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Insight from an OTR. I don't think there would be a problem with the COTA

filling in for vacation. I do see some concern that this SNF is using a COTA in

a restorative manner. It should be made very clear that this COTA cannot

function in an OT capacity when she is wearing the restorative tech hat unless

there is a written restorative program from the OTR. For instance, if the

OTR/COTA are out to lunch and a resident's splint needs adjusting/repair the

staff cannot ask the COTA/Restorative Tech to perform these repairs. Reson

being that she is not under the supervision of an OTR. A good COTA would

recognize this and make an OT referral. Sometimes SNF take this approach

thinking it would be cost effective to bypass the therapy department and just

have the tech do it after all " She is a COTA. " I can't imagine how stiffling it

would be to pursue a carrer and then take a position where legally you can't use

it. Yikes! It sounds like there is great potential for that COTA/R!

estorative Tech to be providing OT services without the supervions of an OTR.

Keep us posted on what is happening.

ptmanageregroups wrote:

>

> I work in a SNF, and our administrator has informed me that the DON would

> like to hire a COTA to work as a restorative tech.  The DON feels that we

> could justify this individual receiving a higher salary than budgeted for

> the position because he/she could fill in for our regular COTA when she is

> on vacation.  Aside from the problems I have with the DON hiring for the

> therapy department, my internal " red flags " are going up because this

> individual would be documenting as a tech one week and a COTA the next.

> There would also be confusion among residents and staff as to what this

> person's role truly is.  I would appreciate any insights/opinions regarding

> this issue and especially any documentation that I could provide to the

> administrator about why this is a bad idea.  Thank you in advance.

>

> Janet J. Batek, PT

> Nashville, TN

>

>

> Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

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> Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

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.

> Visit our EStore at www.RehabBusiness.com

>

>

>

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I agree with tccdore comments in regard to supervision and practice act

guidelines.

I am sad to see that the job market is such that COTAs are forced to take

restorative tech positions.

Ann Lambert, OTR/L, MHSA

Baker Newman and Noyes

Portland, Maine

>>> tccdore@... 08/04/00 08:38AM >>>

Insight from an OTR. I don't think there would be a problem with the COTA

filling in for vacation. I do see some concern that this SNF is using a COTA in

a restorative manner. It should be made very clear that this COTA cannot

function in an OT capacity when she is wearing the restorative tech hat unless

there is a written restorative program from the OTR. For instance, if the

OTR/COTA are out to lunch and a resident's splint needs adjusting/repair the

staff cannot ask the COTA/Restorative Tech to perform these repairs. Reson

being that she is not under the supervision of an OTR. A good COTA would

recognize this and make an OT referral. Sometimes SNF take this approach

thinking it would be cost effective to bypass the therapy department and just

have the tech do it after all " She is a COTA. " I can't imagine how stiffling it

would be to pursue a carrer and then take a position where legally you can't use

it. Yikes! It sounds like there is great potential for that COTA/R!

estorative Tech to be providing OT services without the supervions of an OTR.

Keep us posted on what is happening.

ptmanageregroups wrote:

>

> I work in a SNF, and our administrator has informed me that the DON would

> like to hire a COTA to work as a restorative tech. The DON feels that we

> could justify this individual receiving a higher salary than budgeted for

> the position because he/she could fill in for our regular COTA when she is

> on vacation. Aside from the problems I have with the DON hiring for the

> therapy department, my internal " red flags " are going up because this

> individual would be documenting as a tech one week and a COTA the next.

> There would also be confusion among residents and staff as to what this

> person's role truly is. I would appreciate any insights/opinions regarding

> this issue and especially any documentation that I could provide to the

> administrator about why this is a bad idea. Thank you in advance.

>

> Janet J. Batek, PT

> Nashville, TN

>

>

> Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

-.

> Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

> How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register at

.

> Visit our EStore at www.RehabBusiness.com

>

>

>

----------

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http://webmail.netscape.com/

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540-0774.

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Michigan. Register at today.

