CMS SOM App. J, Tag W120

Guidance §483.410(d)(3)

Outside services are any services needed by the clients and not provided directly by the facility

(hospital visits, dental visits, day program services, etc.).

Programs and services must be coordinated between the facility and the outside service, and

foster consistency of implementation across settings of teaching strategies and behavior

management.

The facility monitors outside services on an ongoing basis to ensure that services provided are

consistent with the needs of each client as identified in the Individual Program Plan (IPP). For

example, if the facility is implementing a behavior management or a communication program

for the client, it is shared with the outside program and implemented by the outside program

(workshop, day program, etc.) and the outside program agrees to incorporate it into their day

program. At periodic intervals, the facility staff visit or communicate with the outside program

to verify consistency across the two settings.

With outside resources, it is the responsibility of the facility to assure that the services are

provided in a safe clean environment, by appropriately qualified professions, and any untoward

outcome of services are promptly addressed. If, in spite of attempts by the facility to assure

compliance, the outside program does not implement the program for the client, then the

facility remains responsible for the lack of active treatment.