As a provider of physical therapy services, I'm often asked about information not related to my position. Questions regarding insurance coverage, co-pays, length of stay etc. are all technically outside my expertise as a PTA. I could answer these questions, and more, but often choose not to and defer them to another department or to a supervisor.
This brings me into a gray area regarding participation with therapy services. Who is responsible to educate and ensure the patient will actively work with therapy? My argument is that I provide the service but do not coerce or beg the patient to work with me. I might educate the patient on the benefits of therapy but cannot force the patient to work despite needing another 30 minutes to reach the RU level of reimbursement. The MDS provider may not agree, but therapy, like any other prescription, can be refused by the patient at any time.
Patient participation is not necessarily my problem or responsibility. It is a facility's problem when a patient doesn't want to do therapy. What does the facility do when a patient refuses his medication? Does the facility run to the manufacturer of the medication and demand they get the patient to take it? No, they simply write an "R" for "refused" in the medication chart and move on. But with therapy, a facility will quietly demand we get the minutes or there will be heck to pay for weeks and months to come. This is insane.
Soon the facilities will be demanding that therapy collect co-pays and give us a coin purse to carry around because they're having a hard time with collections. When will we step back and stand up and allow another person's difficulty to become his problem and not ours? If a facility wants RUs on patients, it can be more selective with admissions. The admission clerk can also educate the patient regarding therapy and the need to participate every day. I have yet to hear an MDS nurse or an admissions clerk educate a patient regarding RUG levels and reimbursement rates in relation to therapy participation. When that happens, I'll make the facility's problems my responsibility.