Re: Acute Care therapy orders

[Guest guest]

We had to change our evaluation forms to have a signature line for the

docs to sign off on. In doing this they then signed off on our

treatments. This was the result of a CMS survey that we had. The

therapist now has to seek out the doc and get a signature or we use

" sign here " stickers.

Colette Fellows OT supervisor

Cooley Dickinson Hospital

Northampton MA

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Kent

Sent: Thursday, March 17, 2011 2:37 PM

To: PTManager

Subject: Acute Care therapy orders

I have a question about orders for therapy in the acute care setting. We

do not typically write clarification orders or have the physicians sign

therapy plans of care in the hospital. Many of our physicians have

started writing " Consult PT " or " PT, OT, SLP eval " instead of " eval and

treat " . I am trying to find out if other facilities go back and write a

clarification order before initiating treatment. My understanding is the

therapist can establish and initiate a POC in the hospital setting

without the physician's signature. However, the question has now come up

- since we do not have a " treat " order, do we need to get another order

before initiating the plan? I would appreciate any information or

reference you can provide. Thanks!

Kent, MS, CCC-SLP

Director of Physical Medicine & Rehab

Delta Regional Medical Center

Greenville, MS 38701

skent@... <mailto:skent%40deltaregional.com>

ph

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[Guest guest]

We had to change our evaluation forms to have a signature line for the

docs to sign off on. In doing this they then signed off on our

treatments. This was the result of a CMS survey that we had. The

therapist now has to seek out the doc and get a signature or we use

" sign here " stickers.

Colette Fellows OT supervisor

Cooley Dickinson Hospital

Northampton MA

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Kent

Sent: Thursday, March 17, 2011 2:37 PM

To: PTManager

Subject: Acute Care therapy orders

I have a question about orders for therapy in the acute care setting. We

do not typically write clarification orders or have the physicians sign

therapy plans of care in the hospital. Many of our physicians have

started writing " Consult PT " or " PT, OT, SLP eval " instead of " eval and

treat " . I am trying to find out if other facilities go back and write a

clarification order before initiating treatment. My understanding is the

therapist can establish and initiate a POC in the hospital setting

without the physician's signature. However, the question has now come up

- since we do not have a " treat " order, do we need to get another order

before initiating the plan? I would appreciate any information or

reference you can provide. Thanks!

Kent, MS, CCC-SLP

Director of Physical Medicine & Rehab

Delta Regional Medical Center

Greenville, MS 38701

skent@... <mailto:skent%40deltaregional.com>

ph

fax

This email message, including any attachments, is for the sole use of

the intended recipient(s) and may contain confidential and privilaged

information. Unauthorized review, use, disclosure and distribution is

prohibited. If you are not the intended recipient, please contact the

sender by reply email and destroy all copies of the original message.

[Guest guest]

We had to change our evaluation forms to have a signature line for the

docs to sign off on. In doing this they then signed off on our

treatments. This was the result of a CMS survey that we had. The

therapist now has to seek out the doc and get a signature or we use

" sign here " stickers.

Colette Fellows OT supervisor

Cooley Dickinson Hospital

Northampton MA

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Kent

Sent: Thursday, March 17, 2011 2:37 PM

To: PTManager

Subject: Acute Care therapy orders

I have a question about orders for therapy in the acute care setting. We

do not typically write clarification orders or have the physicians sign

therapy plans of care in the hospital. Many of our physicians have

started writing " Consult PT " or " PT, OT, SLP eval " instead of " eval and

treat " . I am trying to find out if other facilities go back and write a

clarification order before initiating treatment. My understanding is the

therapist can establish and initiate a POC in the hospital setting

without the physician's signature. However, the question has now come up

- since we do not have a " treat " order, do we need to get another order

before initiating the plan? I would appreciate any information or

reference you can provide. Thanks!

Kent, MS, CCC-SLP

Director of Physical Medicine & Rehab

Delta Regional Medical Center

Greenville, MS 38701

skent@... <mailto:skent%40deltaregional.com>

ph

fax

This email message, including any attachments, is for the sole use of

the intended recipient(s) and may contain confidential and privilaged

information. Unauthorized review, use, disclosure and distribution is

prohibited. If you are not the intended recipient, please contact the

sender by reply email and destroy all copies of the original message.

[Guest guest]

Our understanding is that we must have evaluate and treat to continue

recommended plan of care once evaluation is completed.

Carol Rehder, PT

Manager, Physical Therapy

Genesis Medical Center

rehder@...

