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plan as required by §456.380 of this chapter that specifies plan of care requirements for ICFs;

and

Guidance §483.460(b)(1)

During the admission process, which takes place from the time the client is admitted to the

facility to the time the initial IPP is completed, a physician is required to ensure that an

assessment of the client's medical status is thoroughly considered and incorporated into the IPP

planning process by the team as it develops the IPP. The physician's input may be by means of

written reports, evaluations, and recommendations.

The physician (consistent with Medicaid Utilization Control regulations at §456.380) must

evaluate the client at the time of admission to identify all diagnoses and complaints, provide

orders for all medications and treatments and provide recommendations for restorative and

rehabilitative services.

§456.380 requires that a physician conduct this initial assessment therefore, it may not be done

by a physician extender (e.g., Physician assistant or Advanced Practice Registered Nurse).