Lec 9 - Supervision And Extenders Of Care

Question 1

PT Decision Making includes:

Answer 1

Refer
Consult
Co-manage
Retain –> Direct/Supervise

Question 2

In the PT decision making process, if you direct/supervise, who does it go to?

Answer 2

Physical therapist assistants

Physical therapy aides/techs

Question 3

Decision Making About Involvement of Other Provider: What is co-management?

Answer 3

The PT SHARES responsibility for the individual with another professional who is also managing that individual

Question 4

Decision Making About Involvement of Other Provider: What is consultation?

Answer 4

In some cases the PT renders professional expert opinion or advice by applying highly specialized knowledge and skills to ID problems, recommend solutions, or produce a specified outcome or product in a given amt of time based on an individual

Question 5

Decision Making About Involvement of Other Provider: Consultation- at other times, the PT seeks ___________ from another provider to inform the PT POC and/or to obtain services for the individual that are ___________________ of the PT.
In this case, the PT shares ______ for the individual with the consultant

Answer 5

Consultative services
Beyond the professional/personal scope of practice

Responsibility

Question 6

Decision Making About Involvement of Other Provider: In referral, the PT may:

1) Refer an individual to _________ and _________, or not develop a ___________.
2) Refer an individual to _________ and _________ the POC at the same time
3) Receive an individual referred from another provider who chooses _________________
4) Receive an individual from another provider who __________ to treat the individual

Answer 6

1) another provider, conclude
2) another provider, continue
3) not to continue treating the individual
4) continues

Question 7

Decision Making About Involvement of Other Provider: What is direction and supervision?

Answer 7

The PT remains ACCOUNTABLE for the services provided when the PT’s POC involves the use of other recognized assistive personnel

Question 8

Decision Making About Involvement of Other Provider: PTs also coordinate, communicate, and document the services provided throughout the EOC to ensure ___________ of the individual.

Answer 8

Optimal management

Question 9

PTs are responsible and accountable for ensuring that the provision of services is in accordance with ______

Answer 9

APTA

Question 10

Working as a PT/PTA Team: The PT retains ________ for the patient throughout the _______

Answer 10

Responsibility

Episode of Care

Question 11

How are some ways that the physical therapist retains responsibility for the pt through the EOC?

Answer 11

Professional and ethical documents
PTA education and scope of work
State PT practice act
Payer regulation related to PTAs

Question 12

PTA Education and Scope of Work: Licensed health care providers that are graduates of intensive ___-year (__ semester) PTA education programs accredited by _______.

Answer 12

2 year
5 semester
CAPTE

Question 13

Licensure/certification and successful completion of PTA _____ is required in all jurisdictions

Answer 13

NPTE

Question 14

PTA means a natural person who is licensed pursuant to the provisions of this act and who assists a licensed ____ under his direct ______ in accordance with this act and regulations of the ______

Answer 14

PT
Supervision
Board

Question 15

Direct supervision means what?

Answer 15

The presence of the supervising PT on SITE

Available to respond to any consequence occurring during any treatment procedure

Question 16

You cannot supervise more PTAs than the Board feels can adequately be supervised… so this generally means ___ per therapist.
You can petition for an exception, but you must insure the _____ and _____ of the public

Answer 16

2

Health and Safety

Question 17

PTA may only work under the direct supervision of a PT, T/F?

Answer 17

True

Question 18

T/F: The PTA can initiate treatment ONLY at the direction and under direct supervision of the PT

Answer 18

TRUE

Question 19

T/F: Documentation by the PTA must be reviewed and co-signed by the PT

Answer 19

TRUE

Question 20

T/F: The PTA is not allowed to collect data for patient exam, and not allowed to interpret

Answer 20

False: can collect data, but may not interpret

Question 21

T/F: PTA may not perform a PT examination, eval, Dx or Px, develop or modified POC, or independently engage in PT instruction including recommendations of ADs and modification of pt’s physical environment

Answer 21

TRUE

Question 22

T/F: If the PTA thinks that the patient is unsafe during ambulation, they can suggest a rolling walker.

Answer 22

False - cannot recommend ADs

Question 23

PTAs can only work under _________ of a licensed PT

Answer 23

DIRECT SUPERVISION

Question 24

How many PTs to PTAs?

Answer 24

1 PT to 2 PTAs

Question 25

Who retains the responsibility of patients when you have a PTA?

Answer 25

The supervising PT

Question 26

If there is a change of supervising PT, who assumes resposibility?

Answer 26

The subsequent supervisor

Question 27

In the unanticipated absence of the PT, the PTA may continue for how many business days for patients with established POC, who the PTA has previously participated in intervention with?

Answer 27

ONE

Question 28

Supervision has to be in the ____ building or ______ building constantly available via electronic communication for recall to area

Answer 28

SAME | CONTIGUOUS

Question 29

Who is ultimately responsible?

Answer 29

PT supervisor

Question 30

Who must consign PTA notes contemporaneously?

Answer 30

PT Supervisor

Question 31

When should a PT review of POC be done?

