Re: PT's screening for placement in SNF

[Guest guest]

I work in an acute care hospital in NY State. We are asked to do evals on SNF

patients for two reasons 1. If pt qualifies for " restorative " PT up to the

first 100 days of their SNF stay is covered by Medicare, so everyone wants us to

" try " . 2. There is an understanding, and it depends on who talks to the fiscal

intermedaries etc. that it is " required " to have a pt seen by PT even if they

are already identified as needing permanent placement in the NH.

Our frustration comes with pts who are NH residents, not on a PT program who

come to the hospital, and the MDs just blanket order PT to keep pt " mobalized " ,

even pts who require total assist.

Katesel Strimbeck PT, MS

PT Supervisor

St. 's Hospital

Albany, NY

PT's screening for placement in SNF

At the hospital where I work we are frequently overwhelmed by

evaluations of patients who are basically accepted to SNF but the SNF

requires a PT eval prior to admission.

I would rather spend my time providing therapy for patients that

would benefit from therapy. For example, those that will be on service

for atleast a few days.

One obvious solution is have a PT order earlier in the

hospitalization. Can we also avoid doing the evaluation of patients

that have an obvious need for SNF placement, as identified by the

physician???

[Guest guest]

One other caveat to this issue is that it is often the HMO asking for

the PT eval while in hospital prior to certifying an SNF stay.

-Chris

Benfield, P.T.

Director of Rehabilitation

RiverWoods

3201 River Road

burg, PA 17837

Direct:

Main:

Fax:

email: .Benfield@...

Web: www.albrightcare.org <http://www.albrightcare.org/>

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of toddmillerto

Sent: Thursday, December 28, 2006 7:39 PM

To: PTManager

Subject: PT's screening for placement in SNF

At the hospital where I work we are frequently overwhelmed by

evaluations of patients who are basically accepted to SNF but the SNF

requires a PT eval prior to admission.

I would rather spend my time providing therapy for patients that

would benefit from therapy. For example, those that will be on service

for atleast a few days.

One obvious solution is have a PT order earlier in the

hospitalization. Can we also avoid doing the evaluation of patients

that have an obvious need for SNF placement, as identified by the

physician???

[Guest guest]

We also get a good number of PT referrals to see pt's for our

recommendations regarding subacute/acute rehab/LTAC/home d/c. We do see

this as an important part of our role as acute care therapists as we are

the most appropriate caregivers to determine a pt's safety for mobility

in any particular d/c setting and also the most appropriate caregivers

to determine immediate future rehab needs. That being said, our d/c

planners are, for the most part, very good at not requesting PT consults

from the MD's for recommendations regarding subacute placement if the PT

is already skilled for placement by some other need such as wound care,

vent care, etc as these pt's do not need a documented PT eval to qualify

for skilled placement. Over the years I'm finding that acute care

practice is becoming a blended skill set that includes a great deal of

consultation as much as actual hands on provision of therapy

interventions, especially as acute care lengths of stay continue to

decrease. I will say that often the physician's idea of what the

patient's most appropriate d/c location can be quite different from ours

as they do not often see the pt's up out of bed moving around and can

have an inaccurate impression about the pt's skills and abilities. I

take it as a great complement that our physicians have come to respect

and rely on our knowledge and input on decisions regarding safe

discharge.

Becky White, PT, CCS

Supervisor and Cardiovascular Clinical Specialist

Acute Care Team

University of Michigan Hospitals

Ann Arbor, MI

Electronic Mail is not secure, may not be read every day, and should

not be used for urgent or sensitive issues.

>>> " toddmillerto " 12/28/2006 7:39 PM >>>

At the hospital where I work we are frequently overwhelmed by

evaluations of patients who are basically accepted to SNF but the SNF

requires a PT eval prior to admission.

I would rather spend my time providing therapy for patients that

would benefit from therapy. For example, those that will be on service

for atleast a few days.

One obvious solution is have a PT order earlier in the

hospitalization. Can we also avoid doing the evaluation of patients

that have an obvious need for SNF placement, as identified by the

physician???

**********************************************************

Electronic Mail is not secure, may not be read every day, and should not be used

for urgent or sensitive issues.

