APTA clarifies HCFA therapy LTC issues

[Guest guest]

For those of you who are APTA members I believe the following information will

be published shortly. As there has been so much concern and discussion on this

topic I am providing it to you now.

Source APTA: 08.05.99

" A therapy student who is practicing in field experience must be under the " line

of sight " supervision of the professional therapist. According to HCFA, they are

not licensed or supervised to practice in an unsupervised status. In addition,

HCFA states that none

of the minutes of therapy services provided by the students may be recorded on

the MDS as minutes of therapy received by the beneficiary. Under 42 CFR section

413.85, Medicare recognizes the costs associated with approved educational

activities as pass through

costs and thus SNFs are paid these amounts outside of the RUGS III payment.

These costs include salaries and fringe benefits of physical therapists who

supervise students. In FY 1997 " pass through " payments for nursing and allied

health training programs totaled

about $250 million. "

If you or your staff are not APTA members I strongly encourage you to become

members for the only way we will obtain relief from some of the burdens of the

BBA is through the actions of the APTA and it's members.

Attachment: vcard [not shown]

[Guest guest]

,

Is APTA endorsing HCFA's clearly erroneous statement that a " therapy

student who is practicing in field experience must be under the 'line of

sight' supervision of the professional therapist. " ? That seems to be the

implication of the quoted passage you provided.

Jim Gordon

Gordon, EdD, PT

Program in Physical Therapy

New York Medical College

Valhalla, NY 10595

FAX

james_gordon@...

> ----------

> From: M. White

> Reply To: ptmanageregroups

> Sent: Tuesday, August 10, 1999 3:13 PM

> To: ptmanageregroups

> Subject: APTA clarifies HCFA therapy LTC issues

>

> <<File: douglaswhite.vcf>>

>

> For those of you who are APTA members I believe the following information

> will be published shortly. As there has been so much concern and

> discussion on this topic I am providing it to you now.

>

> Source APTA: 08.05.99

>

> " A therapy student who is practicing in field experience must be under the

> " line of sight " supervision of the professional therapist. According to

> HCFA, they are not licensed or supervised to practice in an unsupervised

> status. In addition, HCFA states that none

> of the minutes of therapy services provided by the students may be

> recorded on the MDS as minutes of therapy received by the beneficiary.

> Under 42 CFR section 413.85, Medicare recognizes the costs associated with

> approved educational activities as pass through

> costs and thus SNFs are paid these amounts outside of the RUGS III

> payment. These costs include salaries and fringe benefits of physical

> therapists who supervise students. In FY 1997 " pass through " payments for

> nursing and allied health training programs totaled

> about $250 million. "

>

> If you or your staff are not APTA members I strongly encourage you to

> become members for the only way we will obtain relief from some of the

> burdens of the BBA is through the actions of the APTA and it's members.

>

>

> ------------------------------------------------------------------------

>

> eGroups.com home: /group/ptmanager

> - Simplifying group communications

>

>

>

>

[Guest guest]

Doug:

I will echo your comments, but with a slightly less " politically correct "

tone. At this point in time and evolution in the Health Care industry, if

you are not an active member of your professional association, you're

kidding yourself. This is true for all professionals, not just PTs and

PTAs.

Ken Mailly, PT

President

Mailly Consulting Inc.

Director of Government Affairs

aptanj

khmailly@...

APTA clarifies HCFA therapy LTC issues

>

>For those of you who are APTA members I believe the following information

will be published shortly. As there has been so much concern and discussion

on this topic I am providing it to you now.

>

>Source APTA: 08.05.99

>

> " A therapy student who is practicing in field experience must be under the

" line of sight " supervision of the professional therapist. According to

HCFA, they are not licensed or supervised to practice in an unsupervised

status. In addition, HCFA states that none

>of the minutes of therapy services provided by the students may be recorded

on the MDS as minutes of therapy received by the beneficiary. Under 42 CFR

section 413.85, Medicare recognizes the costs associated with approved

educational activities as pass through

>costs and thus SNFs are paid these amounts outside of the RUGS III payment.

These costs include salaries and fringe benefits of physical therapists who

supervise students. In FY 1997 " pass through " payments for nursing and

allied health training programs totaled

>about $250 million. "

>

>If you or your staff are not APTA members I strongly encourage you to

become members for the only way we will obtain relief from some of the

burdens of the BBA is through the actions of the APTA and it's members.

