Week 3 - Healthcare Systems Pt. 3

Question 1

Consider the following characteristics of a patient in an Acute Care setting that is ready for discharge. Which is the most appropriate discharge setting for this patient?

• the patient is status post Stroke
• the patient lived alone prior to the Stroke
• the patient will be able to tolerate up to 3 hours of physical and occupational therapy per day for 5 days a week
• the patient will require 7 days of skilled nursing care
• significant improvement is expected within 14 days

Answer 1

Inpatient Rehab Facility

Question 2

Early Intervention Services

Answer 2

functional based activities are provided in the natural environment

Question 3

Is it legal to see a patient without a physician’s referral if the patient’s insurance company allows Direct Access to PT services, even when the state does now allow Direct Access?

Answer 3

NOOOOO, its not legal

Question 4

The following patient is ready for discharge from an acute care hospital. He has been in the hospital for 3 days and has not experienced any complications. The healthcare team is looking for your discharge recommendations. What setting do you recommend?

-68 year old, status post left total knee replacement

-lives in a 1 story house, with his wife who can drive him to appointments

-able to perform all ADLs with modified independence

-able to ambulate 300’ with a walker with supervision

Answer 4

Outpatient Physical Therapy

Question 5

Acute Care Hospital

Answer 5

short term patient care w/ avg length of stay 3-5 days

Question 6

Outpatient Physical Therapy

Answer 6

ambulatory care services in which the patient is NOT homebound

Question 7

Home Health Physical Therapy

Answer 7

services from skilled nursing therapy to medical, to address the ADLs and mobility for a pt who is UNABLE to leave their house

Question 8

Inpatient Rehab Setting

Answer 8

3 hours of INTENSIVE rehab services, 5 days/wk, of 2+ disciplines

7 days of skilled nursing with expectations of improvement

Question 9

Skilled Nursing Facility

Answer 9

7 days of skilled nursing care/wk,

5 days/wk of PT (min 15 min/day)

interventions centered on improving

Question 10

Educational Setting

Answer 10

therapy centered around the educational needs of the child to enhance their ability to learn in the classroom

Question 11

What is true about Outpatient Rehab Setting

Answer 11

• can include outpatient hospital clinics, private practice, corporate outpatient clinics, part B services in long term care facilities, and telehealth services
• can treat a variety of patient populations and diagnoses
• patients are generally seen for 2-3x/week for longer periods of time

Question 12

PT Interventions for a pt under Hospice Care

Answer 12

• pain management
• caregiver education
• transfers and bed mobility
• gait training and assistive device recommendations
• strength training
• contracture management

Question 13

Homebound Criteria to qualify for Home Health Care Services under Medicare

Answer 13

• pt needs the aid of an assistive device
• the pt requires the assistance of another person to leave the home
• leaving the home requires considerable and taxing effort
• the patient is bed-bound and unable to leave the home

Question 14

Physician Owned Physical Therapy Practices (POPTS)

Answer 14

allow an MD to gain financially from a PT referral

Question 15

A patient in the Acute Care setting is ready for discharge. The healthcare team is asking for your discharge recommendations. Given the following information, which setting do you recommend?

• 70 year old, admitted for Pneumonia, 7 day hospital admission with 3 days in ICU
• lives alone in a 1 story home with 2 steps to enter (no railing), previously sedentary, only ambulated short distances
• requires frequent rest breaks, activity is currently limited by dyspnea
• requires moderate assistance for bed mobility and transfers
• ambulates 50’ with rolling walker with minimal assistance
• unable to tolerate >30 minutes of activity

Answer 15

SNF

Question 16

Telehealth PT services can reach??

Answer 16

rural areas

Question 17

Prohibiting a physician from referring a Medicare patient to any organization for certain designated health services if that physician holds a financial interest in that organization, is known as what?

Answer 17

Stark Law

Question 18

Which of the following is an example of a physical therapy intervention that can be used in the Educational Setting: (select all that apply)

Answer 18

• wheelchair positioning to eat at snack time
• teaching a student to navigate the school hallways in a power wheelchair
• teaching a child with a visual impairment to ambulate from the classroom to the lunch room

Question 19

A patient in the Acute Care setting is ready for discharge. The healthcare team is asking for your discharge recommendations. Given the following information, what setting do your recommend?

-33 year old, status post traumatic brain injury from a car accident

-lives in a 2nd floor apartment with fiance who works during the day

-requires minimal assistance for bed mobility and transfers

-ambulates 20’ with a hemi-walker with moderate assistance

Answer 19

Inpatient Rehabilitation Facility (IRF)