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Life of a PTA

Working Christmas Day

Published December 20, 2013 4:33 PM by Allison Young

About a month before Christmas, I formally requested the day off, which is standard protocol for the large, corporate-run, skilled nursing facility where I work. The "request" was in writing, detailing dates and "vacation days" remaining in my yearly benefits. I also verbally discussed taking the day off with my rehab director and his assistant. In the end I received a weak, "we'll see what we can do" response. This was not what I was hoping to hear, in light of such advanced notice.

To be honest, I was feeling stressed and a little entitled. I'd just worked Thanksgiving and celebrated the holiday without my kids, as they were with their father and his family. I was looking forward to them spending Christmas with me, in accordance with our separation agreement, and I wanted to enjoy the whole day together. And, hey -- I just worked Thanksgiving!

As we all know, there are many differences between inpatient and outpatient PT, which fellow ADVANCE blogger Michael discussed this week. Frankly, the two have complete different skill sets and schedules. A hospital never closes, after all. Although I love working in a SNF, working holidays and rotating weekends can be depressing -- especially when my outpatient PT friends are enjoying three-day weekends on Labor Day. With that said, holiday pay is extremely helpful and welcome when the 4th of July falls on a Wednesday. Anyway, a few weeks went by and I found myself hovering around the PT work-schedule calendar posted in the rehab office. My name was still on for December 25th without even a possible question mark (which is what usually happens when they need a PRN therapist to fill a shift).

Finally, my boss dropped the bad news in my lap one evening as I was leaving for the day. He sympathetically explained that as one of the three full-time PTAs, it would be necessary for me to work that day -- despite my one-month advance request. The newly hired PT was off that day, per her contractual agreement. I was completely bummed, for lack of a better description. I went home and immediately started "Operation Plan B Christmas." It involved relatives babysitting my kids in the morning and arriving home for takeout Christmas dinner.

After stewing over the bad news (all week), I came to a few realizations. I'm not the only person working on Christmas and I'm lucky to have this job at all. More importantly, my patients will also be away from their homes and working as well, with me in therapy. Perhaps going to work and making a difficult situation a little more tolerable for someone else is the whole point of Christmas. Having finally made peace with my modified holiday, the rehab director announced a week later that he made the executive decision to close the gym for Christmas anyway. I was thrilled of course (if not initially confused) and grateful for the gift of time I can spend with my family. But there was a bit of regret I wouldn't be there for my patients on that day. This will be the last Christmas I take for granted, for a long time.

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On certain holidays the therapy gym should be closed.  This should be at the discretion of the DOR.

And Julie, Medicare has no holidays. Not sure why that is still being said after all these years.  If an ARD falls on the 25th of December do you honestly think the government is going to simply skip that day?  What we do is ensure the patients have enough minutes and time between disciplines and then take the day off.  

Think of it like running the gym for 6 days a week, if an ARD falls on the 7th day does it still count or is it skipped and no RUG levels are allowed on that day because the gym is closed?

Karen B December 21, 2013 12:37 PM

The idea that Christmas is a Medicare holiday is, unfortunately, an urban legend.  It counts towards the ARD and affects the RUG just like any other day.


Ann Taylor, PT December 21, 2013 11:54 AM
Spokane WA

I also work in SNF and although the facility would like me to work Christmas we are not! As part of our contract we have "choice time" which is PTO that we accrue based on the hours we work. If we give at least 3 weeks notice ( time to find per dem help) we should have it off! We earned it and it's not called "choice time" for nothing !

Besides, Christmas is a Medicare Holiday -so ARD days and RUG levels aren't required that day.

I have been doing this for 11 years and not very many people want to do PT on Christmas !

Julie Cortez, Physical Therapy - PTA, Centennial December 20, 2013 5:47 PM
Portland OR

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