Ron,
I have never heard of this type of payment system but it doesn't surprise me. I have heard of, in an adult day care setting (CORF), a therapist being paid a percentage of each billable unit depending upon how many treatment units (and of course, some types of treatment are reimbursed at a higher rate than others) as a contract therapist. The contract therapist is also responsible for filing state and federal taxes independently.
I do see the ethical dilemma, but health care is money driven. What are the first words asked of all of us when we seek medical help......."Do you have insurance?"
I work in a SNF/subacute rehab/LTC setting in which therapists are expected to be at a 75% productivy level and COTA's/PTA's at 80%. Is this realistic under PPS? Not in the facility where I am working. Carol
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