Brent, I believe the criticism originally came from Ron in regards to a therapist in a rehab hospital.? We?can all be?guilty of poor rehab at times no matter what practice setting.? I responded to warn people of potential fraud that therapists might be committing and not even realizing it.
Chris Nahrwold MS, OTR -----Original Message----- From: Brent Cheyne <[EMAIL PROTECTED]> To: Ron Carson <[email protected]> Sent: Tue, 2 Dec 2008 6:40 pm Subject: Re: [OTlist] Arrgh! SNF OTs on the hot seat! ??? Some further thoughts on OT?practice in the?SNF. However critical and disappointed some of us who don't work in SNF feel about the pracitices of those who do, keep in mind that each practice setting has its own unique challenges and limitations. ??? The PPS system has the RUG system where the highest reinbursment is for those patient who participate in as much as 360 minutes of OT a week.. That's? 6 days of 60 minute sessions, so if a person stays for a month they receive 24 hours (?1440 minutes) of OT in a month. And this process is multiplied got?each OT practitioner?by a caseload (lets say for average) 7 patients per day.?Each minute of each session is structured and guided by the therapist while navigating a complex system of all the other therapies, nursing care, and scheduling taking place?within the facility. ??? This means there is a lot of therapy? being provided and?therefore a lot of designing and implementing and documenting interventions. Making every? minute of every session wonderful, meaningful, enjoyable, and occupational is quite a challenge. I venture to predict that rehab professional in SNF spend more time with their clients than any other professionals in the whole healthcare system! Other posts on this list have also observed that the SNF rehab client is not always the most motivated of clients either and clients are often unable to identify meaningful occupations on which to base treatments. ???? Due to reasons explained previously in my other recent post, and the factors above, some patients might have incidences of "bad OT".? Given the shear abount of time spent in treatment, the odds of having some non-meaningful?or bad experiences are? pretty high. ???? I think any of us can identify unsatisfactory experiences with healthcare and other professionals on occasion. I personally have had?occasional frustration and disappointment?at the dentist, doctor, optometrist, or even with the waiter at a restaurant. I think on average there are a lot of hard working OTs in SNF doing a great job! Of course we always hear about the worst and best therapy experiences that people have. ? While all the criticism, judgement and discussion ongoing in the OT community may be necessary to encourage us to focus on occupation, there is no shortage of equal scrutiny by our administrations and regulators who have there own definition of what expected and required of OTs. Keeping everyone satisfied in no easy task and I think "bad OT "is more a function of being overwhelmed than being lazy. Let us find a way to support and encourage eachother! Brent C -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
