Physical Rehabilitation Therapy

RRM Category: AMBULATORY CLINICS

Overview

The RRM module estimates the number of staff for physical therapy services using physical therapy visits (PTV) Occupational Therapy (OT) using Occupational Therapy visits and Speech Language Pathology (SLP) using Speech Lanquage Pathology Visits. The physical therapy department staff includes licensed physical therapists (PT), licensed physical therapist assistants (LPTA), physical therapy assistants/aides (PT Aides) and rehabilitation clerical staff. The basic staff includes the department supervisor and clerical/aide support. Additional staff is justified based on physical therapy visit volume. Physical therapy can provide both inpatient and outpatient services depending on the health care facility. Occupational Therapy staff includes Occupational Therapist, Occupational Therapy Supervisor and Occupational Therapy Tech. The Speech Language Pathology department includes Speech Language Pathologist and Speech Language Therapy Supervisor.

Services Description:

Physical therapy provides examination, evaluation, diagnosis, prognosis, intervention, and care management for a wide variety of physical conditions including musculoskeletal, neuromuscular, cardiovascular/pulmonary, and integumentary. Care is provided by physical therapists or may be provided by assistants and aides under the direction of a physical therapist. Physical therapists interact and collaborate with a variety of professionals; as well as directly with patients to address risk factors, provide consultation, education, manage and conduct specialty clinics, perform department supervision and general administration. Physical therapy serves a major role in primary care, secondary and tertiary care as well as in prevention and the promotion of health, wellness and fitness.

Physical therapy interventions include:

Therapeutic exercise
Balance and gait training
Physical agents and mechanical modalities
Electrotherapeutic modalities
Wound care including sharp debridement
Orthotic prescription, fabrication and prosthetic management
EMG and nerve velocity conduction studies
Manual therapy techniques including mobilization/manipulation
Airway clearance techniques for management of chronic pulmonary conditions
Functional Activity Training
Patient and family education
Pulmonary Function Tests/Spirometry

Occupational Therapy (OT) is the therapeutic use of everyday life activities, also known as occupations or activities of daily living, to increase or improve an individual’s participation in roles and situations in home, school, workplace, community, and leisure settings. OT provides evaluation, diagnosis, rehabilitation/intervention, and care management for the physical, cognitive, psychosocial, and/or sensory aspects of human performance.

Speech-Language Pathology (SLP) is the use of evaluation and diagnostic tools, which facilitate selecting the most valid rehabilitative techniques for the management of speech, language, cognitive-communication, and swallowing or other upper aerodigestive disorders. SLP restores, maintains and promotes the communication and swallowing-related demands affecting the individual's quality of life, and optimizes the individual's abilities to perform social, academic, and vocational activities.

Staffing Criteria

Physical Therapy Departments will be considered when a minimum of 1000 Physical Therapy Visits (PTV) are projected for a user population. Physical Therapy staff for populations which produce less than 1000 PTV will be allocated to a pool of professional staff which is used at the discretion of the facilities leadership to purchase appropriate services.

Outpatient:
Physical Therapist staff of 1.0 FTE per department plus 1.0 FTE Physical Therapist or Licensed Physical Therapist Assistant for every 1790 OP PTV above 900 PTV

Occupational Therapist staff of 1.0 FTE per department plus .36 FTE Occupational Therapist for every 1790 OTV above 1253.

Speech Language Pathology staff of 1.0 FTE per department plus 1.0 FTE Speech Language Pathologist for every 1790 SLPV above 1253.

Rehab Clerk/Physical Therapy Aide staff of 1.0 FTE per department plus 0.36 Physical Therapy Aide for every 1790 PTV above 900 PTV.

Example:

For additional PT/LPTA staff: Projected PTV minus 900 PTV divided by 1790 PTV = additional PT/LPTA
For additional PT Aide staff: Projected PTV minus 900 PTV divided by 1790 PTV multiplied by 0.36 = Additional PT Aides

Inpatient:
Additional staff to cover the inpatient volume will be determined by the staff formulas described above with the addition of Inpatient PTV (IP PTV, OTV and SLPV). IP PTV will be calculated per average daily patient load (ADPL). The IP PTV, OTV and SLPV will be added to the outpatient PTV (OP PTV) obtained from the above formula. The HSP generated total will be the Projected PTV for the physical rehabilitation therapy department.

Example:

OP PTV minus 900 PTV plus IP PTV divided by 1790 PTV = additional PT/LPTA FTE
OP PTV minus 900 PTV plus IP PTV divided by 1790 PTV times 0.36 = additional PT Aide FTE

Staffing Formulae

Driving Variables:

Department
Outpatient PTV
Inpatient PTV
Occupational Therapy Visits
Speech Language Pathology Visits

Minimum Staffing Levels (fixed):

Personal Category	FTEs	per	Driving Variables	Min.	Max.
Supervisor Physical Therapy	1.0	Department	PTV	1000	n/a
Physical Therapy Aide/Clerk	1.0	Department	PTV	1000	n/a
Occupational Therapy Supervisor	1.0	Department	OTV	1253
Occupational Therapy Tech	1.0	Department	OTV	1000
Speech Language Pathology Supervisor	1.0	Department	SLPV	1253
Rehab Clerk	1.0	Department		1000

Variable Staffing Levels:

Personal Category	FTEs	per	Driving Variables	Min.
Physical Therapist	1.0	1790	PTV less 900	1000
Licensed Physical Therapy Assistant	1.0	1790	PTV less 900	1000
Physical Therapy Aide	0.36	1790	PTV less 900	1000
Occupational Therapist	1.0	1790	OT Visits	1253
Speech Language Pathology Therapist	1.0	1790	SLP Visits	1253