on this list.

Beckley

Bloomingdale Consulting Group, Inc

BloomingdaleConsulting.com <http://www.bloomingdaleconsulting.com/

<http://www.bloomingdaleconsulting.com/> >

(fax)

_____

From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com> ]

On

Behalf

Of BettyeSaleh

Sent: Wednesday, January 31, 2007 8:09 PM

To: PTManager <mailto:PTManager%40yahoogroups.com>

Subject: RE: pool therapy

I can't negotiate that CMS website very well to give references but it

is my

understanding that if you rent space in a pool it must be solely used

for

your clients at the time. If there are two pools in the same room it

would

be OK to have exclusive use of that one while the other is being used

for

another purpose.

Bettye -Saleh, PT

Easter Seals TriCounties

Ventura, CA

________________________________

From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

on

behalf of kpalma892

Sent: Wed 1/31/2007 14:11

To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

Subject: pool therapy

Does anyone know where I can reference in Medicare Manuals any clause

that prohibits the use of a fitness pool being used for both our

clients and those in the fitness center. At one of our off-sites we

lease pool time from the fitness center we are in thebuilding with.

While we have a portion of the pool for limited time; club members can

use the rest of the pool. I was reading in the APTA website a clause

in CMS manuals stating we can only use those pools if we are alone in

the pool with our patients. Is this true or only for private practice

facilities? We are part of an outpatient hospital setting.

thanks Kim

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