----- Original Message -----
Sent: Saturday, July 12, 2003 7:16
AM
Subject: [OTlist] Three Questions
1st Can COTA/L do
recerts?
No, recertification (i.e, 701s
usually used) is a process involving 'assessment' of status/ goals and
establishing/ re-establishing them along with an updated plan of treatment.
The OTR is responsible for all these functions, as the physician recertifies
the need for continued skilled services. A COTA/L may assist with the process
such as, writing down demographics and gathering data, however, the regs
requires the OTR to infer, modify and re-establish need for
services.
2nd What requirements
are necessary for a restorative Aide? Either by the State or by Medicare?
A restorative aide is different from a Tech.
How?
as far as
the requirements?
A restorative aide usually
functions based upon a restorative 'nursing' plan of care that may have been
established with the assistance of a therapist; but again an RN should be
signing-off on the POC nad reviewing it 'periodically'. In states that count
the restorative programs for their case-mix index (CMI), e.g., OH & WV,
you must be aware that you must have at least 2 programs run 6 days a week, at
least 15 mins each program, each day. I have not come across a written
statement from Medicare or the State (my state OH), where, they mandate any
particular qualification for restorative aides. But prudently as supervised
under a nursing POC technically, they should be CNAs/ STNAs. Most facilities
prefer an CNA with 1 year experience.
Again to the best of my
knowledge, there are no mandated qualifications by the states or medicare for
techs. either. Hence, it's upto the discretion of the SNFs. They are different
in the sense that a restorative aide has the prime responsibility to
carry out the restorative programs, and at least technically for the states
that have restorative programs count towards CMI are supervised per a nursing
POC. Techs basically assist therapists to file, clean-up, set-up, provide
non-judgmental/ simple direct care under 'line-of-sight' supervision
of a licensed therapist in states that allow it, and ofcourse also
perform......other duties as assigned!
A restorative aide may
function as a rehab technician as well. Most facilities require both the
restorative and rehab aides to be CNAs. And, in states that do not count
restorative programs towards CMI, I do not see why a non CNAs/STNAs ( a rehab
tech not also certified as a CNA) can not perform a maintainence program as a
rehab aide that is periodically reviewed by a therapist or nurse.
Joe