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Janet,

My thoughts as long as the individual knows which role she is in at the time and

there should not be a problem. Just make certain that the indivdual performs

only those job duties at the specific time and does not mix the 2. functionIs

the facility going to have 2 different pay rates for the 2 jobs and performance

eval might be of concern

Jeffery R. Weiss MS PT/ATC

Manager of Rehabilitation

Allegheny Valley Hospital

Natrona Heights, PA

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Download the OT Licensure law form the Web site

www.state.tn.us/sos/rules/1150/1150.htm.

The OT Board would probably frown on this as well as AOTA, check their practice

guidelines. The COTA would be responsible under his/her license even if just a

tech so the COTA would have to be supervised & practice according to the state

law.

Pat

Pat Corrigan Jobes, PT

Director of Rehabilitation Services

Methodist Healthcare-North Hospital

3960 New Covington Pike

Memphis, Tn 38128

Phone: (901)384-5320

Fax: (901)384-5099

E-Mail: jobesm@...

>>> " Janet Batek " 08/04/00 07:03AM >>>

I work in a SNF, and our administrator has informed me that the DON would

like to hire a COTA to work as a restorative tech. The DON feels that we

could justify this individual receiving a higher salary than budgeted for

the position because he/she could fill in for our regular COTA when she is

on vacation. Aside from the problems I have with the DON hiring for the

therapy department, my internal " red flags " are going up because this

individual would be documenting as a tech one week and a COTA the next.

There would also be confusion among residents and staff as to what this

person's role truly is. I would appreciate any insights/opinions regarding

this issue and especially any documentation that I could provide to the

administrator about why this is a bad idea. Thank you in advance.

Janet J. Batek, PT

Nashville, TN

Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details -(800)

540-0774.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester

Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register at

.

Visit our EStore at www.RehabBusiness.com

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Actually this wec site is the rules and regs , not the law. You can get to the

law from the Board of OT/PTExaminers web page

http://170.142.76.180/bmf-bin/BMFprofgen.pl

MPJ

Pat Corrigan Jobes, PT

Director of Rehabilitation Services

Methodist Healthcare-North Hospital

3960 New Covington Pike

Memphis, Tn 38128

Phone: (901)384-5320

Fax: (901)384-5099

E-Mail: jobesm@...

>>> " -Pat Jobes " 08/04/00 08:18AM >>>

Download the OT Licensure law form the Web site

www.state.tn.us/sos/rules/1150/1150.htm.

The OT Board would probably frown on this as well as AOTA, check their practice

guidelines. The COTA would be responsible under his/her license even if just a

tech so the COTA would have to be supervised & practice according to the state

law.

Pat

Pat Corrigan Jobes, PT

Director of Rehabilitation Services

Methodist Healthcare-North Hospital

3960 New Covington Pike

Memphis, Tn 38128

Phone: (901)384-5320

Fax: (901)384-5099

E-Mail: jobesm@...

>>> " Janet Batek " 08/04/00 07:03AM >>>

I work in a SNF, and our administrator has informed me that the DON would

like to hire a COTA to work as a restorative tech. The DON feels that we

could justify this individual receiving a higher salary than budgeted for

the position because he/she could fill in for our regular COTA when she is

on vacation. Aside from the problems I have with the DON hiring for the

therapy department, my internal " red flags " are going up because this

individual would be documenting as a tech one week and a COTA the next.

There would also be confusion among residents and staff as to what this

person's role truly is. I would appreciate any insights/opinions regarding

this issue and especially any documentation that I could provide to the

administrator about why this is a bad idea. Thank you in advance.

Janet J. Batek, PT

Nashville, TN

Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details -(800)

540-0774.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester

Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register at

.

Visit our EStore at www.RehabBusiness.com

Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details -(800)

540-0774.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester

Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register at

.