Answer 31

Before first visit Before implement new or revised POC With supervisor change

Question 32

At least every _____ days, documentation of review

Answer 32

30

Question 33

The PTA shall not render or continue to render care without obtaining ongoing direction from _______

Answer 33

PT supervisor

Question 34

The PTA must obtain signature of designated supervisor for ________ review

Answer 34

POC

Question 35

The PTA needs to review POC and document supervision at least every ____ days

Answer 35

30

Question 36

Delegation to unlicensed personnel includes: (2)

Answer 36

1) Routine tasks related to cleanliness, maintenance of equipment, physical plant and management of the business aspects of the practice 2) Pt transport, assist with dressing/undressing, positioning

Question 37

T/F: An unlicensed person is not allow to advise, teach, or instruct patients about their condition

Answer 37

TRUE

Question 38

T/F: An unlicensed person can carry out testing or evaluation procedures

Answer 38

FALSE

Question 39

T/F: An unlicensed person can make notations in the patient's record in relation to clinical treatment

Answer 39

FALSE

Question 40

T/F: An unlicensed person can place electrodes of any kind on the skin

Answer 40

FALSE

Question 41

T/F: An unlicensed person is not allowed to administer any modalities!

Answer 41

TRUE

Question 42

T/F: An unlicensed person cannot instruct and or perform therapeutic exercise

Answer 42

TRUE

Question 43

T/F: An unlicensed person cannot perform therapeutic activities

Answer 43

TRUE

Question 44

T/F: An unlicensed person cannot provide therapeutic massage

Answer 44

TRUE

Question 45

PTs are the only professional who provide ______ interventions

Answer 45

PT

Question 46

PTAs are the only individuals who provide ______ PT interventions under the direction and at least ______ supervision of the PT

Answer 46

Selected | General

Question 47

Interventions that require immediate and continuous examination and evaluation throughout the intervention are performed exclusively by the ____

Answer 47

PT

Question 48

Examples of interventions that require immediate and continuous examination only performed by a PT include:

Answer 48

Spinal and peripheral joint mobs/manips, which are components of manual therapy And sharp selective debridement, which is a component of wound management

Question 49

PT eligible to enroll a ______ for a payer/insurer

Answer 49

provider

Question 50

PTA services are billed by who?

Answer 50

The supervising PT

Question 51

Regardless of payer, the PT maintains control of the patient's care; provides the appropriate level of _____ and _______ for the PTA, and can bill for services provided for the _______ team

Answer 51

Direction and supervision | PT-PTA

Question 52

PT services provided by PTAs are reimbursed under who's ID number?

Answer 52

The PT's

Question 53

Are PTs and PTAs generally paid at the same rate for services?

Answer 53

Yes

Question 54

Medicare: PTAs are ________ providers when furnishing services under the direction and supervision of a qualified PT, who is working with the _____ scope of practice in the state in which the services are furnished

Answer 54

Qualified State

Question 55

Medicare, other payers and plans -- may have more specific policies on payment for services provided by a _____, and _____ requirements

Answer 55

PTA | Supervision

Question 56

Medicare and PTAs: The services of PTAs used when providing covered therapy benefits are included as part of the __________. There services are billed by the ____________ PTAs may not provide ______ services, make ___________, or take ______ for the service. They act at the ______ and under the _______ of the treating PT and in accordance with state laws

Answer 56

Covered service Supervising PT Evaluation Clinical judgments Responsibility Direction Supervision

Question 57

A PT must supervise ____

Answer 57

PTAs

Question 58

Who are qualified professionals?

Answer 58

``` PT OT SLP MD NP CNS PA Licensed/certified by state to perform therapy services ``` (May include PTA and COTA under supervision of qualified therapist as allowed by state law)

Question 59

Medicare and PTAs: General supervision is required for PTAs in all settings except _______ (which requires ______ supervision) unless state practice requirements are more stringent, in which case state or local requirements must be following

Answer 59

Private practice Direct

Question 60

Medicare and PTAs: The services of a PTA shall not be billed as services incident to a physician/NPP's service, because they do not meet the _______ of a therapist

Answer 60

Qualifications

Question 61

Medicare and PT aides: Services provided by aides, even if under the supervision of a therapist, are ___________ and are ____________

Answer 61

NOT THERAPY SERVICES | NOT COVERED BY MEDICARE

Question 62

Although an aide may help the therapist by providing unskilled services, those services that are unskilled are not covered by Medicare and shall be _____ as not reasonable and necessary if they are billed

Answer 62

DENIED

Question 63

How many models in the continuum of direction and supervision models in PT service delivery?

Answer 63

4

Question 64

What is model 1?

Answer 64

``` Examination Eval Dx Px Intervention [PTA, Aide/Tech] ```

Question 65

What is Model 2?

Answer 65

``` Exam Eval Dx Px Intervention [PTA and other recognized assistive personnel, aide/tech] ```

Question 66

What is model 3?

Answer 66

Exam [PTA and other recognized assistive personnel] Eval Dx Px Intervention [PTA and other recognized assistive personnel, aide/tech]

Question 67

What is model 4?

Answer 67

Exam [PTA and other recognized assistive personnel] Eval [PTA and other recognized assistive personnel] Dx Px Interventions (PTA and other recognized assistive personnel, aide/tech]