Test 1 Flashcards
Define PT?
PTs are the experts in the science of healing and the art of caring.
What are the 3 Pillars of PT?
- Neurology
- Orthopedics
- Cardiopulmonary
What do PTs do?
- Diagnose and manage movement
- Restore, maintain and promote optimal physical function, wellness and quality of life
- Prevent the onset, symptoms and progression of impairments, functional limitations and disabilities
What is “scope of practice” ?
Definition: PT is the care and services provided by or under the direction and supervision of a PT.
- Exam individuals with impairments, functional limitations and disabilities.
- Alleviate impairments and functional limitations
- Prevent injuries, impairments, functional limitations and disability
- Engage in consultation, education and research
What was the first class of physical therapy graduates called? What methods did they use?
Reconstruction Aides
Used Zander’s exercise machines and Ling’s Swedish movements to rehabilitate disabled soldiers from WWI
What year was the earliest documented origins of actual PT?
1894- Chartered Society of Physiotherapy
What happened in the 1940’s and 50’s?
The advent of WWII and polio epidemic created an increased demand for PTs
In the late 50’s PT moved beyond hospitals into outpatient clinics, public schools, geriatrics and rehab centers.
When and who formed the first PT professional association?
Mary McMillan in 1921
What does APTA, FSBPT & CAPTE stand for?
American Physical Therapy Association
What 3 bodies oversee PTs and PTAs?
APTA: professional association
FSBPT: licensure
CAPTE: education
What are the benefits of joining the APTA?
- Advocacy
- Consumer Awareness
- Education and info on changes in the practice
- Research journals
- Strengthen knowledge and skills
- CEU courses
- Gain recognition and advance your career
What was the 2020 Vision?
“By 2020 PT will be provided by PTs who are doctors of PT. They will be recognized by consumers and health care professionals as the practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function and health.”
What is the role of a PT?
Establish treatment diagnosis, prognosis, goals, frequency and duration of care and plan of care.
They must graduate from an accredited program and pass the national license exam
What is the role of a PTA?
To provide physical therapy services under the direction and supervision of a physical therapist.
Help people of all ages who have medical problems that limit their ability to move and perform daily functional activities
Teaching exercise for mobility, strength, and coordination
Training for activities like walking with crutches, canes and walkers.
Must complete 2 year associates degree ams pass national board exam
What are the Professional Behaviors?
- Commitment to learning
- Interpersonal skills
- Communication skills
- Effective use of time
- Use of constructive feedback
- Problem solving
- Professionalism
- Responsibility
- Critical thinking
- Stress Management
Define Ethics
Branch of philosophy concerned with rightness or wrongness of human behavior and the goodness or badness of its effects.
To do no harm
Beneficence
What are the 5 Ethical Principles applicable to healthcare providers?
- Respect for human life and dignity
- Beneficence: do no harm
- Autonomy: ability to provide service w/o someone telling you what to do
- Honesty
- Justice: treat everyone the same
What does the JCAHO recommend everyone do?
All adults discuss their wishes regarding treatment measures if something bad were to happen to them and they were not able to make a decision on their own.
What are the 7 Core Values?
Abbey Anderson Cooks Excellent Pies In School
- Accountability
- Altruism
- Compassion/caring
- Excellence
- Professional Duty
- Integrity
- Social Responsibility
Define Accountability
Is the active acceptance of the responsibility for diverse roles, obligations and actions of PTs.
Define Altruism
Is the primary regard to a patients interest. Putting the need of your patient ahead of your own.
Define Compassion/Caring
Compassion is the desire to identify with another’s experience.
Caring is the concern, empathy and consideration for the needs and values of others
Define Excellence
Is PT practice that consistently uses current knowledge and theory while understanding the personal limits of your patient.
Define Professional Duty
Is the commitment to meeting ones obligations to provide effective PT to your patients, to serve the profession, and positively influence the health of society.
Define Integrity
Steadfast adherence to high ethical principles or professional standards; truthfulness, fairness and doing what you say you will do.
Define Social Responsibility
The promotion of a mutual trust btw the profession and the larger public.
Constitutional Law
Establish Executive, Legislative, and Judicial branches of government.
Statutory law
Protects and provides for general welfare of society
Administrative law
Carries out specific duties of various agencies
Common case law
Avoids duplication and unnecessary expense of litigating issues many times.
How does Medicaid work under the Social Security Amendment of 1965?
It’s a joint federal and state program and you must be authorized by an agency of the state government in order to provide PT services.
How does Medicare work under the social security amendment of 1965?
Federal healthcare plan for people 65 of age and over, those who are disabled or have kidney failure must be authorized by an agency of FEDERAL government in order to provide PT services.
What does Medicare Part A pay for?
Hospital insurance (in patient)
What does Medicare Part B pay for?
Medical insurance (out patient)
What were the provisions included in The American Disability Act of 1995 that affect PTs and PTAs?
- Access to public buildings
- Equal protection of disabled persons
- Nondiscrimination in employment
What is the Health Insurance Portability and Accountability Act of 1996?
Limits the extent to which health insurance plans may exclude care for pre-existing conditions.
Sets standards regarding the electronic exchange of private and sensitive health information.
What are HIPPAs Privacy Standards?
