Hello Barb: I know it's hard to NOT thing's personally, but please keep in mind that comments are NOT generally directed to any one person. Instead, we tend to talk in generalities that may or may not apply to a particular person.
On this list, I think it's important that two things happen: 1. Everyone is honest 2. Everyone is open to new ideas Having said this, I understand how and why you might be offended but please don't let mine or anyone else's negativity adversely affect what you do. Take what I and other's say with "the grain of salt". I strongly believe that the PROFESSION of OT needs to wake up and get its head out of the sand. I am constantly being negative, because I think that's about the only way to raise awareness. And without awareness, there will never be any change! Thanks for sharing your honest opinion!!!!!!! Ron -- Ron Carson MHS, OT ----- Original Message ----- From: [EMAIL PROTECTED] <[EMAIL PROTECTED]> Sent: Thursday, December 04, 2008 To: OTlist@OTnow.com <OTlist@OTnow.com> Subj: [OTlist] Arrgh! SNF OTs on the hot seat! bcn> I am a recently recertified COTA who has just started a new bcn> position working in an SNF. My prior experience was PRIOR to bcn> PPS. Whew! What a change! I whole-heartedly agree with Brent's bcn> post. I am trying my best to provide skilled treatment, but PPS bcn> and productivity standards set by the for-profit sector make that bcn> difficult. I joined this list to get more ideas about bcn> functional/meaningful activities to do with my patients, so it bcn> has been very painful to read the extremely judgemental bcn> discussion about "bad" treatment! I already feel uncomfortable bcn> with some of the choices I have to make each day. I am hoping bcn> that as I learn to juggle better, I will be able to provide a bcn> higher percentage of meaningful tx. So I would appreciate any bcn> and all concrete suggestions from those who work in a similar bcn> environment, and less of the judgement based on uninformed assumptions. bcn> Thank you. bcn> Barb Howard bcn> Grand Rapids, MI bcn> -------------- Original message -------------- bcn> From: [EMAIL PROTECTED] >> Brent, >> I believe the criticism originally came from Ron in regards to a therapist >> in a >> rehab hospital.? We?can all be?guilty of poor rehab at times no matter what >> practice setting.? I responded to warn people of potential fraud that >> therapists >> might be committing and not even realizing it. >> >> Chris Nahrwold MS, OTR >> >> >> -----Original Message----- >> From: Brent Cheyne >> To: Ron Carson >> Sent: Tue, 2 Dec 2008 6:40 pm >> Subject: Re: [OTlist] Arrgh! SNF OTs on the hot seat! >> >> >> >> ??? Some further thoughts on OT?practice in the?SNF. However critical and >> disappointed some of us who don't work in SNF feel about the pracitices of >> those >> who do, keep in mind that each practice setting has its own unique >> challenges >> and limitations. >> ??? The PPS system has the RUG system where the highest reinbursment is for >> those patient who participate in as much as 360 minutes of OT a week.. >> That's? 6 >> days of 60 minute sessions, so if a person stays for a month they receive 24 >> hours (?1440 minutes) of OT in a month. And this process is multiplied >> got?each >> OT practitioner?by a caseload (lets say for average) 7 patients per >> day.?Each >> minute of each session is structured and guided by the therapist while >> navigating a complex system of all the other therapies, nursing care, and >> scheduling taking place?within the facility. >> ??? This means there is a lot of therapy? being provided and?therefore a lot >> of >> designing and implementing and documenting interventions. Making every? >> minute >> of every session wonderful, meaningful, enjoyable, and occupational is quite >> a >> challenge. I venture to predict that rehab professional in SNF spend more >> time >> with their clients than any other professionals in the whole healthcare >> system! >> Other posts on this list have also observed that the SNF rehab client is not >> always the most motivated of clients either and clients are often unable to >> identify meaningful occupations on which to base treatments. >> ???? Due to reasons explained previously in my other recent post, and the >> factors above, some patients might have incidences of "bad OT".? Given the >> shear >> abount of time spent in treatment, the odds of having some non-meaningful?or >> bad >> experiences are? pretty high. >> ???? I think any of us can identify unsatisfactory experiences with >> healthcare >> and other professionals on occasion. I personally have had?occasional >> frustration and disappointment?at the dentist, doctor, optometrist, or even >> with >> the waiter at a restaurant. I think on average there are a lot of hard >> working >> OTs >> in SNF doing a great job! Of course we always hear about the worst and best >> therapy experiences that people have. >> ? While all the criticism, judgement and discussion ongoing in the OT >> community >> may be necessary to encourage us to focus on occupation, there is no >> shortage of >> equal scrutiny by our administrations and regulators who have there own >> definition of what expected and required of OTs. Keeping everyone satisfied >> in >> no easy task and I think "bad OT "is more a function of being overwhelmed >> than >> being lazy. Let us find a way to support and encourage eachother! >> Brent C >> >> >> >> -- >> Options? >> www.otnow.com/mailman/options/otlist_otnow.com >> >> Archive? >> www.mail-archive.com/otlist@otnow.com >> >> -- >> Options? >> www.otnow.com/mailman/options/otlist_otnow.com >> >> Archive? >> www.mail-archive.com/otlist@otnow.com bcn> -- bcn> Options? bcn> www.otnow.com/mailman/options/otlist_otnow.com bcn> Archive? bcn> www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
