PT (Wound Management Consultant) making Wound Care, dressings recommendations.

[Guest guest]

Dear List-Members,

Dear list Members, I have the following question:

I work for a Rehab Provider and have the Contract with a SNF (TN) where a WCON

(RN) saw pts twice a month with no Team Work concept, no PT involvement, etc

Wound Care was basically dressings change.

I am a " Wound Management Consultant " . I had to change the Wound Management

Policy, Form, Tools,etc.

I couldn't resist the ethical challenge and I started developing a Wound

management Concept. The Administrator bought the idea, perminated the Contract

with that Wound Care Nurse and now we have a Team. I do Rounds with Tx Nurses

weekly. Its working fine but a Clinical Manager for the Company I work for has

concerns about a PT (me) recommending treatments, dressings, etc. After I do

rounds I give my recommendations to the Tx Nurse and she obtains a MD order for

it. NEVER MD disagreed.

Do you see a legal problem with it? If no, what documentation can I use as

evidence?

Thanks in advance!

, PT

[Guest guest]

I would simply tell them that your professional training in the

integumentary system equips you to make informed clinical decisions on

wound care, and that your license allows you to use that skill in a

patient setting

Ron Barbato PT

Administrative Director, Rehabilitation Services

Program Director, Cancer Support Services

Ephraim McDowell Health

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PT (Wound Management Consultant) making Wound Care,

dressings recommendations.

Dear List-Members,

Dear list Members, I have the following question:

I work for a Rehab Provider and have the Contract with a SNF (TN) where

a WCON (RN) saw pts twice a month with no Team Work concept, no PT

involvement, etc

Wound Care was basically dressings change.

I am a " Wound Management Consultant " . I had to change the Wound

Management Policy, Form, Tools,etc.

I couldn't resist the ethical challenge and I started developing a Wound

management Concept. The Administrator bought the idea, perminated the

Contract with that Wound Care Nurse and now we have a Team. I do Rounds

with Tx Nurses weekly. Its working fine but a Clinical Manager for the

Company I work for has concerns about a PT (me) recommending

treatments, dressings, etc. After I do rounds I give my recommendations

to the Tx Nurse and she obtains a MD order for it. NEVER MD disagreed.

Do you see a legal problem with it? If no, what documentation can I use

as evidence?

Thanks in advance!

, PT

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[Guest guest]

,

I do the same thing on a regular basis at our facility. Nursing will request a

wound care consult from PT, we will go over and eval the patient and wound and

then make recommendations for treatment. Nursing confirms orders with the doc

and all goes on smoothly from there.

You may need to have a discussion with your clinical manager that MD's request

consult from various specialties and PT is one of those areas. Moreover, the PT

profession has a firm understanding of A & P including the skin.

My 2 cents...

Gwilliam, PT, MHA, CWS

Director of Rehabilitation

Bowie Memorial Hospital

>

> Dear List-Members,

> Dear list Members, I have the following question:

> I work for a Rehab Provider and have the Contract with a SNF (TN) where a WCON

(RN) saw pts twice a month with no Team Work concept, no PT involvement, etc

> Wound Care was basically dressings change.

> I am a " Wound Management Consultant " . I had to change the Wound Management

Policy, Form, Tools,etc.

> I couldn't resist the ethical challenge and I started developing a Wound

management Concept. The Administrator bought the idea, perminated the Contract

with that Wound Care Nurse and now we have a Team. I do Rounds with Tx Nurses

weekly. Its working fine but a Clinical Manager for the Company I work for has

concerns about a PT (me) recommending treatments, dressings, etc. After I do

rounds I give my recommendations to the Tx Nurse and she obtains a MD order for

it. NEVER MD disagreed.

> Do you see a legal problem with it? If no, what documentation can I use as

evidence?

> Thanks in advance!

>

> , PT

>

[Guest guest]

As long as you are obtaining physician orders for your recommendations, there

shouldn't be any problems.  You are basically doing an assessment; you need to

be sure that you are documenting everything correctly;  pictures help.  Also,

be very careful regarding charging; is it debridement with sharps or similar

debridement as per CPT code 97597, wound vac, multi-layer compression, Unnaboot

which is covered by Medicare?  Or are you just changing the drressing? 

Medicare does not cover non-selective wound care under Part B.  Good luck! S

Whitney PT

________________________________

To: PTManager

Sent: Wednesday, August 10, 2011 12:57 PM

Subject: PT (Wound Management Consultant) making Wound Care,

dressings recommendations.

 

Dear List-Members,

Dear list Members, I have the following question:

I work for a Rehab Provider and have the Contract with a SNF (TN) where a WCON

(RN) saw pts twice a month with no Team Work concept, no PT involvement, etc

Wound Care was basically dressings change.

I am a " Wound Management Consultant " . I had to change the Wound Management

Policy, Form, Tools,etc.

I couldn't resist the ethical challenge and I started developing a Wound

management Concept. The Administrator bought the idea, perminated the Contract

with that Wound Care Nurse and now we have a Team. I do Rounds with Tx Nurses

weekly. Its working fine but a Clinical Manager for the Company I work for has

concerns about a PT (me) recommending treatments, dressings, etc. After I do

rounds I give my recommendations to the Tx Nurse and she obtains a MD order for

it. NEVER MD disagreed.

Do you see a legal problem with it? If no, what documentation can I use as

evidence?

Thanks in advance!

, PT

[Guest guest]

As long as you are obtaining physician orders for your recommendations, there

shouldn't be any problems.  You are basically doing an assessment; you need to

be sure that you are documenting everything correctly;  pictures help.  Also,

be very careful regarding charging; is it debridement with sharps or similar

debridement as per CPT code 97597, wound vac, multi-layer compression, Unnaboot

which is covered by Medicare?  Or are you just changing the drressing? 

Medicare does not cover non-selective wound care under Part B.  Good luck! S

Whitney PT

________________________________

To: PTManager

Sent: Wednesday, August 10, 2011 12:57 PM

Subject: PT (Wound Management Consultant) making Wound Care,

dressings recommendations.

 

Dear List-Members,

Dear list Members, I have the following question:

I work for a Rehab Provider and have the Contract with a SNF (TN) where a WCON

(RN) saw pts twice a month with no Team Work concept, no PT involvement, etc

Wound Care was basically dressings change.

I am a " Wound Management Consultant " . I had to change the Wound Management

Policy, Form, Tools,etc.

I couldn't resist the ethical challenge and I started developing a Wound

management Concept. The Administrator bought the idea, perminated the Contract

with that Wound Care Nurse and now we have a Team. I do Rounds with Tx Nurses

weekly. Its working fine but a Clinical Manager for the Company I work for has

concerns about a PT (me) recommending treatments, dressings, etc. After I do

rounds I give my recommendations to the Tx Nurse and she obtains a MD order for

it. NEVER MD disagreed.

Do you see a legal problem with it? If no, what documentation can I use as

evidence?

Thanks in advance!

, PT