>

>

>------------------------------------------------------------------------

>

>eGroups.com home: /group/ptmanager

> - Simplifying group communications

>

>

>

>

[Guest guest]

At my facility we have always required 'line of sight' supervision of

students. That is the only way you can truly know what a student is

doing... and guide/teach them in their " education. " When I was a student,

I was thrown in to many situations that I was not comfortable, and I had no

one with me to supervise my decisions. I took care of the situation at the

time by contacting my ACCE. I really think that students are done a

disservice when they do not have appropriate supervision.

I am not implying that all facilities abuse students, however, I do know of

many that used their students as " free labor. " For those facilities I am

thankful that 'line of sight' supervision of students is required.

I do have significant trouble with the MDS minutes not being counted,

especially if the licensed therapist is providing 'line of sight'

supervision to assure that the patient is getting the quality of therapy

care they need.

My 2 cents.

Tina

Indpls, IN

APTA clarifies HCFA therapy LTC issues

> >

> > <<File: douglaswhite.vcf>>

> >

> > For those of you who are APTA members I believe the following

information

> > will be published shortly. As there has been so much concern and

> > discussion on this topic I am providing it to you now.

> >

> > Source APTA: 08.05.99

> >

> > " A therapy student who is practicing in field experience must be under

the

> > " line of sight " supervision of the professional therapist. According to

> > HCFA, they are not licensed or supervised to practice in an unsupervised

> > status. In addition, HCFA states that none

> > of the minutes of therapy services provided by the students may be

> > recorded on the MDS as minutes of therapy received by the beneficiary.

> > Under 42 CFR section 413.85, Medicare recognizes the costs associated

with

> > approved educational activities as pass through

> > costs and thus SNFs are paid these amounts outside of the RUGS III

> > payment. These costs include salaries and fringe benefits of physical

> > therapists who supervise students. In FY 1997 " pass through " payments

for

> > nursing and allied health training programs totaled

> > about $250 million. "

> >

> > If you or your staff are not APTA members I strongly encourage you to

> > become members for the only way we will obtain relief from some of the

> > burdens of the BBA is through the actions of the APTA and it's members.

> >

> >

> > ------------------------------------------------------------------------

> >

> > eGroups.com home: /group/ptmanager

> > - Simplifying group communications

> >

> >

> >

> >

>

> ------------------------------------------------------------------------

>

> eGroups.com home: /group/ptmanager

> - Simplifying group communications

>

>

>

>

>

[Guest guest]

:

The information quoted below is not an endorsement by the APTA. It is a

statement of the Rule and HCFA's interpretation of it.

GORDON JAMES wrote:

> ,

> Is APTA endorsing HCFA's clearly erroneous statement that a " therapy

> student who is practicing in field experience must be under the 'line of

> sight' supervision of the professional therapist. " ? That seems to be the

> implication of the quoted passage you provided.

> Jim Gordon

>

> Gordon, EdD, PT

> Program in Physical Therapy

> New York Medical College

> Valhalla, NY 10595

>

> FAX

> james_gordon@...

>

>

> > ----------

> > From: M. White

> > Reply To: ptmanageregroups

> > Sent: Tuesday, August 10, 1999 3:13 PM

> > To: ptmanageregroups

> > Subject: APTA clarifies HCFA therapy LTC issues

> >

> > <<File: douglaswhite.vcf>>

> >

> > For those of you who are APTA members I believe the following information

> > will be published shortly. As there has been so much concern and

> > discussion on this topic I am providing it to you now.

> >

> > Source APTA: 08.05.99

> >

> > " A therapy student who is practicing in field experience must be under the

> > " line of sight " supervision of the professional therapist. According to

> > HCFA, they are not licensed or supervised to practice in an unsupervised

> > status. In addition, HCFA states that none

> > of the minutes of therapy services provided by the students may be

> > recorded on the MDS as minutes of therapy received by the beneficiary.

> > Under 42 CFR section 413.85, Medicare recognizes the costs associated with

> > approved educational activities as pass through

> > costs and thus SNFs are paid these amounts outside of the RUGS III

> > payment. These costs include salaries and fringe benefits of physical

> > therapists who supervise students. In FY 1997 " pass through " payments for

> > nursing and allied health training programs totaled

> > about $250 million. "

> >

> > If you or your staff are not APTA members I strongly encourage you to

> > become members for the only way we will obtain relief from some of the

> > burdens of the BBA is through the actions of the APTA and it's members.

