DPT 5010 Test 2: "Other"

Question 1

Primary Sources of Law

Answer 1

I. Federal and State Constitutions
II. Legislatively Created Statutory Laws
III. Common (court case) Laws
IV. Administrative Law
      (MN Board of PT, Dept. of Health)

Government operated

Question 2

Secondary Sources of Law

Answer 2

I. Professional Association
(APTA)
II. Accreditation standards and guidelines
(JCAHO, CARF, NCQA)
III. Facility/Corporate Policies and Procedures

even if we are not an APTA member, they are Secondary Law, so their rules apply

Question 3

Civil Action vs. Criminal Action

Answer 3

Civil: violate duty owed to an individual and/or his property

Criminal: violated duty owed to society as a whole

Question 4

Doctrines of Law Common in PT

Answer 4

1. Informed Consent
2. False Imprisonement
3. Abandonment
4. Assault and Battery
5. Mandated Reporter Rquirements
6. Delegation of Duties (PTA; PT Aide)

Question 5

Informed Consent

Answer 5

ethical and legal duty of every health care clinician to obtain patient (or surrogate) informed consent.

1. Patient Autonomy
2. Patient self-determination

Question 6

Required Elements of Informed Consent

Answer 6

1. explain diagnosis and pertinent findings
2. nature of treatment intervention
3. material risks of serious harm or complications
4. expected benefits of treatment
5. reasonable alternatives to proposed treatment

Must have informed consent 2x’s:
Exam & Treatment

Question 7

False Imprisonment

Answer 7

Intentional
To unlawfully restrict a patient’s free movement.

• must have specific intent
• patient must be conscious of fact that he/she is being confined or threatened w/ force if he/she moves

Question 8

Abandonment

Answer 8

Improper, unilateral termination of a patient by a treating physical therapist.
Where there is a professional-patient relationship

This termination must have caused injury to patient.
These injuries must warrant award of monetary damages in order to “make patient whole”

Question 9

Assault and Battery

Answer 9

unjustified & unexcused
harmful, offensive or otherwise impermissible
intentional conduct by a tortfeasor
with another person
-can be direct or indirect acts of touching that offends patient
- impenidng contact –> make pt anticipate
must have informed consent to avoid this
self defense okay, but must be reasonable

Question 10

Mandated Reporter

Answer 10

Must report:

Maltreatment
- abuse (physical or emotional)

Neglect

Exploitation

• Physical
• Emotional
• Financial

Question 11

Template for Documenting a PT Plan of Care in Patient/Cline Management

Answer 11

Goals & anticipated outcomes

Proposed intervention

Anticipated frequency/duration for episode of care

Anticipated discharge plan

Question 12

Goal

Answer 12

must include 6 components
made in collaboration w/ pt
must support medical necessity for PT services
must support need for skilled intervention

Question 13

Proposed Intervention

Answer 13

should provide clear common. for coordination of care w/ staff

include:

• progression parameters
• precautions
• sequencing of interventions
• skilled monitoring required (vital signs, pulse ox, pain waiting, rate of perceived exertion, etc.

Question 14

Anticipated Discharge Plan

“Transition Plan”

Answer 14

may be reflected in veal statement, goals, or written separate

Question 15

American Heath Care Systems: What determines how we practice?

Answer 15

1. Legislation
  (Health care bills, State Practice Acts)
2. Reimbursement
  (Medicare/Medical Assistance, Private Ins. Payers,
   Managed care payers)
3. Regulatory Agencies
4. Accrediting bodies
5. Professional Organizations
6. Consumers

Question 16

American Heath Care Systems: Financing vs. Delivery

Answer 16

Financing- payment for services including premium & payment

Delivery- provision of services

Question 17

American Heath Care Systems: Models of Health Care Financing in U.S.

Answer 17

1. Out of pocket payment
2. Individual private insurance
3. Employment based group insurance
4. Government Insurance- Medicare, MA, VA

Question 18

History of U.S. Health Care

Answer 18

1900-1940’s: Pts paid directly, provider decided cost

1940’s: Companies offer HC coverage for employees

1950’s: Advances in HC

1960’s: HC financed by private ins. companies and gov’t

1970’s: fee for service/ retrospective system

1980’s: Cost increase

1990’s Managed care expands to falter

2000’s: Increased freedom of choice for consumers and increased cost.

2010: Patient Protection & Affordable Care Act

Question 19

Impacts of HC change on PT

Answer 19

dx related groups in hospitals (DRGs)
common procedural terminology (CPT)
managed care
Balanced Budget Act of 1997
Therapy Cap
Prospective Payment System (PPS) -skilled nursing facilities
direct access

Question 20

DRG’s

Answer 20

Diagnostically Related Groups

-provide guidelines to determine hospital reimbursement

Question 21

CPT

Answer 21

Common procedural Terminology

-CPT codes for reimbursement –> payment determined by resource value

Question 22

Managed Care

Answer 22

Health care payer and delivery system

Limit financial risk by purchasing healthcare services @ fixed rates.

*missing focus on quality

Question 23

Balanced Budget Act of 1997

Answer 23

Reduction in Medicare and Medicaid spending a

Address fraud and abuse in Health Care spending

Question 24

Direct Access to PT

Answer 24

Degree of direct access determined by state

MN APTA advocates for direct access

Question 25

Vision 2020 for DPT education

Answer 25

1. Autonomous Practice
2. Direct, unrestricted access
3. Ability to refer to other HC providers
4. Diagnostic Tests
5. Transition from MPT–>DPT