Re: Re: [Assiting in Nursing Home

[Guest guest]

Hi Tom,

We are being asked to assist with things like toileting, supervising or

participating in a Hoyer transfer.  We currently assist with passing breakfast

trays on the rehab unit- primarily for rehab patients and  help pass a meal tray

if we are returning residents at the time of a meal. All of us help with quick

boosts, acknowledge call lights if passing a room and go to the nursing staff

with the request (pain medication, etc) and whenever possible respond to patient

safety alarms for high fall risk residents. 

Though we recognize the dilemma re: productivity, our overriding concerns are

regarding safety and liability.  The staff are concerned that if they have not

fully reviewed the current records as would a PT or OTR for an eval, they would

be liable if an injury occured. (For example if a resident had a hypotensive

episode transferring to the toilet) 

We have all been trained that in this environment, we are not to touch a

resident without an evaluation order or that it is at our own risk. Our screens

are " hands-off " and based on record review, dialogue and observation.  We do not

transfer new residents out of cars on arrival  as we would have to review the

records and evaluate before safely doing so. 

I understand that the trend is for rehab to help as much as possible, but as

this is new to us, and counter to what was familiar and comfortable, I was

hoping to find a precident for what we can and or shouldn't be helping with.

Reisa

________________________________

To: PTManager

Sent: Thu, March 1, 2012 4:01:45 PM

Subject: Re: Re: [Assiting in Nursing Home

> Hi Reisa,

It would be helpful to us to have you explain the specifics of what you

mean by " assisting with the care of other residents not actively on

caseload " .

This is important because most facilities that I am aware of encourage all

staff to help any resident in need as long as it does not interfere with

their primary responsibilities.  Plus in facilities I worked at, we were

always keeping up on other residents vis nursing, via screens to see if

anyone may need a referral for therapy.

What it may come down to (and that is why specifics are needed)is the

difference between policy and cost/benefit analysis.  Most therapy staff

in a SNF are expected to be productive, meaning spending a set percentage

of their time in the facility doing billable activities so to be pulled to

help out with other residents may go against this.  Just let us know more

specifics of what you are being asked to do and then we can better help

you figure this out.

M Howell, PT, MPT

IPTA Payment Specialist

Meridian, ID

thowell@...

> Good Afternoon All,

>

> I am looking for input as to whether ( & if so how) your staff in SNFs

> are  assiting with the care of residents not actively on  caseload. 

> Until now, we  have been clearly 'hands-off' but are hearing that the

> national trend is to have  rehab staff help with other residents.  Any

> input would be welcome

>

> Thanks!

>

> Reisa Fedorchuck, PT, MPH

> Highland Health Care Center

> Cheshire CT

>

>