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Can we count a nursing assistant’s help with ADLs and walking as restorative nursing time?

Q: We have a Medicare Part A post knee or hip surgery patient who is receiving at least 5 days of physical and occupational therapy and a nursing assistant is assisting the patient with ADLs and walking the patient in the evenings. Can we count the nursing assistant’s time as restorative nursing time?

A: Routine ADL assistance as a normal course of care is not considered restorative nursing care.

Restorative nursing does not include procedures or techniques carried out by or under the direction of qualified therapists. Restorative programs are usually initiated after a resident is discharged from specialized rehabilitative services. If, however, restorative needs occur apart from formal therapy, a program may be initiated to address those specific issues. Remember, restorative programs are nursing-based and must be supervised and periodically evaluated by a licensed nurse (RN, LPN, LVN); not a therapist. Nursing assistants must be skilled in the techniques they provide in a restorative nursing program.