Visit our EStore at www.RehabBusiness.com

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Would it not be alright, if the COTA was hired and payed as such, a licensed

assistant, be under the direction of the OT department and perform skilled OT

treatment as written and supervised by an OT ( which is reimbursable) and

provide restorative treatment to patients under that classification, and of

course not bill for such service. When in the restorative role, she would

have to refer to the OT for any skilled treatment issues that need to be

addressed, at which time a new treatment plan be established. Who would

benefit from such service, " the patient " , receiving knowlegeable care

throughout his/her remaining, yet changing, years.

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Do restorative techs need certification in your state (CNA?) and does this

COTA have that certification? I would be more worried about complying with

nursing home regulations before the COTA issues. You would hate to put the

facility or COTA at risk.

Joana Freedman, PT

Portland, OR

COTA as restorative tech

I work in a SNF, and our administrator has informed me that the DON would

like to hire a COTA to work as a restorative tech. The DON feels that we

could justify this individual receiving a higher salary than budgeted for

the position because he/she could fill in for our regular COTA when she is

on vacation. Aside from the problems I have with the DON hiring for the

therapy department, my internal " red flags " are going up because this

individual would be documenting as a tech one week and a COTA the next.

There would also be confusion among residents and staff as to what this

person's role truly is. I would appreciate any insights/opinions regarding

this issue and especially any documentation that I could provide to the

administrator about why this is a bad idea. Thank you in advance.

Janet J. Batek, PT

Nashville, TN

Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

-.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

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A professional (or in this case, para-professional) may not " leave behind "

their professional designation or training if hired to function in a lower

level position. I'm quite sure that legally (read: " if anything goes

wrong " ), this person would be held to the level of responsibility of a COTA,

regardless of the job description. Which, of course, begs the question:

" who is the supervising OTR? " A poor idea, in my estimation.

Trager, PT

Rehabilitation Services Manager

Kaweah Delta Health Care District

Visalia, CA.

COTA as restorative tech

I work in a SNF, and our administrator has informed me that the DON would

like to hire a COTA to work as a restorative tech. The DON feels that we

could justify this individual receiving a higher salary than budgeted for

the position because he/she could fill in for our regular COTA when she is

on vacation. Aside from the problems I have with the DON hiring for the

therapy department, my internal " red flags " are going up because this

individual would be documenting as a tech one week and a COTA the next.

There would also be confusion among residents and staff as to what this

person's role truly is. I would appreciate any insights/opinions regarding

this issue and especially any documentation that I could provide to the

administrator about why this is a bad idea. Thank you in advance.

Janet J. Batek, PT

Nashville, TN

Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

-.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

Visit our EStore at www.RehabBusiness.com

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Interesting delima but certainly one that can (and does) easliy occur in

todays job market.

I can see your concerns but also want to point out a basic axiom on hiring..

You always want to hire the most qualified person for a job. I would think

that the person just must not represent themselves as a licensed person in

the restorative job. If the person was an OT this would not be a critical;

since, they do not need oversight of the professional to treat.

Certainly we should not exclude a person from a job just because they have

training and experience that exceeds the minimal requirements.

Steve Passmore

VP Clinical Services

Evergreen Rehabilitation

steve@...

COTA as restorative tech

> I work in a SNF, and our administrator has informed me that the DON would

> like to hire a COTA to work as a restorative tech. The DON feels that we

> could justify this individual receiving a higher salary than budgeted for

> the position because he/she could fill in for our regular COTA when she is

> on vacation. Aside from the problems I have with the DON hiring for the

> therapy department, my internal " red flags " are going up because this

> individual would be documenting as a tech one week and a COTA the next.

> There would also be confusion among residents and staff as to what this

> person's role truly is. I would appreciate any insights/opinions

regarding

> this issue and especially any documentation that I could provide to the

> administrator about why this is a bad idea. Thank you in advance.

>

> Janet J. Batek, PT

> Nashville, TN

>

>

> Rehab Pro - The New Way...A Better Way to Rehab Success! Call for

details -.

> Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

> How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

> Visit our EStore at www.RehabBusiness.com

>

>

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I have been following the posts on this issue closely, and I must agree with the

person who earlier noted that in most states, a

licensed or certified professional is held to that degree of certification even

if working outside the boundaries of the

respective practice act. I believe to move forward here one needs to:

a. Check the laws of the state in question

b. If I am correct in my above statements, then the COTA would need to

abandon her certification in order to assume the

" tech " role.

Just my $0.02, inflation adjusted, cents.

Ed Flickinger, PT, MBA

LjbPT@... wrote:

> Who is (where is) the supervising OTR in all this discussion?

> The potential for confusion and problems is HUGE.

> Lucy Buckley PT

>

> Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

-.

> Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

> How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register at

.

> Visit our EStore at www.RehabBusiness.com

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As I understand a restorative program in LTC reimbursable under Part A low

rehab it is to be 6 days a week with 2 orders of at least 15 minutes each

supervised under nursing done by a certified nursing assistant. It is a

nursing restorative program where rehab. may recommend and train the CNA and

restorative nurse to carry on or to re-enforce the PT/OT achieved goals and

to assist with developing the restorative goals for restorative nursing to

achieve.

Gail Davies PT, GCS

Chatham, NJ

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I have hired PTA's and COTA's to be rehab aides before. I have always paid

them the same salary classification as I would any other aide -- but maybe a

step or two higher.

I have also used them as prn for my therapy staff. I made one stipulation --

if they were an aide on inpatient they could not be a therapist on inpatient

-- but they could in pediatrics or another area.

I was very clear in their job descriptions and responsibilities. They even

had different name badges.

The aides were outstanding aides. They were even better therapist in the long

run as they understood the behind the scene operations -- especially if they

worked the front desk -- and they had a greater respect for the future aide.

I will tell you that it was difficult to retain therapist long in this

capacity -- they quickly jumped ship when a full time position came open --

whether with you or your competitor. Nor can I blame them -- but it made for

some expensive labor by the time you counted training time and costs.

If you want to discuss my experiences further don't hesitate to contact me

directly.

Carolyn Gum

CG Consulting, LLC

gumcj@...

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Carolyn:

I am very surprised that the arrangement you described

was allowed under the law. I would think that the law would hold

the COTA to her/his highest level of certification. Even though you say

there were different job descriptions, I find it hard to believe that you

can tease out the difference between ambulating a patient as a rest. tech

vs. ambulation as a COTA...how exactly did she/he modify their skills to

demonstrate a difference?

And what of professional identity? How does one

develop professional behaviors when flip flopping between a professional

job title and a supportive job title? Was it not confusing to any

of the clients in the facility, who perhaps changed levels of care and

thus were treated by this person one day as a professional and the next

as supportive staff?

I think that we, as managers have a responsibility

to help our employees who hold professional titles develop professional

behaviors. I believe it is demeaning to them, as well as to their rank

within the profession, to allow them to function in such a manner

as you described.

This is just my $0.02 cents...but if I were an

outsider looking in - why would I ever pay a COTA a higher wage than a

restorative tech when I see one person functioning as both, with the difference

in job responsibilities existing on paper only? I think we, as managers,

need to stop and think about what we are doing to our professions as a

whole - not just in our little corner of the world.

Ed Flickinger, PT, MBA

Gumcj@... wrote:

I have hired PTA's and COTA's to be rehab aides before.

I have always paid

them the same salary classification as I would any other aide -- but

maybe a

step or two higher.

I have also used them as prn for my therapy staff. I made one stipulation

--

if they were an aide on inpatient they could not be a therapist on

inpatient

-- but they could in pediatrics or another area.

I was very clear in their job descriptions and responsibilities. They

even

had different name badges.

The aides were outstanding aides. They were even better therapist in

the long

run as they understood the behind the scene operations -- especially

if they

worked the front desk -- and they had a greater respect for the future

aide.

I will tell you that it was difficult to retain therapist long in this

capacity -- they quickly jumped ship when a full time position came

open --

whether with you or your competitor. Nor can I blame them -- but it

made for

some expensive labor by the time you counted training time and costs.