[Guest guest]

From the SNF side of it, our admissions dept has discovered that they get the

most accurate picture of the pt from the PT evals. The nsg side of the

information is very scarce and usually not complete. The therapists tend to

pull everything together into one place from all areas of the hospitalized pt's

chart.

Shari France

Carolton Rehab

Fairfield,ct

Benfield wrote:

One other caveat to this issue is that it is often the HMO asking for

the PT eval while in hospital prior to certifying an SNF stay.

-Chris

Benfield, P.T.

Director of Rehabilitation

RiverWoods

3201 River Road

burg, PA 17837

Direct:

Main:

Fax:

email: .Benfield@...

Web: www.albrightcare.org <http://www.albrightcare.org/>

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of toddmillerto

Sent: Thursday, December 28, 2006 7:39 PM

To: PTManager

Subject: PT's screening for placement in SNF

At the hospital where I work we are frequently overwhelmed by

evaluations of patients who are basically accepted to SNF but the SNF

requires a PT eval prior to admission.

I would rather spend my time providing therapy for patients that

would benefit from therapy. For example, those that will be on service

for atleast a few days.

One obvious solution is have a PT order earlier in the

hospitalization. Can we also avoid doing the evaluation of patients

that have an obvious need for SNF placement, as identified by the

physician???

[Guest guest]

Also from the SNF side, we use the PT eval info from acute to assess a

residents specific needs prior to coming into the building such as DME,

finding the best possible room set up for a patients transfer status,

initiating any specific educational needs for nursing assistants, and much

more. All of the information from the screens that is gathered allows the

SNF to set up the best possible transition for the safety and comfort of

each of our residents, regardless if they are short or long term. When

receiving a patient from acute care, the SNF therapists also find the PT

eval/notes from the hospital a useful tool as it is usually the most

accurate with respect to weight bearing status, other limitations and a

patient's PLOF. Often the dictated discharge summary from the MD can be

incomplete or inaccurate.

We as a facility find a good PT assessment invaluable in the SNF as most of

our admissions come in on 3-11, and sometimes the patients that do arrive

prior to PT going home for the day do not wish to be mobilized at that

moment. The nursing staff can use the evals make the best plan for

transfers and safety with the information provided if rehab is not

available. We also can use patient comments that are documented regarding

mood state, pain and any behaviors etc. to anticipate the needs of the

patient.

Our success in accommodating the needs, safety, comfort and satisfaction of

any patient starts well before they come through the doors of a SNF, so

please consider your time spent with any patient a service that will benefit

them at some point in their illness and/or recovery.

Happy New Year!

Malloy-Salmon, PT,MHP

Director of Rehabilitation Services

The Salmon Family Of Services

1 Lyman Street

Westborough, MA 01581

kimsalmon@...

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Carolton Rehabilitation

Sent: Friday, December 29, 2006 9:56 AM

To: PTManager

Subject: RE: PT's screening for placement in SNF

From the SNF side of it, our admissions dept has discovered that they get

the most accurate picture of the pt from the PT evals. The nsg side of the

information is very scarce and usually not complete. The therapists tend to

pull everything together into one place from all areas of the hospitalized

pt's chart.

Shari France

Carolton Rehab

Fairfield,ct

Benfield <christopher.

<mailto:christopher.benfield%40albrightcare.org> benfield@...>

wrote:

One other caveat to this issue is that it is often the HMO asking for

the PT eval while in hospital prior to certifying an SNF stay.

-Chris

Benfield, P.T.

Director of Rehabilitation

RiverWoods

3201 River Road

burg, PA 17837

Direct:

Main:

Fax:

email: . <mailto:.Benfield%40Albrightcare.org>

Benfield@...

Web: www.albrightcare.org <http://www.albright

<http://www.albrightcare.org/> care.org/>

________________________________

From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

[mailto:PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com] On

Behalf Of toddmillerto

Sent: Thursday, December 28, 2006 7:39 PM

To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

Subject: PT's screening for placement in SNF

At the hospital where I work we are frequently overwhelmed by

evaluations of patients who are basically accepted to SNF but the SNF

requires a PT eval prior to admission.

I would rather spend my time providing therapy for patients that

would benefit from therapy. For example, those that will be on service

for atleast a few days.

One obvious solution is have a PT order earlier in the

hospitalization. Can we also avoid doing the evaluation of patients

that have an obvious need for SNF placement, as identified by the

physician???