- requires client consent to use or disclose protected health info
- grants clients the right to inspect and copy their medical records
- give clients the right to correct errors
- requires all healthcare agencies to have policies in place to ensure compliance with such rules
What are the 3 primary goals of the Patients Bill of Rights?
- strengthen consumer confidence
- reaffirm importance of strong patient health care provider relationship
- reaffirm critical role consumers play in safeguarding own health
What are the 7 sets of rights and 1 set of responsibilities under the Patient Bill of Rights?
- The right to information
- The right to choose
- Access to Emergency Services
- Being full partner in health care decisions
- Care without discrimination
- The right to privacy
- The right to speedy complaint resolution
-Taking on new responsibilities
What does RIPS stand for?
Realm-Individual Process-Situation
What are the 3 Realms in the RIPS model?
- Individual: concerned with the good of patient/client. Least complex problems.
- Institutional/Organizational: concerned with the good of the organization.
- Societal: concerned with the common good. Most complex.
What is Step 1 in Ethical Decision Making?
Recognize and define the ethical issue
-RIPS
What is Step 2 in Ethical Decision Making?
Reflect
- what info is needed
- what are the consequences
- have any laws been broken
- what ethical principles have been broken
What is Step 3 in Ethical Decision Making?
Decide the right thing to do
What action needs to be taken
What is Step 4 in Ethical Decision Making?
Implement, evaluate, and assess needed changes to prevent recurrence
What is Palliative Care?
Making the patient as comfortable as possible during their last moments of life.
Ex. Someone dying of Stage 4 cancer
Define Health Care Financing
The flow of dollars from individual enrollees, employers or government TO a health care plan
Define Reimbursement
The flow of dollars from a health care plan TO a provider
Reimbursed: Fee for Service
Each fee directly associated with a service
Reimbursed: Per Visit
Specific amount reimbursed each time a patient is treated
Reimbursed: Per Case or Per Episode
Providers given one payment for each episode or hospital admission
Reimbursed: Capitation
One payment for each health plan member is paid each month or year.
What are the 4 basic types of Health Care Financing?
- Out of pocket payments
- Individual private insurance
- Employment based private insurance
- Government financing
Out of Pocket Payments
Based on Fee for Service
Increased health care costs make this an unrealistic means of financing
Individual Private Insurance
Purchased by individuals who pay monthly premiums in exchange for a defined set of medical services
Employment based Private Insurance
Employers pay all or part of premium that purchases health care insurance for employees
What is the difference btw Experiencing Rating and Community Rating of Employment based insurance?
Experience Rating: places prospective subscribers into various groups based on anticipated use of health care
Community Rating: bases health care on human need instead of anticipated use
Government Financing
Medicare and Medicaid programs that are government subsidized health care plans.
How can someone qualify for Medicare?
- Must be a citizen of US who has worked and contributed to Social Security for at least 10 years.
- Must be 65 or older, have end stage renal disease
- eligible for benefits if spouse has met employment requirements
Medicare Part A pays for what, reimbursed by who, financed through what?
Pays for: inpatient hospital stay, skilled nursing, hospice, and home health services
Reimbursed by: Prospective Payment System
Financed by: largely by Social Security taxes from employers and employees
Medicare Part B pays for what, reimbursed by who, financed through what?
Pays for: out patient/ physician services, PT, lab work, eye, medical equipment, prosthetics
Reimbursed by: based on CPT charges
Financed by: federal taxes and monthly premiums
What Medicare plan is “participatory” and not all inclusive? What is the cap?
Medicare Part B
$1840 cap as of Jan. 1, 2009
Medicare Part C
Known as Medicare Advantage
Plans include HMOs, POSs, PPOs and PSOs
Must reside in plans service area to participate
Medicare Part D pays for what, what is the deductible?
Pays for outpatient prescription drugs
Plan starts out with a $250 deductible and will pay:
- 75% of next $2000 spent
- nothing for the next $2800 spent
- 95% for drug bills over $5100
What is Medicaid?
Stare administered program that provides medical assistance to the unemployed, elderly, disabled and poverty
How is Medicaid eligibility, financed through?
Based on income
Financed through state and federal taxes
What are the types of Hospital Reimbursement?
- payment for procedure: similar to FFS (not cost effective)
- payment per diem: incentive to reduced days in hospital
- payment per episode of hospitalization: $per diagnosis
- payment per patient: common with HMOs
- payment per institution: used in VA hospitals
How are Skilled Nursing homes reimbursed?
Case mix-adjusted PPS for all SNF services
RUGS: based on total number of minutes of PT per week, days of PT per week, number and types of therapy
How are PTs reimbursed?
It depends on payer, types of services provided, and site and level of care at which services were provided
What are the types of Health Care Facilities? And how are they reimbursed?
- Hospitals: Acute & Sub-acute -Medicare A (SS)
- Skilled Nursing Facilities- Medicare A (SS)
- Home Health Care- Medicare A (SS)
- Outpatient Facilities- Medicare B (federal taxes)
What is Acute Care?
Provides care to the more critically ill patients
Avg stay at hospital is 5 days
What is Sub-Acute care?
Inpatient care that does not depend heavily on high tech monitoring or diagnostic procedures
What is an example of a sub-acute care facility?
Skilled nursing facility or a transitional care center
3 common types of managed care?
- FFS: 3rd party involvement
- PPO: specific group agree to provide care at negotiated FFS rate
- HMO: combines insurers and providers into 1 entity; prepaid group practice