If you want to discuss my experiences further don't hesitate to contact

me

directly.

Carolyn Gum

CG Consulting, LLC

gumcj@...

Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

-.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement

- Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

Visit our EStore at www.RehabBusiness.com

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Steve:

Many, if not most, states will hold one to their

highest level of certification/licensure. It does not restrict them from

work, however if you choose to work outside of your licensed profession

you must give up your licensure or risk being held by its standards.

Ed Flickinger, PT, MBA

Steve Passmore wrote:

Can you limit someone's

ability to work.. Hire the most qualified person for a job...

I think as long as you do not protray youself in the professional role

it is allowed.Steve PassmoreEvergreen

Rehabilitationsteve@...

Re: COTA as restorative

tech

Carolyn:

I am very surprised that the arrangement you described

was allowed under the law. I would think that the law would hold

the COTA to her/his highest level of certification. Even though you say

there were different job descriptions, I find it hard to believe that you

can tease out the difference between ambulating a patient as a rest. tech

vs. ambulation as a COTA...how exactly did she/he modify their skills to

demonstrate a difference?

And what of professional identity? How does one

develop professional behaviors when flip flopping between a professional

job title and a supportive job title? Was it not confusing to any

of the clients in the facility, who perhaps changed levels of care and

thus were treated by this person one day as a professional and the next

as supportive staff?

I think that we, as managers have a responsibility

to help our employees who hold professional titles develop professional

behaviors. I believe it is demeaning to them, as well as to their rank

within the profession, to allow them to function in such a manner

as you described.

This is just my $0.02 cents...but if I were an

outsider looking in - why would I ever pay a COTA a higher wage than a

restorative tech when I see one person functioning as both, with the difference

in job responsibilities existing on paper only? I think we, as managers,

need to stop and think about what we are doing to our professions as a

whole - not just in our little corner of the world.

Ed Flickinger, PT, MBA

Gumcj@... wrote:

I have hired PTA's and COTA's to be rehab aides

before. I have always paid

them the same salary classification as I would any other aide -- but

maybe a

step or two higher.

I have also used them as prn for my therapy staff. I made one stipulation

--

if they were an aide on inpatient they could not be a therapist on

inpatient

-- but they could in pediatrics or another area.

I was very clear in their job descriptions and responsibilities. They

even

had different name badges.

The aides were outstanding aides. They were even better therapist in

the long

run as they understood the behind the scene operations -- especially

if they

worked the front desk -- and they had a greater respect for the future

aide.

I will tell you that it was difficult to retain therapist long in this

capacity -- they quickly jumped ship when a full time position came

open --

whether with you or your competitor. Nor can I blame them -- but it

made for

some expensive labor by the time you counted training time and costs.

If you want to discuss my experiences further don't hesitate to contact

me

directly.

Carolyn Gum

CG Consulting, LLC

gumcj@...

Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

-.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement

- Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

Visit our EStore at www.RehabBusiness.com

Rehab Pro - The New Way...A Better Way to Rehab Success! Call

for details -.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement

- Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000

Register at .

Visit our EStore at www.RehabBusiness.com

Rehab Pro - The New Way...A Better Way to Rehab Success! Call

for details -.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement

- Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000

Register at .

Visit our EStore at www.RehabBusiness.com

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Can you limit someone's ability to work.. Hire the most qualified person for a job... I think as long as you do not protray youself in the professional role it is allowed.

Steve Passmore

Evergreen Rehabilitation

steve@...