A J.D. Power and Associates

Distinguished Hospital for providing

" An Outstanding Patient Experience "

>>> " Kent " 3/17/2011 1:36 PM >>>

I have a question about orders for therapy in the acute care setting. We

do not typically write clarification orders or have the physicians sign

therapy plans of care in the hospital. Many of our physicians have

started writing " Consult PT " or " PT, OT, SLP eval " instead of " eval and

treat " . I am trying to find out if other facilities go back and write a

clarification order before initiating treatment. My understanding is the

therapist can establish and initiate a POC in the hospital setting

without the physician's signature. However, the question has now come up

- since we do not have a " treat " order, do we need to get another order

before initiating the plan? I would appreciate any information or

reference you can provide. Thanks!

Kent, MS, CCC-SLP

Director of Physical Medicine & Rehab

Delta Regional Medical Center

Greenville, MS 38701

skent@...

ph

fax

This email message, including any attachments, is for the sole use of

the intended recipient(s) and may contain confidential and privilaged

information. Unauthorized review, use, disclosure and distribution is

prohibited. If you are not the intended recipient, please contact the

sender by reply email and destroy all copies of the original message.

[Guest guest]

We take " Consult " orders to mean assess the patient and intervene as

indicated, we do not seek treatment orders. We seek clarification only

if the order is for " eval " . We currently do not obtain physician

signatures on acute (part A) plans of care.

J Kuharich, OTR/L

Director of Inpatient Therapy Services

Aultman Health Foundation

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[Guest guest]

*,*

***

*

*The Federal Register has the answers to these types of questions and the

answers are specific to the level of care in which you provide services.

Since you are talking about the acute care setting, this is addressed in

CFR 482.56 Rehabilitation Services (Title 42 - Public Health), part 482

Condition of Participation for Hospitals*

*

*

*http://law.justia.com/cfr/title42/42-3.0.1.5.21.html#42:3.0.1.5.21.4.199.6*

§ 482.56 Condition of participation: Rehabilitation services.

**

*(a) Standard: Organization and staffing. The organization of the service

must be appropriate to the scope of the services offered.*

If the hospital provides rehabilitation, physical therapy, occupational

therapy, audiology, or speech pathology services, the services must be

organized and staffed to ensure the health and safety of patients.

(1) The director of the services must have the necessary knowledge,

experience, and capabilities to properly supervise and administer the

services.

(2) Physical therapy, occupational therapy, or speech therapy, or audiology

services, if provided, must be provided by staff who meet the qualifications

specified by the medical staff, consistent with State law.

*( Standard: Delivery of services. Services must be furnished in

accordance with a written plan of treatment. Services must be given in

accordance with orders of practitioners who are authorized by the medical

staff to order the services, and the orders must be incorporated in the

patient's record. *

If you have an IRF/U inside of your acute care, then you must follow the

sections specific to those regulations which then have timelines for when

documentation must be done. (412.29)

Hope this helps!

Darlene L. D'Altorio-,PT.,MBA-HCM

Strategist, Rehabilitation Management

CORE Results Group

Join Discussions: www.mediserve.com/blog

Office:

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djones@...

585 N. Juniper Dr., Suite 100 | Chandler, AZ 85226 | 1. |

On Thu, Mar 17, 2011 at 2:36 PM, Kent wrote:

>

>

> I have a question about orders for therapy in the acute care setting. We

> do not typically write clarification orders or have the physicians sign

> therapy plans of care in the hospital. Many of our physicians have

> started writing " Consult PT " or " PT, OT, SLP eval " instead of " eval and

> treat " . I am trying to find out if other facilities go back and write a

> clarification order before initiating treatment. My understanding is the

> therapist can establish and initiate a POC in the hospital setting

> without the physician's signature. However, the question has now come up

> - since we do not have a " treat " order, do we need to get another order

> before initiating the plan? I would appreciate any information or

> reference you can provide. Thanks!

>

> Kent, MS, CCC-SLP

>

> Director of Physical Medicine & Rehab

>

> Delta Regional Medical Center

>

> Greenville, MS 38701

>

> skent@...

>

> ph

>

> fax

>

> This email message, including any attachments, is for the sole use of

> the intended recipient(s) and may contain confidential and privilaged

> information. Unauthorized review, use, disclosure and distribution is

> prohibited. If you are not the intended recipient, please contact the

> sender by reply email and destroy all copies of the original message.

>

>