RE: PT vs. OT vs. SLP prod

[Guest guest]

Group,

Can anyone give me advice regarding the expected productivity for PT vs. OT

vs. SLP? In particularly interested in OT vs. PT. Is there any difference

in productivity expectations??

Todd Freeman, MHSA, PT, CHE

Director of Wellness & Rehabilitation

Sumner Regional Medical Center

Gallatin, TN (Nashville suburb)

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[Guest guest]

Shouldn't be any differences in productivity across the board!!

[Guest guest]

Todd,

I am the director of an acute service and your dilemma is an interesting one.

When looking strictly at visits, PT's typically are able to generate more visits

per day than OT's and OT's more than SLP's in my setting. Given this disparity,

we track productivity by patient care units. Patient care units are 15 minute

units reflecting billed and unbilled time spent in direct patient care. If your

facility is anything like mine, the nursing shortage and high medical acuity of

patients neccesitates greater involvement by rehab staff in assisting nursing

with many functions. For example, we don't have the luxury of calling nurses to

take over if the patient needs to use the toilet. If the patient soils their

bedding, we typically must manage this as well, (though often with help of or

delegated to aides). Using this system, we don't have a differential in

expected patient care units. I expect every clinician to generate 26 fifteen

minutes units daily (8 hours) Subtracted from a possible 30 units, this allows

approximately 60 minutes daily for personal needs (everybody's got to pee)

documentation, QA, and non patient care meetings.

Given that approximately 70% of our acute population is on fixed reimbursement,

ie DRG's, Managed care contracts etc, we as a hospital have determined that the

focus needs to be on providing care to our patients and working as an

interdisciplinary team. Our average PT treatment length is 36 minutes, OT is 47

minutes, and SLP is 51 minutes. Average number of visits per patient are 3.4

for PT, 1.5 for OT, and 1.4 for Speech.

This is determined by classifying time as either billable or non billable

patient care time. An assessment will typically generate 45 minutes (3 units

billable) The therapist codes this as one unit of charged assessment (for

charging purposes) and 2 units of non charged assessment (for productivity

purposes) Perhaps this is followed up with 15 minutes of time spent with

confused or distraught family members (15 minutes of non-billable patient care.

Together this result in 4 units of productive time though only 1 unit chargeable

and 2 units non chargeable. We have a daily tracking sheet that codes each time

of patient interaction for each therapist and results in a daily productivity

score.

Hope this is helpful, (sorry for the length)

Redge L MS OTR/L

Director of Rehabilitation Services

on Hospital

Bremerton, WA 98310

[Guest guest]

Todd,

I am the director of an acute service and your dilemma is an interesting one.

When looking strictly at visits, PT's typically are able to generate more visits

per day than OT's and OT's more than SLP's in my setting. Given this disparity,

we track productivity by patient care units. Patient care units are 15 minute

units reflecting billed and unbilled time spent in direct patient care. If your

facility is anything like mine, the nursing shortage and high medical acuity of

patients neccesitates greater involvement by rehab staff in assisting nursing

with many functions. For example, we don't have the luxury of calling nurses to

take over if the patient needs to use the toilet. If the patient soils their

bedding, we typically must manage this as well, (though often with help of or

delegated to aides). Using this system, we don't have a differential in

expected patient care units. I expect every clinician to generate 26 fifteen

minutes units daily (8 hours) Subtracted from a possible 30 units, this allows

approximately 60 minutes daily for personal needs (everybody's got to pee)

documentation, QA, and non patient care meetings.

Given that approximately 70% of our acute population is on fixed reimbursement,

ie DRG's, Managed care contracts etc, we as a hospital have determined that the

focus needs to be on providing care to our patients and working as an

interdisciplinary team. Our average PT treatment length is 36 minutes, OT is 47

minutes, and SLP is 51 minutes. Average number of visits per patient are 3.4

for PT, 1.5 for OT, and 1.4 for Speech.

This is determined by classifying time as either billable or non billable

patient care time. An assessment will typically generate 45 minutes (3 units

billable) The therapist codes this as one unit of charged assessment (for

charging purposes) and 2 units of non charged assessment (for productivity

purposes) Perhaps this is followed up with 15 minutes of time spent with

confused or distraught family members (15 minutes of non-billable patient care.

Together this result in 4 units of productive time though only 1 unit chargeable

and 2 units non chargeable. We have a daily tracking sheet that codes each time

of patient interaction for each therapist and results in a daily productivity

score.

Hope this is helpful, (sorry for the length)

Redge L MS OTR/L

Director of Rehabilitation Services

on Hospital

Bremerton, WA 98310

[Guest guest]

There's also an incentive with the pay by billable unit model for

overutilization of services to maintain or achieve personal income needs & /or

goals. I'm aware that many if not most therapists are more ethical than this,

but I've also known it to occur...and even when we remain ethical, the direct

ratio between earnings and billable units will likely result in extreme

scrutiny by most payors once discovered due to known current and historical

abuses which cost us all in terms of increased regulatory burdens and

capitation of reimbursement.

D. Geyer, P.T.