Re: COTA as restorative tech

Carolyn: I am very surprised that the arrangement you described was allowed under the law. I would think that the law would hold the COTA to her/his highest level of certification. Even though you say there were different job descriptions, I find it hard to believe that you can tease out the difference between ambulating a patient as a rest. tech vs. ambulation as a COTA...how exactly did she/he modify their skills to demonstrate a difference? And what of professional identity? How does one develop professional behaviors when flip flopping between a professional job title and a supportive job title? Was it not confusing to any of the clients in the facility, who perhaps changed levels of care and thus were treated by this person one day as a professional and the next as supportive staff? I think that we, as managers have a responsibility to help our employees who hold professional titles develop professional behaviors. I believe it is demeaning to them, as well as to their rank within the profession, to allow them to function in such a manner as you described. This is just my $0.02 cents...but if I were an outsider looking in - why would I ever pay a COTA a higher wage than a restorative tech when I see one person functioning as both, with the difference in job responsibilities existing on paper only? I think we, as managers, need to stop and think about what we are doing to our professions as a whole - not just in our little corner of the world. Ed Flickinger, PT, MBA Gumcj@... wrote: I have hired PTA's and COTA's to be rehab aides before. I have always paid them the same salary classification as I would any other aide -- but maybe a step or two higher. I have also used them as prn for my therapy staff. I made one stipulation -- if they were an aide on inpatient they could not be a therapist on inpatient -- but they could in pediatrics or another area. I was very clear in their job descriptions and responsibilities. They even had different name badges. The aides were outstanding aides. They were even better therapist in the long run as they understood the behind the scene operations -- especially if they worked the front desk -- and they had a greater respect for the future aide. I will tell you that it was difficult to retain therapist long in this capacity -- they quickly jumped ship when a full time position came open -- whether with you or your competitor. Nor can I blame them -- but it made for some expensive labor by the time you counted training time and costs. If you want to discuss my experiences further don't hesitate to contact me directly. Carolyn Gum CG Consulting, LLC gumcj@... Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details -. Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register at . Visit our EStore at www.RehabBusiness.comRehab Pro - The New Way...A Better Way to Rehab Success! Call for details -.Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today.How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register at .Visit our EStore at www.RehabBusiness.com

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flickingerpt@... 08/07/00 11:50PM states:

" I think that we, as managers have a responsibility to help our employees who

hold professional titles develop professional behaviors. I believe it is

demeaning to them, as well as to their rank within the profession, to allow them

to function in such a manner as you described " .

The responsibilities of a restorative aide are demanding and important. We have

also used PTAs as restorative aides. In our situation, it was easier as this

was their only responsibility, so role confusion was not a problem. Our

outcomes were excellent and it added a new dimension to the restorative program.

They certainly did not consider the work demeaning and delivered a superior

service in a professional manner to a very needy population. I don't consider

any work as demeaning, but I should appropriately use my skills and do what is

expected of me in any job.

The main challenge has been cost. We feel it is a good investment for a SNF and

are in the process of rolling out more programs. Survey deficiencies related to

poor carry-through in a restorative program can be very costly. It is always

hard to keep focused on the big picture.

Sometimes we need to " think out of the box " in order to help deliver quality

services to residents/patients. The government continues to increasingly

restrict practice and we need, when possible, not to collaborate in this process

where we can improve access or quality.

Chris

I Reese

GNA

Grand Haven, MI

reesec@...

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Posted
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When you use PTA's in this role, do you follow the

same supervisory rules as you do when the are seeing a skilled PT patient?

The issue of "demeaning" is not the job, but the performance of a task

in a job role that IS NOT the same from a requirement standpoint. A restorative

aide/tech is not required to go to PTA school, but a PTA cannot be a PTA

unless they attend an accredited school...this is my point about undermining

the professional identity of our professionals.

The way to correct deficiencies is to better train

and/or select better persons as restorative techs - not to demote a trained

professional to a lessor job description. Everyone's work is important

- but that work has a meaningful rung on a ladder of skill, and appropriate

people must be placed at each rung. You, in my opinion, are re-arranging

the rungs.....

Ed Flickinger, PT, MBA

Reese wrote:

flickingerpt@... 08/07/00 11:50PM

states:

"I think that we, as managers have a responsibility to help our employees

who hold professional titles develop professional behaviors. I believe

it is demeaning to them, as well as to their rank within the profession,

to allow them to function in such a manner as you described".

The responsibilities of a restorative aide are demanding and important.

