Long-Term Care Survey Alert

Published on Sun Nov 18, 2007 PDF

Get your therapists on this bandwagon for quality improvement.

Maximizing the use of rehabilitation therapy can improve residents' outcomes and your quality indicators/measures, not to mention customer satisfaction.

Three simple strategies will boost your therapy program's productivity to new levels.

1. Take advantage of group therapy under Medicare Part A. Physical therapist and consultant Katy O'Connor finds that some facilities don't use much group therapy. Yet "it's a good modality in the sense that it provides a different experience for residents who may benefit from social support, socialization, healthy competition, etc.," says O'Connor, with Zimmet Healthcare Services Group in Morganville, NJ. And it can boost efficiency in providing therapy.

Expand your service capability: Group therapy is a good option for facilities to offer on weekends for shorter-stay residents who want a more aggressive therapy schedule seven days a week.

Remember: Under Medicare Part A, therapy minutes can't exceed 25 percent of the total therapy time recorded on the MDS per discipline.

2. Ask this key question to get rehab on the case where needed. And that is which of a patient's diagnoses is causing him to be in a wheelchair 24/7, says O'Connor.

"Often the resident's medical diagnoses don't match their physical capabilities," says O'Connor. The therapist's job is to "figure out how to get that person more functional."

Nurses can also take note of residents spending a lot of time in a wheelchair as a first step toward getting rehab or restorative nursing on the case. Clare Hendrick, ARNP, a nurse practitioner and consultant in San Clemente, CA, used to work with a director of nursing who during rounds would always ask: "Why the wheelchair?"

3. Develop modalities to provide therapy in a patient's room or use transport time to discuss therapy-related issues. Doing so represents "good clinical practice and effective use of both the therapist's and patient's time," observes Shehla Rooney, PT, principal of Premier Therapy Solutions in Cookeville, TN. The therapist or therapist assistant can use transport time to accomplish the following, suggests Rooney:

• Explain the treatment plan for the day

• Ask how the patient responded to the treatment the day before

• Assess for new complaints or concerns

• Discuss the patient's progress.

"Oftentimes, therapists will perform wheelchair management training or gait training versus just transporting the patient," Rooney adds.