---
kind: "section"
citation: "42 C.F.R. § 456.610"
title: "42"
number: "456.610"
heading: "Basis for determinations."
url: "https://uscodex.org/cfr/42/456.610"
---

# §456.610. Basis for determinations.


In making the determinations on adequacy of services and related matters under [§ 456.609](/cfr/42/456.609.md) for each beneficiary, the team may consider such items as whether—

- (a) The medical evaluation, any required social and psychological evaluations, and the plan of care are complete and current; the plan of care and, where required, the plan of rehabilitation are followed; and all ordered services, including dietary orders, are provided and properly recorded;
- (b) **The attending physician reviews prescribed medications—**
  - (1) At least every 30 days in psychiatric facilities, and mental hospitals; and
  - (2) At least quarterly in ICFs;
- (c) Tests or observations of each beneficiary indicated by his medication regimen are made at appropriate times and properly recorded;
- (d) Physician, nurse, and other professional progress notes are made as required and appear to be consistent with the observed condition of the beneficiary;
- (e) **The beneficiary receives adequate services, based on such observations as—**
  - (1) Cleanliness;
  - (2) Absence of bedsores;
  - (3) Absence of signs of malnutrition or dehydration; and
  - (4) Apparent maintenance of maximum physical, mental, and psychosocial funtion;
- (f) **In an ICF, the beneficiary receives adequate rehabilitative services, as evidenced by—**
  - (1) A planned program of activities to prevent regression; and
  - (2) Progress toward meeting objectives of the plan of care;
- (g) The beneficiary needs any service that is not furnished by the facility or through arrangements with others; and
- (h) The beneficiary needs continued placement in the facility or there is an appropriate plan to transfer the beneficiary to an alternate method of care.

## Notes

### Amendments

[43 FR 45266, Sept. 29, 1978, as amended at 61 FR 38399, July 24, 1996]

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 43 FR 45266, Sept. 29, 1978, unless otherwise noted.

### Amendments

[43 FR 45266, Sept. 29, 1978, as amended at 61 FR 38399, July 24, 1996]