We have also used PTAs as restorative aides. In our situation, it

was easier as this was their only responsibility, so role confusion was

not a problem. Our outcomes were excellent and it added a new dimension

to the restorative program. They certainly did not consider the work

demeaning and delivered a superior service in a professional manner to

a very needy population. I don't consider any work as demeaning,

but I should appropriately use my skills and do what is expected of me

in any job.

The main challenge has been cost. We feel it is a good investment

for a SNF and are in the process of rolling out more programs. Survey

deficiencies related to poor carry-through in a restorative program can

be very costly. It is always hard to keep focused on the big picture.

Sometimes we need to "think out of the box" in order to help deliver

quality services to residents/patients. The government continues

to increasingly restrict practice and we need, when possible, not to collaborate

in this process where we can improve access or quality.

Chris

I Reese

GNA

Grand Haven, MI

reesec@...

Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

-.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement

- Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

Visit our EStore at www.RehabBusiness.com

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Sometimes we need to "think out of the box" in order to help deliver quality services to

residents/patients. The government continues to increasingly restrict practice and we need,

when possible, not to collaborate in this process where we can improve access or quality.

- in regard to your last comments quoted

above, if we demote our professionals to lower skilled job roles arbitrarily,

we set a precedent for further restriction of practice.

Ed

"G. Flickinger, PT, MBA" wrote:

When you use PTA's in this

role, do you follow the same supervisory rules as you do when the are seeing

a skilled PT patient? The issue of "demeaning" is not the job, but the

performance of a task in a job role that IS NOT the same from a requirement

standpoint. A restorative aide/tech is not required to go to PTA school,

but a PTA cannot be a PTA unless they attend an accredited school...this

is my point about undermining the professional identity of our professionals.

The way to correct deficiencies is to better train

and/or select better persons as restorative techs - not to demote a trained

professional to a lessor job description. Everyone's work is important

- but that work has a meaningful rung on a ladder of skill, and appropriate

people must be placed at each rung. You, in my opinion, are re-arranging

the rungs.....

Ed Flickinger, PT, MBA

Reese wrote:

flickingerpt@... 08/07/00 11:50PM

states:

"I think that we, as managers have a responsibility to help our employees

who hold professional titles develop professional behaviors. I believe

it is demeaning to them, as well as to their rank within the profession,

to allow them to function in such a manner as you described".

The responsibilities of a restorative aide are demanding and important.

We have also used PTAs as restorative aides. In our situation, it

was easier as this was their only responsibility, so role confusion was

not a problem. Our outcomes were excellent and it added a new dimension

to the restorative program. They certainly did not consider the work

demeaning and delivered a superior service in a professional manner to

a very needy population. I don't consider any work as demeaning,

but I should appropriately use my skills and do what is expected of me

in any job.

The main challenge has been cost. We feel it is a good investment

for a SNF and are in the process of rolling out more programs. Survey

deficiencies related to poor carry-through in a restorative program can

be very costly. It is always hard to keep focused on the big picture.

Sometimes we need to "think out of the box" in order to help deliver

quality services to residents/patients. The government continues

to increasingly restrict practice and we need, when possible, not to collaborate

in this process where we can improve access or quality.

Chris

I Reese

GNA

Grand Haven, MI

reesec@...

Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

-.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement

- Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

Visit our EStore at www.RehabBusiness.com

Rehab Pro - The New Way...A Better Way to Rehab Success! Call

for details -.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement

- Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000

Register at .

Visit our EStore at www.RehabBusiness.com

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Ed,

The first place we did this was in an area where there were more PTAs than there

were jobs, due to a local program. One PTA was working as a grocery store

checker. This program offered an opportunity to work in a position where skills

and interests could be used. While these individuals may have preferred a PTA

job to a restorative job - this solution in this situation was a win for

everyone.

The program was supervised by a nurse, with therapy acting as a consultant and

trainer to the program.

In many areas of the country finding good, committed restorative techs is almost

a crisis level problem. Turnover, hence constant retraining is also a problem.

