9) Extenders of Care Flashcards
Co-management
PT and another HCP who also manages the pt work together to provide collaborative care
Consultation
Giving your professional opinion/advice by applying your scope’s specialized knowledge and skills to ID problems, recommend solutions, or produce a specific outcome
- PT’s can give and ask for a consult
- Like on Grey’s Anatomy
Explain Direction and Supervision
PT’s are accountable for services provided by recognized assistive personnel
What individual ultimately directs the POC?
The PT
Who retains responsibility for a pt t/o the episode of care?
The PT
- There should never be a full hand-off of a pt
What are some changes to the new NJ practice act?
- PTA’s can do home care
- New grads can take the NPTE 120 days prior to graduation
Describe the education of PTA’s
Licensed HCP that graduated from a CAPTE-accredited 2-yr PTA program
Are PTA’s allowed to interpret results from assessments?
No
What things should be considered prior to giving a pt to a PTA?
- Is the pt comfortable w/the PTA?
- Pt complexity
- Will the pt need on-going skilled assessment?
Direct Supervision (NJ Practice Act Definition)
The supervising PT has to be on-site and available to respond to any consequence that may occur during tx
What does the NJ Practice Act say about PTA supervision?
- PT can’t supervise more PTA’s than the State Board feels adequate → Usually 2
- Can petitions for an exception
- PTA can work only under the direct supervision of a PT
According to the NJ Practice Act, what can the PTA do?
- Initiate tx only when a PT tells them to and must be under their direct supervision
- Collect data for pt exam
- Documentation → PT still needs to cosign
According to the NJ Practice Act, what can’t PTA’s do?
- Perform a PT exam/eval
- Interpret exam findings
- Make a dx or px
- Devo/modify POC
- Make any type of decision about pt’s care, including recommending AD’s or modification of pt’s physical environment
- Joint mobes/manips
- Sharp selective debridement
What happens in the event of an unanticipated absence of the supervising PT?
PTA may tx for 1 business day, as long as they already have an established POC and the PTA has worked w/that pt before
According to the NJ Practice Act, where does the PT have to be in order to give direct supervision?
In the same building or ones that touch/are connected and constantly available via electronic communication
According to the NJ Practice Act, how frequently do the PT and PTA need to review a POC together?
- Before the 1st visit
- Before implementing/revising a POC
- At least every 30 days
- If there’s a new supervising PT
According to the NJ Practice Act, what tasks can an unlicensed person (aide, volunteer, etc) do?
- Cleaning
- Equipment maintenance
- Physical plant
- Business tasks
- Pt transport
- Assist w/dressing/undressing
- Pt positioning
According to the NJ Practice Act, what things can’t an unlicensed person do?
Basically anything that’s skilled
- Advise, instruct, or teach the pt about their condition
- Perform any testing or eval procedures
- Make notes in the pt’s chart about clinical tx
- Place electrodes
- Administer PA’s
- Instruct or perform therex
- Provide therapeutic massage
Do PTA’s have their own billing ID?
No → PTA services are billed under the supervising PT
Does Medicare consider PTA’s to be qualified providers?
Yes, as long as they are following the rules
Who sets the rules about PTAs and who should we follow?
- Medicaid
- Different plans
- Different payers
- The state
*Follow the one that’s most restrictive
What does Medicare consider billing for unsupervised care?
Fraud
Are PTA’s and COTA’s considered qualified professionals according to the Medicare Manual?
Yes
What is the only setting that requires direct supervision? What do other settings require?
- Private practice requires direct supervision
- All other settings require general supervision
Can services administered by a PTA be billed “incident to” a physician’s/NPP’s services and why?
No → They don’t meet the qualifications of a therapist
According to Medicare, what is billing for services provided by an aide?
Fraud → Its not skilled care
Why is bringing other recognized assistive personnel into exam & eval a good idea? Why is it a not so good idea?
Good
- Will bring a wider pt pop into clinics
- Promotes broader POC’s
- Billing ($$$)
- Save $ on salaries
Not-So-Good
- Takes away our role as PT’s
- Less need to hire PT’s
- If we can use AT’s and EP’s, so can physicians and then there goes our value
