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Healthcare Delivery- JD > Lec 9 - Supervision And Extenders Of Care > Flashcards

Lec 9 - Supervision And Extenders Of Care Flashcards

1
Q

PT Decision Making includes:

A

Refer
Consult
Co-manage
Retain –> Direct/Supervise

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2
Q

In the PT decision making process, if you direct/supervise, who does it go to?

A

Physical therapist assistants

Physical therapy aides/techs

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3
Q

Decision Making About Involvement of Other Provider: What is co-management?

A

The PT SHARES responsibility for the individual with another professional who is also managing that individual

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4
Q

Decision Making About Involvement of Other Provider: What is consultation?

A

In some cases the PT renders professional expert opinion or advice by applying highly specialized knowledge and skills to ID problems, recommend solutions, or produce a specified outcome or product in a given amt of time based on an individual

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5
Q

Decision Making About Involvement of Other Provider: Consultation- at other times, the PT seeks ___________ from another provider to inform the PT POC and/or to obtain services for the individual that are ___________________ of the PT.
In this case, the PT shares ______ for the individual with the consultant

A

Consultative services
Beyond the professional/personal scope of practice

Responsibility

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6
Q

Decision Making About Involvement of Other Provider: In referral, the PT may:

1) Refer an individual to _________ and _________, or not develop a ___________.
2) Refer an individual to _________ and _________ the POC at the same time
3) Receive an individual referred from another provider who chooses _________________
4) Receive an individual from another provider who __________ to treat the individual

A

1) another provider, conclude
2) another provider, continue
3) not to continue treating the individual
4) continues

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7
Q

Decision Making About Involvement of Other Provider: What is direction and supervision?

A

The PT remains ACCOUNTABLE for the services provided when the PT’s POC involves the use of other recognized assistive personnel

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8
Q

Decision Making About Involvement of Other Provider: PTs also coordinate, communicate, and document the services provided throughout the EOC to ensure ___________ of the individual.

A

Optimal management

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9
Q

PTs are responsible and accountable for ensuring that the provision of services is in accordance with ______

A

APTA

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10
Q

Working as a PT/PTA Team: The PT retains ________ for the patient throughout the _______

A

Responsibility

Episode of Care

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11
Q

How are some ways that the physical therapist retains responsibility for the pt through the EOC?

A

Professional and ethical documents
PTA education and scope of work
State PT practice act
Payer regulation related to PTAs

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12
Q

PTA Education and Scope of Work: Licensed health care providers that are graduates of intensive ___-year (__ semester) PTA education programs accredited by _______.

A

2 year
5 semester
CAPTE

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13
Q

Licensure/certification and successful completion of PTA _____ is required in all jurisdictions

A

NPTE

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14
Q

PTA means a natural person who is licensed pursuant to the provisions of this act and who assists a licensed ____ under his direct ______ in accordance with this act and regulations of the ______

A

PT
Supervision
Board

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15
Q

Direct supervision means what?

A

The presence of the supervising PT on SITE

Available to respond to any consequence occurring during any treatment procedure

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16
Q

You cannot supervise more PTAs than the Board feels can adequately be supervised… so this generally means ___ per therapist.
You can petition for an exception, but you must insure the _____ and _____ of the public

A

2

Health and Safety

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17
Q

PTA may only work under the direct supervision of a PT, T/F?

A

True

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18
Q

T/F: The PTA can initiate treatment ONLY at the direction and under direct supervision of the PT

A

TRUE

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19
Q

T/F: Documentation by the PTA must be reviewed and co-signed by the PT

A

TRUE

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20
Q

T/F: The PTA is not allowed to collect data for patient exam, and not allowed to interpret

A

False: can collect data, but may not interpret

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21
Q

T/F: PTA may not perform a PT examination, eval, Dx or Px, develop or modified POC, or independently engage in PT instruction including recommendations of ADs and modification of pt’s physical environment

A

TRUE

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22
Q

T/F: If the PTA thinks that the patient is unsafe during ambulation, they can suggest a rolling walker.

A

False - cannot recommend ADs

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23
Q

PTAs can only work under _________ of a licensed PT

A

DIRECT SUPERVISION

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24
Q

How many PTs to PTAs?

A

1 PT to 2 PTAs

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25
Q

Who retains the responsibility of patients when you have a PTA?

A

The supervising PT

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26
Q

If there is a change of supervising PT, who assumes resposibility?

A

The subsequent supervisor

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27
Q

In the unanticipated absence of the PT, the PTA may continue for how many business days for patients with established POC, who the PTA has previously participated in intervention with?

A

ONE

28
Q

Supervision has to be in the ____ building or ______ building constantly available via electronic communication for recall to area

A

SAME

CONTIGUOUS

29
Q

Who is ultimately responsible?

A

PT supervisor

30
Q

Who must consign PTA notes contemporaneously?

A

PT Supervisor

31
Q

When should a PT review of POC be done?

