Administration

Question 1

Service plan of operation

Answer 1

-referred to as “policy and procedure manual”
-CTRS should be concerned with 1. agency’s plan of operation 2. TR department’s plan of operation
-Agency’s plan should include TR services as component of service as accreditation surveyors will review this
-Plan should also include patient management functions (assessment, treatment plans, progress notes, treatment plan reviews, discharge summaries) and program management functions (quality improvement process, utilizations reviews, and patient care monitoring), with TR included as appropriate

Question 2

Written plan of operation

Answer 2

-every TR department must have this and all staff should be familiar
-should have written philosophy that reflects philosophy of agency, have overall goals for the program, and describe the purpose and function of TR within the agency
-should also include nature and diversity of activities to be utilized with clients and include information related to both patient and program management functions

Question 3

TRAM

Answer 3

-Therapeutic Recreation Accountability Model suggests that thorough program design is important for creating accountable programs that can potentially provide client outcomes

Question 4

Recruitment of staff, volunteers, and student interns

Answer 4

-CTRS needs to know legal requirements for interviewing and hiring staff
-necessary to recruit and hire staff with necessary qualification or credentials
-provide necessary orientation and training
-develop health workplace environment
-must write clear job descriptions that include responsibilities of job, general requirements, major duties and responsibilities

Question 5

Staff

Answer 5

-main objective=have enough staff to meet needs of clients
-include staff in developing schedules in order for them to feel some commitment to the plan

Question 6

Clinical supervision

Answer 6

2 purposes:
1. to improve clinical practice skills
2. ensure that the therapeutic intents of a program are being provided or met
3 roles of supervisor:
1. teacher
2. counselor
3. consultant
-work together to establish goals that supervisee wishes to attain
-content and timeframe of program is created based on goals
-evaluation is final step
-performance evaluation to help someone improve clinical skills not by HR

Question 7

Volunteers

Answer 7

-once determines needs volunteers, must create a volunteer plan including policies, job descriptions, and marketing plan with promotional materials for recruitment and retention
-may not be used for implementation of an intervention

Question 8

Intern supervision

Answer 8

-entry level CTRS cannot supervise intern until after 1 year
-in preparation, should prepare with internship goals and objectives, establish policies and procedures, ensure staff and facility are prepared to take interns, develop training materials, establish intern manual, determine selection process, and establish recruitment plan
3 major tasks for intern supervisor:
1. communication with and observation of intern
2. documentation of intern activities and experiences
3. provision of training and education opportunities

Question 9

Payment systems

Answer 9

-managed care systems are now predominant compared to previous retrospective
-Managed care systems have shifted so now payers of care determine services for clients
-CTRSs are often challenged by insurance companies regarding the need for their services

Question 10

Prospective Payment systems (PPS)

Answer 10

-established to contain health care costs, ensure quality, assure Medicare recipients access to care, and has a beneficiary-centered focus
Elements:
1. price-based system
2. prices set in advance
3. price is inclusive of all services provided
4. no additional payment or settlement will occur
5. current year’s actual costs do not impact the price established

Question 11

Medicare

Answer 11

-federal health insurance program that provides care for people 65 and over, people with certain disabilities, and people with end-stage renal disease
2 parts:
Part A: hospital care, skills nursing care, home health care, and hospice
Part B: supplemental medical insurance such as physician services, outpatient services, emergency department visits, and medical equipment

Question 12

Medicaid

Answer 12

-combined program of state and federal insurance for qualified needy individuals
-when finances have been depleted by medical care, Medicaid will pay the difference between income and cost of care

Question 13

Patient Protection and Affordable Care Act (ACA)

Answer 13

3 policy areas:
1. access to care
2. quality in terms of health outcomes
3. cost containment

Question 14

Area and facility management

Answer 14

-important to know how areas and facilities are going to be used
-CTRS should have good understanding of accessibility standards and requirements for specific recreation areas, such as trails, playgrounds, pools
-ordering and maintaining equipment and supplies

Question 15

Funding sources

Answer 15

-tax-based from federal, state, or local government
-grants and contracts
-contributions and donations
-fees, charges, and reimbursement
-community program revenue are mostly tax-based appropriations and fees for services
-health care revenue consumers are charged directly for services and may be paid by insurance companies of third-party payers

Question 16

Ancillary services

Answer 16

-prescribed by physician to meet consumer need

Question 17

Routine services

Answer 17

-those provided as part of basic services and built into overhead or operating costs

Question 18

Budgets

Answer 18

1. Revenue and expense/operating: delineates day-to-day expenses and revenues for a year
2. Capital expenditure: related to long-range planning and usually spans a 3-5 year period
3. Program: focused on meeting goals and objectives or allocating resources based on costs and benefits of specific programs
4. Zero-based: requires that a manager is re-evaluating the programs within their department annually; every program must be re-justified and program may not be funded again if it was previous year; manager is forced to set priorities and justify resources annually
5. Flexible: allows manager to adjust a budget dependent upon unexpected occurrences like a smaller number of clients or ones who require more intense or costly interventions than previously budgeted

Question 19

Prospective payment system (PPS)

Answer 19

1. price based system
2. Prices are set in advance
3. price is inclusive of all services provided
4. no additional payment or settlement will occur
5. the current year’s actual costs do not impact the price established

Question 20

Strategic plan

Answer 20

projecting future needs and activities of an organization