Introduction

Rehabilitation Technology services are defined as the application of enabling technology systems designed to meet the needs of a specific person experiencing any permanent or long-term loss or abnormality of physical or anatomical structure or function.   These services, prescribed by a physician, primarily address wheeled mobility, seating and alternative positioning, ambulation support and equipment, environmental control, augmented communication and other equipment and services that assist the person in performing their activities of daily living.  Rehabilitation Technology services facilitate and/or enhance access and independence thereby improving the person’s quality of life. 




What Makes RTS Different.  

A key element that differentiates Rehab Technology Suppliers from HME Companies is the process required to evaluate Rehab Technology clients’ needs. Rehab Technology Suppliers conduct individualized evaluations of clients’ Rehab Technology needs in order to provide them with the most appropriate equipment to meet their needs. The evaluation is conducted in the environment in which the client will be utilizing the adaptive equipment and includes input from other health professionals such as a Physical Therapist, Occupational Therapist and the client’s physician. An integral part of the evaluation is the clear identification of the client’s goals relating to what they need or want to achieve in terms of their individual medical and functional needs. The final fitting of rehabilitation technology products should take place in the client’s home or work environment to assure that the product is suitable and that it fulfills the client needs. The client evaluations must be performed by a certified Rehab Professional who is defined as one who has successfully attained the title of Assistive Technology Supplier (ATP) or Assistive Technology Practitioner (ATP) [As awarded by the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA)].

The physical plant needs differ greatly from standard HME companies. The Rehab Technology Supplier must have designated room(s) for evaluation and fitting that are private, clean and safe for the client and comply with the accessibility standards of the Americans with Disabilities Act. The Rehab Technology Supplier must offer the client an assortment of products to improve the selection process in determining the item(s) that best serve the client’s needs, goals and objectives. In order to determine product suitability and to appropriately meet the needs of the client, the Rehab Technology Supplier must provide either the exact item to be purchased or a close facsimile to properly demonstrate its effectiveness. The Rehab Technology Supplier must be able to provide loaner equipment to clients while their equipment is being repaired.

In addition to serving the client’s equipment and service needs, Rehab Technology Suppliers have a much more personalized involvement with each individual client. This includes assisting clients with the funding process, informing them of their options, negotiating with payers for coverage and reimbursement, and complex claims processing. The Rehab Technology Suppliers must employ trained and qualified personnel in order to facilitate this process. Rehab Technology Suppliers must offer their clients accurate pre-screening of coverage and payment options so the client is aware of all funding issues. Also, Rehab Technology Suppliers must provide education for the client’s other healthcare providers (doctors, therapists, and social workers), who may not know about the Rehab Technology process or the funding issues involved.
 

Review of Standards

This section will summarize the Accreditation Commission for Health Care’s scope of standards section of the RTS accreditation manual. The section is not meant to take the place of the complete manual for accreditation that is available from ACHC. The section does not include ACHC’s core standards for accreditation which outline the necessary facility requirements related to business operations and administration, financial management, human resource management, consumer services and records, performance management and product safety.

Rehabilitation Technology Supplier services must be provided in accordance with accepted ethical and industry standards as well as all applicable local, state and federal statutes. Rehab Technology Companies must employ at least one Rehab professional per location. The supervisor of services must be an Assistive Technology Supplier (ATS) or an Assistive Technology Practitioner (ATP). Rehab Technology Companies must employ at least one trained technician per service center that has attended an industry-wide technician-training program. Customer Service/Billing staff must attend an industry sponsored customer service/billing training course(s).

The company must pursues communication and interaction with other rehabilitation suppliers in order to maintain the standards of professionalism, increase awareness of services and products, improve overall product quality, and enhance product and service development within the field.

The company must have written policies and procedures that describe the process for provision of services to its clients. The scope of services section must include, at a minimum, the following written policies and procedures:

• The types of services/equipment provided, target client populations, and goals of the program.
• Hours of operation and how after hours calls are documented and responded to.
• The process for the client evaluation/assessment of need, the development of the plan of service and the frequency and the process for the plan of service review.  The evaluation must be conducted in all appropriate settings to include the client’s home, school and work environment, as applicable. The evaluation must include input from other health professionals such as the client’s Physical Therapist, Occupational Therapist and Physician.
• How the client is involved in the development of the plan of service and any changes to the plan. 
• Describe the education of the client including the proper use of products provided, safety hazards associated with products provided, maintenance of equipment, plan of service; and how to notify the company of problems, concerns and complaints. Written instructions must be provided to the client regarding the safe use and care of any equipment/supplies provided.
• Transfer and discharge policies and procedures. How are client transfers and/or discharges documented in the client record?
• The cleaning, storage, and transportation of client-ready equipment.
• The separation of dirty equipment from client-ready equipment in the warehouse and delivery vehicles.
• The warehousing and tagging of equipment.
• The use of cleaning and disinfecting agents and processing of contaminated or soiled equipment, including curbside disinfection.
• The set-up, delivery, environmental requirements, and electrical safety of the equipment.
• The maintenance and repair of equipment.
• Te separation of inoperative equipment.
• The tracking of equipment and the procedures relating to manufacturer recalls.
• Define the training, qualifications, and skill validation required by personnel to perform routine maintenance and repair of all RTS equipment.  Define the use of outside repair sources.
• How equipment assembly is documented.
• The provision of on-site services including the accessibility standards of the Americans with Disabilities Act.
• The provision of equipment for demonstration, simulation and trial.
• The loan of equipment to clients.
• Equipment and product warranty.

During the accreditation survey process, the surveyor will collect data to document the following: (1) The company has written policies and procedures that comply with accreditation standards; (2) All staff members are educated and understand the company’s policies and procedures; (3) Clients are educated per the company’s polices and procedures, and; (4) Staff members comply with the company’s policies and procedures and accreditation standards.

This article was written to provide a short review of the accreditation standards and survey process for Rehabilitation Technology Suppliers, and to educate other Home Health Care organizations about the differences between Home Medical Equipment companies and Rehabilitation Technology Suppliers. As you are aware, the Centers for Medicare and Medicaid will require all DMEPOS companies to be accredited. RTS companies that are not currently accredited should start now to prepare for accreditation.