Hey Ron, No problem. Try speaking to the nursing home, not as an OT, but as a consultant regarding for instance behavioral managment strategies for dementia patients. What about laying your cards out on the table. Example: Ask the administator how much therapy utilization he is seeing regarding managment of dementia related behaviors. If the home is typical, he will report very minimal to none. Most nursing home therapies are populated by fresh grads with no idea how to manage dementia patients. Market yourself as a fresh and new way to address the problem. If they have an ironclad contract with the therapy provider, market yourself as utilization review, education, management. This will be harder in part A (homes with skilled nursing units) homes. These homes function under consolidated billing and must be the sole billing agent for all therapy related matters to Medicare. It may be that your area is overpopulated with OT providers willing to contract for OT services. When I was a clinical manager for a home helath agency, we used several providers that billed under company names. Try exploring why you might have a competitive edge over their current OT providers. Home health agencies are all about the bottom line. Research the regs and dazzle them with your understanding of the benefits of high therapy utilization and competent OT services. Ask questions - do they have a problem with overutilization of aide sevices, nursing visits or are their specific case mixes that cause them problems. The trend in home health is to go to a pay for outcomes basis. The majority of the outcomes being considered relate to the OASIS "functional questions." These questions are related to basic self care tasks. The other major one will be related to the inpatient admission question. Innovative ideas would be enabling diabetics to self test their glucose levels or teaching a CHF patient how to cook a healthy meal. Let them know you are aware and up to date on this information. If you are not, then research the topic and become an expert. Check with the Florida home health regs. Can an OT supervise a home care aide in Florida? If so, what could you do as a supervisor to reduce overutilization? On another topic, I noticed that someone on the list brought up the topic of vestibular rehab. If you are interested, I could give you the name of a guy that sells equipment for vestibular diagnositic testing. The codes for this type of testing pay really well and are not part of the Stark or Anti Kickback legislation. OTs can be a provider under general supervision (defined as reachable by telephone) of a physician. I had looked into this in reference to opening an IDF and rehab facility at one time. It never went through as the others involved just weren't ready to act on it. Jimmie
Ron Carson <[EMAIL PROTECTED]> wrote: Hello Jimmie: Every time I've approached a home health agency, they insist on contracting with me as an individual provider, not my company. In some ways, HH is a competitor so I don't blame them for not wanting to contract with my company. Every nursing home I've approached already has a complement of OT/PT/SLP services. I've yet to find one that is willing to hire an "outside" OT. I'm not trying to be overly negative about your ideas; I'm just sharing my experience/perceptions. Thanks, Ron ----- Original Message ----- From: Jim Arceneaux Sent: Wednesday, October 25, 2006 To: [email protected] Subj: [OTlist] Another Question JA> In regards to your question about ways to rejuvinate your JA> business: Have you tried contracting with home health agencies to JA> provide OT services for them? Key points to discuss witth them: JA> Have a thorough knowledge of the payment structure of home care. JA> Let them know how aware you are of the benefits a home health JA> agency receives from competent OT care. Specifically address how JA> OT services can help them to meet the obligations of M0825. This JA> is the OASIS question that asks if a patient will meet a high JA> therapy utilization or not. It is a major add on to the home care JA> agencies bottom line if therapy is indicated at a high utilization JA> rate. Let them know how you can help to reduce costs i.e. JA> decreasing home care aide visits by making patients more JA> independent or by reducing twice a day nursing visits for a JA> diabetic that can't self medicate. JA> Another idea might be to provide services to nursing homes JA> that are having difficulty with behavioral management issues on JA> their dementia units. That is an avenue that I am exploring right JA> now. It seems that most OTs working in nursing homes are not JA> strong at providing interventions for dementia patients. Nursing JA> homes, even ones contracted with contracted therapy agencies, in JA> my area are requesting training and services to assist them in JA> handling behavioral management issues. JA> Jimmie JA> Jimmie earlier posted a question from the website: JA> http://welcome.to/occupationaltherapy.com JA> Here's another interesting question and partial answer from the site: JA> ======================================== question>> When a patient is recovering from an injury, what does he question>> want to do? answer>>> He wants to go back to doing the activities and occupations answer>>> that made his life enjoyable. JA> ======================================== JA> Is this true? Not in my experience! What I've found is that when a JA> person is is actively recovering from their injury, that's IS what JA> they want to do. They want to recover! In other words, the person JA> wants their pain to decrease, or their body to work better -- that's JA> what they want to get better. JA> In my opinion, a person with an injury is primarily focusing on just JA> that, the injury (or illness). Not that people don't think about JA> getting back to their "activities and occupations", but in my JA> experience most people see lost "activities and occupations" as a JA> by-product of their injury or illness, not as the problem(s) to be JA> addressed. JA> I know that as a profession, we want to believe that people recovering JA> from injury want to get back to doing their "activities and JA> occupations" but I just don't think that is the way in which our JA> patients generally think. At least not in my experience. If it was the JA> way people think, our profession would be flourishing, both internally JA> and externally. JA> Ron JA> -- JA> Options? JA> www.otnow.com/mailman/options/otlist_otnow.com JA> Archive? JA> www.mail-archive.com/[email protected] JA> ************************************************************************************** JA> Enroll in Boston University's post-professional Master of JA> Science for OTs Online. Gain the skills and credentials to propel JA> your career. JA> www.otdegree.com/otn JA> ************************************************************************************** JA> --------------------------------- JA> Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US JA> (and 30+ countries) for 2ยข/min or less. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ************************************************************************************** --------------------------------- Cheap Talk? Check out Yahoo! Messenger's low PC-to-Phone call rates. --------------------------------- Cheap Talk? Check out Yahoo! Messenger's low PC-to-Phone call rates. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
