Restorative nursing is important to your facility now and will be under the new Patient Driven Payment Model (PDPM) payment system. Ensuring that our residents have services to improve or maintain their functional abilities is imperative for resident outcomes and to reduce medical risk factors and rehospitalizations.

The restorative nursing program hasn’t changed over the years. However, instituting a standard of importance regarding restorative nursing programs is needed.

Let’s talk about section O of the minimum data set (MDS) under PDPM and how restorative nursing plays a vital role in calculating the Nursing Component.

In section O of the MDS, Special Treatments, Procedures, and Programs, restorative nursing programming is drafted to be recorded in section O0500, just like it is now. Restorative nursing is important to the Centers for Medicare and Medicaid Services (CMS) and we know this because CMS has included this important resident care programming as criteria to classify the resident in Nursing Categories under PDPM. This last two Nursing Categories, Behavioral Symptoms and Cognitive Performance and Reduced Physical Function, is where Restorative Nursing plays a vital role in establishing the Behavioral Symptoms and Cognitive Performance as well as the Reduced Physical Function Category.  The following will be recorded on the MDS:

  • Range of motion (Passive) (MDS section O0500A);
  • Range of Motion (Active) (MDS Section O0500B);
  • Splint or Brace Assistance (MDS section O0500C);
  • Bed Mobility (MDS section O0500D);
  • Transfer (MDS section O0500E);
  • Walking (MDS section O0500F);
  • Dressing and/or Grooming (MDS section O0500G);
  • Eating and/or Swallowing (MDS section O0500H);
  • Amputation/Prostheses Care (MDS section O0500I); and
  • Communication (MDS section O0500J).

Why is it important to revitalize your Restorative Nursing Program?  You probably already know the answer to this question.  If the resident doesn’t fall in any of the other four PDPM Nursing Categories, you won’t be able to capture the true care needs of the residents and appropriately classify them in a PDPM Nursing Category.  But more importantly, residents will suffer without an effective Restorative Nursing Program.  Quality Measures will suffer and the risk of rehospitalizations may increase.  If you provide and capture Restorative Nursing Programs, along with recording at least six days per week and 15 minutes per day per program, you will greatly calculate in to the Behavioral Symptoms and Cognitive Performance and Reduced Physical Function PDPM Nursing Category.

How do I revitalize my Restorative Nursing Program?

Evaluate your current restorative nursing program.

  • Is it consistently being done?
  • Do you have enough staff to support the restorative needs of your residents?
  • Brainstorm on how to incorporate restorative nursing beginning day one of the resident’s stay.
  • Revitalize your commitment to ensuring a consistent and effective restorative nursing program.

Preparing yourself for PDPM is extremely important and a piece of that preparation is to ensure you position yourself to be able to effectively categorize residents into a PDPM Nursing Clinical Category and ensure you are consistently and effectively providing preventative medical services. After all, preventing functional declines in communication and swallowing deficits, decreasing falls, decreasing skin integrity issues, to name a few, and maintaining the highest functional level of our residents is not only required but is our duty as health care professionals. 

Restorative Nursing Programming can start on day one of the resident’s stay. Why not explore this new way of thinking? Improving the overall skilled nursing facility experience will ultimately produce great outcomes, decrease rehospitalization’s, and improve resident and family satisfaction.

What could be better than a great community reputation and being the provider of choice because your resident care is superb? I can’t think of anything more satisfying!


For our Functional Pathways’ Clients, we offer Restorative Nursing Program auditing services conducted by our Clinical Reimbursement Specialist. 

For more information regarding this service, please contact


Gina Tomcsik
Director of Compliance and Regulatory Strategy