> >

> >

> > ------------------------------------------------------------------------

> >

> > eGroups.com home: /group/ptmanager

> > - Simplifying group communications

> >

> >

> >

> >

>

> ------------------------------------------------------------------------

>

> eGroups.com home: /group/ptmanager

> - Simplifying group communications

Attachment: vcard [not shown]

[Guest guest]

and Tina Rosier wrote:

> At my facility we have always required 'line of sight' supervision of

> students. That is the only way you can truly know what a student is

> doing... and guide/teach them in their " education. "

How can you ensure that they have the skills and are safe to practice

independently if they are always in line-of-sight. I feel it is vitally

important for a student that is near completion of their education to treat

patients with supervision from afar (for lack of a better description). I

believe it is my responsibility to be assured that the student is safe to be

independent today as a student, so that tomorrow the patient will be safe when

receiving treatment from that newby PT.

Attachment: vcard [not shown]

[Guest guest]

Appreciated doug white's reference to CFR 42 part 413.85 regarding payments

by Medicare for approved educaitonal activities. Problem is...413.85(d)

describes " ..activities not within the scope of this principle. " . Included

is clinical training of students not enrolled in an approved education

program operated by the provider;. Customarily vague, but where does this

leave the institution?

Would appreciate any clarification.

Ken Amsler

south college

APTA clarifies HCFA therapy LTC issues

>> >

>> > <<File: douglaswhite.vcf>>

>> >

>> > For those of you who are APTA members I believe the following

information

>> > will be published shortly. As there has been so much concern and

>> > discussion on this topic I am providing it to you now.

>> >

>> > Source APTA: 08.05.99

>> >

>> > " A therapy student who is practicing in field experience must be under

the

>> > " line of sight " supervision of the professional therapist. According to

>> > HCFA, they are not licensed or supervised to practice in an

unsupervised

>> > status. In addition, HCFA states that none

>> > of the minutes of therapy services provided by the students may be

>> > recorded on the MDS as minutes of therapy received by the beneficiary.

>> > Under 42 CFR section 413.85, Medicare recognizes the costs associated

with

>> > approved educational activities as pass through

>> > costs and thus SNFs are paid these amounts outside of the RUGS III

>> > payment. These costs include salaries and fringe benefits of physical

>> > therapists who supervise students. In FY 1997 " pass through " payments

for

>> > nursing and allied health training programs totaled

>> > about $250 million. "

>> >

>> > If you or your staff are not APTA members I strongly encourage you to

>> > become members for the only way we will obtain relief from some of the

>> > burdens of the BBA is through the actions of the APTA and it's members.

>> >

>> >

>>

> ------------------------------------------------------------------------

>> >

>> > eGroups.com home: /group/ptmanager

>> > - Simplifying group communications

>> >

>> >

>> >

>> >

>>

>> ------------------------------------------------------------------------

>>

>> eGroups.com home: /group/ptmanager

>> - Simplifying group communications

>

>

>------------------------------------------------------------------------

>

>eGroups.com home: /group/ptmanager

> - Simplifying group communications

>

>

>

>

[Guest guest]

" I feel it is vitally

important for a student that is near completion of their education to treat

patients with supervision from afar (for lack of a better description). "

I feel that you can supervise/observe from afar and still be in the 'line of

sight'... same room... of the student. I do not advocate sending a student

to another floor to do a treatment without supervision. In that instance

you can only take the student's word for what happens... if something were

to happen. The licensed PT is ultimately responsible for every action a

student makes. I myself would want to be present... and available... if

something were to happen and that student needed me immediately... it would

be my license on the line.

Again, I think you can give autonomy and still be in the 'line of sight' for

the student's sake.

Tina

Indpls, IN

Re: APTA clarifies HCFA therapy LTC issues

>

>

> and Tina Rosier wrote:

>

> > At my facility we have always required 'line of sight' supervision of

> > students. That is the only way you can truly know what a student is

> > doing... and guide/teach them in their " education. "

>

> How can you ensure that they have the skills and are safe to practice

> independently if they are always in line-of-sight. I feel it is vitally

> important for a student that is near completion of their education to

treat

> patients with supervision from afar (for lack of a better description). I

> believe it is my responsibility to be assured that the student is safe to

be

> independent today as a student, so that tomorrow the patient will be safe

when

> receiving treatment from that newby PT.

>

>

> ------------------------------------------------------------------------

>

> eGroups.com home: /group/ptmanager

> - Simplifying group communications

>

>

>

>