Administration

Question 1

Plan of Operation

Answer 1

CTRSs should be concerned with the
1) agency’s plan of operation
2) TR department plan of operation

Question 2

Agency Plan of Operations

Answer 2

Should include TR services as a component of service.

Includes:

1) Patient management function: client assessments, treatment plans, progress notes, treatment plan and discharge summaries

2) Program management functions: quality improvement, utilization reviews and patient care monitoring

3) Risk Management Plan

Question 3

TR department plan of operation

Answer 3

Elements:

-Written philosophy, overall goals for the program, and describe the purpose and function of TR in the agency.

-Information related to patient management functions, client assessment protocols, treatment plans, interventions and discharge planning

-Program management functions: staff organization and development, quality improvement, utilization review, and patient care monitoring.

Requirement for RT department as per ATRA Standards of Practice

Question 4

Therapeutic Recreation Accountability Model (TRAM)

Answer 4

Model that highlights the various accountability and documentation procedures used by the therapeutic recreation specialist to monitor and make decisions about the delivery of services for producing client outcomes.

It ensures that all clients who receive services from the TR department will receive individual treatment plans with propriate program outcomes and client outcomes.

Question 5

Program evaluation and accountability

Answer 5

Program evaluation is used to determine program effectiveness and to improve services.

Quality of service is delivered, effectiveness of those programs, and the outcomes of those programs are evaluated.

The need to establish an administrative schedule for evaluation and determine the program revision process following data collection for the TR program is attached for the CTRS.

Question 6

Formative evaluation

Answer 6

Ongoing and occurs while the program is in progress, staff can make changes on a daily or weekly basis depending on what the evaluation data indicates.

Question 7

Summative evaluation

Answer 7

Conducted at the end of the program and can be used to compare programs or provide information for the next session of programming.

Question 8

Comprehensive Service Evaluation

Answer 8

Process that focuses on seeking out problematic areas of lower quality, correcting those problems, and evaluating how well those corrections are solving the problems.

Question 9

Utilization Review

Answer 9

Refers to looking at how effectively a department uses its resources.

It addresses overutilization, underutilization, and inefficiency.

Question 10

Quality Improvement and guidelines techniques

Answer 10

Utilization review
Risk management
Peer review
Outcome monitoring

Question 11

Peer Review

Answer 11

A process by which the procedures and results of an experiment are evaluated by other professional who are in the same field or who are conducting similar research.

Question 12

Outcome Monitoring

Answer 12

The continual measurement and reporting of indicators of the status of the social conditions a program is accountable for improving.

Question 13

Categories of Outcome Measures

Answer 13

The Joint Commission has identified 3 categories of outcome measures:

health status: functional well-being of an individual

patient perceptions of care: satisfaction measures of care from patient or family perspective

clinical performance outcomes: outcomes of process of care

Question 14

Quality Improvement

Answer 14

The most common method of evaluating TR services and is mandated by external accreditation agencies
a variety of activities that provide useful data on the quality of care for patients.

Question 15

Performance Appraisal

Answer 15

Sometimes termed employee evaluations, they are the formal evaluations to indicate how well staff members have performance compared with job standards.

Performance appraisals are conducted with the intent of informing staff members on how well they are meeting performance expectations.

May also reveal staff training and development needs.

Question 16

Clinical Supervision

Answer 16

A program provided by a master clinician to supervisees that serves the dual process, to improve clinical practice skills of supervisees and to ensure that the therapeutic intents of a program are being provided or met.

Three roles of a clinical supervisor:
teacher
counselor
consultant

Question 17

Intern Supervision

Answer 17

identify internship goals and objectives

establish policies and procedures

ensure the staff in the facility are prepared to accept interns

develop training materials

establish an intern manual

determine selection procedures
stablish a recruitment plan

Three major tasks an intern supervisor needs to provide: communication with and observation of the intern, documentation of intern activities and experiences, and provision of training and education opportunities.

Question 18

Volunteers

Answer 18

Department should:

Establish a volunteer plan with policies

Job description

Marketing plan with promotional materials for recruitment and retention.

