Suzanne
From: "Suzy Schlegel" <[EMAIL PROTECTED]> Reply-To: [EMAIL PROTECTED] To: <[EMAIL PROTECTED]> Subject: Re: [OTlist] Three Questions Date: Sat, 12 Jul 2003 12:19:45 -0500 (Central Daylight Time)
I have been approached by an RN in an SNF to provide sort of a general
overall strengthening and ROM exercises that the restorative therapists do
in that facility even though I do not supervise what they do or even work
with them. I have some serious reservations about doing this as I'm
concerned about liability if something should go wrong when they are doing a
tx that I have shown them. Typically, the PT on contract will get a
referral and have the restorative therapists perform the service. That may
be an upper or lower extremity exercise program, then he comes back
periodically to review how the patient is doing. This is primarily a psyc
facility and they have no full time OT or PT. I mainly work in a state
psychiatric facility and the SNF is located on the grounds and I go see
patients periodically for positioning or when there's a decrease in ADL's.
If tx is involved, I always do the tx. I don't rely on the restorative
therapists. I was told they need to receive "some training" from the PT and
the OT to continue doing their jobs. I'm not sure I feel comfortable
providing that training. Does anyone have opinions about what I should do?
Thanks, Suzy
-------Original Message-------
From: [EMAIL PROTECTED] Date: Saturday, July 12, 2003 12:04:05 PM To: [EMAIL PROTECTED] Subject: Re: [OTlist] Three Questions
----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] 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
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