RE: PTAs with indirect supervision and home health

December 27, 2008

We are in Illinois, and we utilize a 1:1 ratio of PT's to PTA's on HHC. It has

worked very well for us. We have a requirement that the PT has to see the

patient a minimum of once every 6th visit, and we try to have the PT see each

patient at least one time per week if possible. The PT and PTA see each other

every morning and afternoon to communicate if there are question. I think that

the system may work for you if you have the right PT/PTA combination and the

correct facility guidelines to ensure that the therapist sees each patient on a

regular basis. Good luck.

Lori Jarrett, PT

KSB Hospital

Dixon, Illinois

PTAs with indirect supervision and home health

Hello group,

In Pennsylvania on Oct 2, 2008 the PT practice act was revised to allow PTA's

the ability to apply for a license to provide treatment without direct

supervision. I am aware that this has been invoked in other states previously. I

currently am employed in the home health setting and am growing concerned that

this will negatively affect the profession as a whole and more specifically this

sector of physical therapy. Certified Occupational Therapy Assistants (COTA's)

have had the same ability in PA for some time and I have talked with other

OTR/L's that have had experience in home health and working with COTA's. From my

understanding, it makes the already difficult and time-consuming home health

sector a lot more difficult to handle. I am wondering if there are any PT's that

have experience in dealing with PTA's in the home health setting and what

additional challenges there may be. Just from talking with OTR/L's, it seems

that not only does one have to take care of one's own caseload, but also would

have to keep up with the PTA's caseload as well. In addition, it seems to me

that with any successful business model it would make more sense to have a PTA

treat as many patients as possible and have the PT perform only evals and

discharges (since the company can justify paying the PTA less per visit, their

profit margin would therefore be higher). I am wondering if I'm over-reacting

and reading too much into this, or my concerns are validated.

Any information or experiences shared would be greatly appreciated.

Thank you,

, DPT

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