It is important that program guidelines be established, and that while volunteers may be used for parts of the program, they may not be used for implementation of an intervention.

RTs is still responsible for the assessment, development of program goals, intervention, evaluation, and documentation.

Question 19

Intern and volunteer management key areas

Answer 19

Recruitment
Supervision
Coordination
Evaluation

Question 20

Orientation programs

Answer 20

They are necessary to introduce new employees to the agency and the RT unit.

Information typically included in orientation is the history of the organization, along with its vision, purpose, and structure.

Question 21

In-service training

Answer 21

Helps staff to keep current by updating their skills and knowledge to perform on the job.

Topics may be far ranging, but often involve new client care procedures, learning how to use new equipment, reviewing charting methods, or learning how to use an intervention technique.

Question 21

Medicaid

Answer 21

-Created by Social Security Amendments in 1965.
-Federal and state program but is administered by state that is designed for qualified needy individuals such as eligible low-income adults, children, pregnant women, elderly adults and people with disabilities.
Pays difference between cost of care and income for those with depleted finances.

Question 22

Prospective Payment System (PPS)

Answer 22

Established to contain healthcare costs, ensure quality, assure Medicare recipients access to care and it has a beneficiary centered focus.

It is price-based system prices are set in advance, the price is inclusive for all services provided, no additional payment or settlement will occur in the current year’s actual cost, and not impact the price established.

Government Funding
Managed Care
Private Contract
Medicare
Medicaid

Question 23

Medicare

Answer 23

A federal health insurance program created under the Social Security Amendments in 1965 that provides insurance for those 65+ or people with certain disabilities, and people with end-stage renal disease

4 parts:
Part A provides for: inpatient hospital stays and all listed beneficiaries automatically receive Part A.
Part B provides for: outpatient services ( mostly physicians’ costs) and requires that beneficiaries pay a monthly premium.
Part C provides: provisions for private health insurance. companies to provide benefits through managed care plans.
Part D: Signed into law in 2003, created to provide prescription drug benefits to Medicare beneficiaries and requires a monthly premium payment.

Question 24

Government Funding

Answer 24

Funding coming from the government, to help run facilities.

Question 25

Private Contract

Answer 25

Direct payments by individuals for health services an payments made by private insurance companies
Consists of three types of private financing:
Direct payments by individuals
Employer- based insurance
Direct- purchase insurance

Question 26

Managed Care

Answer 26

A system of healthcare in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company.

Question 27

The Patient Protection and Affordable Act of 2010 (ACA)

Answer 27

Healthcare reform, that addresses three of the key policy areas including access to care, quality in terms of health outcomes, and constant in cost containment.

Question 28

Funding for TR services

Answer 28

Tax base appropriations from the federal, state, or local government, grants and contracts, contributions and donations, fees, charges, and reimbursement, and a combination of any of the aforementioned sources.

Question 29

Ancillary Services

Answer 29

Prescribed by a physician to meet a consumer need.

Question 30

Routine Services

Answer 30

Provided as a part of basic services and are usually built into the overhead of operating costs.

Question 31

Budgets used in TR

Answer 31

Revenue and Expense (Operating Budget)
Capital expenditure budget
Program Budget
Zero-based Budgeting
Flexible Budget

Question 32

Revenue and Expense (Operating Budget)

Answer 32

delineates the day-to-day expenses and revenues for a year

Question 33

Capital expenditure budget

Answer 33

Shows how the money budgeted for capital expenditures is to be allocated among competing projects in the future.
Includes things such as new equipment, maintenance of current buildings, and cost saving improvement.
Typically ranging from 3-5 years

Question 34

Zero-based Budgeting

Answer 34

A budgeting approach in which managers begin with a budget of zero.

Question 35

Program Budget

Answer 35

focused on meeting goals and objectives or allocating resources based on costs and benefits of specific programs.
2 types of program budgets:
Cost to charge ratio
Activity Based Costing

Question 36

Flexible Budget

Answer 36

It is a budget that allows a manager to adjust a budget depending upon unexpected occurrences like a small number of patients or patients who are more severely injured and require different, perhaps more intense, interventions and previously budgeted.