It is not an ideal world.

Chris

I Reese

GNA

Grand Haven, MI

reesec@...

>>> flickingerpt@... 08/08/00 09:00AM >>>

When you use PTA's in this role, do you follow the same supervisory rules as you

do when the are seeing a skilled PT patient? The issue of " demeaning " is not the

job, but the performance of a task in a job role that IS NOT the same from a

requirement standpoint. A restorative aide/tech is not required to go to PTA

school, but a PTA cannot be a PTA unless they attend an accredited school...this

is my point about undermining the professional identity of our professionals.

The way to correct deficiencies is to better train and/or select better persons

as restorative techs - not to demote a trained professional to a lessor job

description. Everyone's work is important - but that work has a meaningful rung

on a ladder of skill, and appropriate people must be placed at each rung. You,

in my opinion, are re-arranging the rungs.....

Ed Flickinger, PT, MBA

Reese wrote:

> flickingerpt@... 08/07/00 11:50PM states:

> " I think that we, as managers have a responsibility to help our employees who

hold professional titles develop professional behaviors. I believe it is

demeaning to them, as well as to their rank within the profession, to allow them

to function in such a manner as you described " .

>

> The responsibilities of a restorative aide are demanding and important. We

have also used PTAs as restorative aides. In our situation, it was easier as

this was their only responsibility, so role confusion was not a problem. Our

outcomes were excellent and it added a new dimension to the restorative program.

They certainly did not consider the work demeaning and delivered a superior

service in a professional manner to a very needy population. I don't consider

any work as demeaning, but I should appropriately use my skills and do what is

expected of me in any job.

>

> The main challenge has been cost. We feel it is a good investment for a SNF

and are in the process of rolling out more programs. Survey deficiencies

related to poor carry-through in a restorative program can be very costly. It

is always hard to keep focused on the big picture.

>

> Sometimes we need to " think out of the box " in order to help deliver quality

services to residents/patients. The government continues to increasingly

restrict practice and we need, when possible, not to collaborate in this process

where we can improve access or quality.

>

> Chris

>

> I Reese

> GNA

> Grand Haven, MI

> reesec@...

>

> Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

-.

> Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

> How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register at

.

> Visit our EStore at www.RehabBusiness.com

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Can someone help me. In my area of the country I am not familiar with

" resorative techs " and what they can do. Also, how do they differ from a PTA?

Jim Dunleavy PT, MS

Administrative Director, Rehab Services

Holy Name Hospital

Teaneck, New Jersey

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Jim,

In my experience of almost 15 years, the term restorative tech implies

routine maintance and non-skilled treatment. Most SNF's use them extensively

for patient who have been discharged from physical therapy either due to

maximal goal achievement or based on financial reasons. I do not bill for

any restorative treatments. This is different than the PTA. You are able to

bill for the skilled treatment. The supervision clause is also extremely

different. The in-site clause applies to unlicensed restorative techs, while

the on-site rule applies to the PTA.

Jeff

JEFF KIRKENDALL, PT

CHAIR, PHYSICAL THERAPIST ASSISTANT PROGRAM

SHAWNEE STATE UNIVERSITY

940 2ND STREET

PORTSMOUTH, OH 45662

PHONE:

FAX :

E-MAIL: JKIRKENDALL@...

Re: COTA as restorative tech

Can someone help me. In my area of the country I am not familiar with

" resorative techs " and what they can do. Also, how do they differ from a

PTA?

Jim Dunleavy PT, MS

Administrative Director, Rehab Services

Holy Name Hospital

Teaneck, New Jersey

Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details

-.

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

Visit our EStore at www.RehabBusiness.com

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Thanks to all who answered my question about about the restorative tech. It

is important to know that the term is a basic OTJ trained title and does not

include the billing of services nor does their work go towards any minutes in

the SNF setting

Thanks Again

Jim Dunleavy PT, MS

Administrative Director, Rehab Services

Holy Name Hospital

Teaneck, New Jersey

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