A

Before first visit
Before implement new or revised POC
With supervisor change

32
Q

At least every _____ days, documentation of review

A

30

33
Q

The PTA shall not render or continue to render care without obtaining ongoing direction from _______

A

PT supervisor

34
Q

The PTA must obtain signature of designated supervisor for ________ review

A

POC

35
Q

The PTA needs to review POC and document supervision at least every ____ days

A

30

36
Q

Delegation to unlicensed personnel includes: (2)

A

1) Routine tasks related to cleanliness, maintenance of equipment, physical plant and management of the business aspects of the practice
2) Pt transport, assist with dressing/undressing, positioning

37
Q

T/F: An unlicensed person is not allow to advise, teach, or instruct patients about their condition

A

TRUE

38
Q

T/F: An unlicensed person can carry out testing or evaluation procedures

A

FALSE

39
Q

T/F: An unlicensed person can make notations in the patient’s record in relation to clinical treatment

A

FALSE

40
Q

T/F: An unlicensed person can place electrodes of any kind on the skin

A

FALSE

41
Q

T/F: An unlicensed person is not allowed to administer any modalities!

A

TRUE

42
Q

T/F: An unlicensed person cannot instruct and or perform therapeutic exercise

A

TRUE

43
Q

T/F: An unlicensed person cannot perform therapeutic activities

A

TRUE

44
Q

T/F: An unlicensed person cannot provide therapeutic massage

A

TRUE

45
Q

PTs are the only professional who provide ______ interventions

A

PT

46
Q

PTAs are the only individuals who provide ______ PT interventions under the direction and at least ______ supervision of the PT

A

Selected

General

47
Q

Interventions that require immediate and continuous examination and evaluation throughout the intervention are performed exclusively by the ____

A

PT

48
Q

Examples of interventions that require immediate and continuous examination only performed by a PT include:

A

Spinal and peripheral joint mobs/manips, which are components of manual therapy

And sharp selective debridement, which is a component of wound management

49
Q

PT eligible to enroll a ______ for a payer/insurer

A

provider

50
Q

PTA services are billed by who?

A

The supervising PT

51
Q

Regardless of payer, the PT maintains control of the patient’s care; provides the appropriate level of _____ and _______ for the PTA, and can bill for services provided for the _______ team

A

Direction and supervision

PT-PTA

52
Q

PT services provided by PTAs are reimbursed under who’s ID number?

A

The PT’s

53
Q

Are PTs and PTAs generally paid at the same rate for services?

A

Yes

54
Q

Medicare: PTAs are ________ providers when furnishing services under the direction and supervision of a qualified PT, who is working with the _____ scope of practice in the state in which the services are furnished

A

Qualified

State

55
Q

Medicare, other payers and plans – may have more specific policies on payment for services provided by a _____, and _____ requirements

A

PTA

Supervision

56
Q

Medicare and PTAs: The services of PTAs used when providing covered therapy benefits are included as part of the __________.

There services are billed by the ____________

PTAs may not provide ______ services, make ___________, or take ______ for the service.

They act at the ______ and under the _______ of the treating PT and in accordance with state laws

A

Covered service

Supervising PT

Evaluation
Clinical judgments
Responsibility

Direction
Supervision

57
Q

A PT must supervise ____

A

PTAs

58
Q

Who are qualified professionals?

A 
PT
OT
SLP
MD
NP CNS
PA
Licensed/certified by state to perform therapy services

(May include PTA and COTA under supervision of qualified therapist as allowed by state law)

59
Q

Medicare and PTAs: General supervision is required for PTAs in all settings except _______ (which requires ______ supervision) unless state practice requirements are more stringent, in which case state or local requirements must be following

A

Private practice

Direct

60
Q

Medicare and PTAs: The services of a PTA shall not be billed as services incident to a physician/NPP’s service, because they do not meet the _______ of a therapist

A

Qualifications

61
Q

Medicare and PT aides: Services provided by aides, even if under the supervision of a therapist, are ___________ and are ____________

A

NOT THERAPY SERVICES

NOT COVERED BY MEDICARE

62
Q

Although an aide may help the therapist by providing unskilled services, those services that are unskilled are not covered by Medicare and shall be _____ as not reasonable and necessary if they are billed

A

DENIED

63
Q

How many models in the continuum of direction and supervision models in PT service delivery?

A

4

64
Q

What is model 1?

A 
Examination
Eval
Dx
Px
Intervention [PTA, Aide/Tech]
65
Q

What is Model 2?

A 
Exam
Eval
Dx
Px
Intervention [PTA and other recognized assistive personnel, aide/tech]
66
Q

What is model 3?

A

Exam [PTA and other recognized assistive personnel]
Eval
Dx
Px
Intervention [PTA and other recognized assistive personnel, aide/tech]

67
Q

What is model 4?

A

Exam [PTA and other recognized assistive personnel]
Eval [PTA and other recognized assistive personnel]
Dx
Px
Interventions (PTA and other recognized assistive personnel, aide/tech]

Healthcare Delivery- JD (12 decks)

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