Plan of Care and PT

I would like to know how other agencies put their PT/OT/ST orders on the initial 485. before we were EMR, we would just put PT assess and eval and check vital signs. Now that we are EMR, only nursing is using the program at this time, PT should start in the next few weeks, but do we have to write out all therapy goals if we are also sending an order from the therapist to the Dr. to sign?

Comments

  • edited May 2017
    Why are you doing both? If PT goes out in the first 5 days, why not put them on the 485 and be done?

    Susan G. Johnsen, RN, MSN, COS-C
    LLUMC Home Health Education & Informatics Specialist
    ph: 909 558 3285

  • Hello Jeannie,

    PT to eval and treat may fall short in meeting the following requirement:

    G-161
    Orders for therapy services include the specific procedures and modalities to be used and the amount, frequency, and duration.

    The regulation requires at G161 that orders for therapy services include the specific procedures and modalities to be used and the amount, frequency, and duration of the therapy ordered.
    “Modalities” are defined as any physical agent applied to produce therapeutic changes to biologic tissue and include, but are not limited to, thermal, acoustic, light, mechanical, or
    electric energy. “Procedures” are defined as a manner of effecting change through the application of clinical skills and/or services that attempt to improve function. This can be achieved through exercise or training and must include active interventions between the therapist and patient.
    Modalities that are supervised but do not require constant patient contact (by the provider) include hot or cold packs, traction, mechanical or electrical stimulation (unattended), acupuncture with electrical stimulation, vasopneumatic devices, paraffin bath, microwave, whirlpool, diathermy, infrared and ultraviolet. Modalities requiring constant attendance include electrical stimulation (manual), iontophoresis, contrast baths, ultrasound and Hubbard tank. Items such as Theraband, free weights and stationary bikes are not considered modalities. They are considered equipment or items used in support of a procedure such as therapeutic exercise or neuromuscular reeducation.

    Michael McGowan, MBA/HCA
    michael@operacare.com 916-343-1164
    www.operacare.com

  • edited May 2017
    Would that not be covered under the actual evaluation done by the therapist? We have a nurse admit, (administrative paperwork only) they include 1m1 0m1 1m1 for them to admit and discharge. Then they also add PT to evaluate and treat. The actual procedures and modalities are approved on the physical therapy evaluation.

  • edited May 2017
    Eval and treat is commonly used. Usually the assessment gives a detail of oreders on therapy plan of care to be signed by physician for specific frequency and servuces and duration

  • edited May 2017
    Also, you cannot include 0 in your frequency/range.

    Sent from my iPhone

  • edited May 2017
    This is a topic that is your choice. But let your PT's do their own OASIS. Sending out a nurse to do a non-billable OASIS admit and discharge (from that frequency there is no skilled care) is throwing money away.

    Susan G. Johnsen, RN, MSN, COS-C
    LLUMC Home Health Education & Informatics Specialist
    ph: 909 558 3285

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