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  • Rural Therapy

    I just returned from a trip out to the Midwest visiting family. They live in a small town with a population of around 4,000 people. Towns out there are miles apart, and the closest city for major shopping is almost an hour away. That got me thinking about my first job as a COTA, driving around rural Missouri providing therapy in small hospitals, ...
    Posted to COTA Thoughts (Weblog) on September 8, 2013
  • Things to Know About the Affordable Care Act

    October 1st is the official sign up start for the Affordable Care Act (ACA), otherwise known as Obamacare. There are some things you will need to know before that time, especially if you purchase your own medical insurance. If you have medical insurance provided through your workplace, not much will affect you immediately. However future ...
    Posted to COTA Thoughts (Weblog) on August 30, 2013
  • Doctors Opting Out of Medicare

    Hello Readers. Sorry I've been gone for a while. From now on I will be posting a new blog every Friday. More rules and smaller reimbursement rates lead to frustrated doctors who have begun to opt out of participation with Medicare. The number of doctors deciding to not participate has tripled in the last three years. At the same time, some ...
    Posted to COTA Thoughts (Weblog) on August 11, 2013
  • Crafts and Activities in OT

      Something that was really missed from my early days in OT is the use of crafts. My schooling included two semesters of Media, which entailed all forms of craft making related to specific diagnoses. These days with tight budgets there are very few craft activities used in OT treatment.   Going back to the early days of OT, crafts ...
    Posted to COTA Thoughts (Weblog) on June 7, 2013
  • Healthcare Fraud and Abuse

      News of fraud and abuse in our healthcare system appears frequently these days. Between scams, double billing and code jamming many dollars are illegally claimed from the system. Whether it be from Medicare, Medicaid or an insurance company, one thing is certain, the honest consumers pay for it.   Just recently the Medicare Fraud ...
    Posted to COTA Thoughts (Weblog) on May 31, 2013
  • It's All About the (Money) Minutes

      It was another day of treating low level patients for high minutes. This really makes me miss one of my old supervisors who stood his ground against management, allowing the therapy team to determine minutes. Completing nearly an hour of treatment with a person who is either barely responsive or has severe memory deficits is a challenge, ...
    Posted to COTA Thoughts (Weblog) on April 13, 2013
  • Caseload Craziness

      So at work this week one of my schedules had five patients on it. Four of these were in the facilities locked unit, meaning their major diagnosis was Alzheimer's or dementia. Three of the four refused to do any therapy without a lot of coaxing and encouragement. Spending the time to talk them into doing any therapy wasted so much time ...
    Posted to COTA Thoughts (Weblog) on March 27, 2013
  • Survey Time

      How do things go in your LTC building when the state survey team walks in the door for their annual visit? I tend to find that projects get started, more staff is visible, and the pace picks up.   Of course the home is aware of when the survey will happen, which I believe is a three month window. In many places I've worked it ...
    Posted to COTA Thoughts (Weblog) on March 21, 2013
  • Hygiene in the Clinic

     At work today another staff member cautioned me to wash my hands often, as there seemed to be a bug in the building. Back in school I remember the importance that was stressed with proper hand washing techniques, before and after treatment with each patient, before and after eating, and after any ADL's. As a teacher I remember teaching the ...
    Posted to COTA Thoughts (Weblog) on March 5, 2013
  • Tight Spaces

      How big is your rehab gym? Is it big enough to hold all the walkers, wheelchairs, parallel bars and other equipment needed in the gym? Are you able to comfortably seat 20% of the therapy caseload in the gym at the same time without having to jump over objects or step on toes?   Over the years I have found that the size of the gym ...
    Posted to COTA Thoughts (Weblog) on February 16, 2013
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