question

The code of ethics will be on the exam

answer

sorry for this, but you need to review them

question

Beneficence

answer

concern for safety and wellbeing a.)respond to referral in timely manner b.provide appropriate eval and plan of interventino c.)reeval and assess- d.) avoid innapropriate use of tests/assessments e.)perform within competent level g.) continuing ed in short, be a good person, and a good OT

question

Nonmaleficince

answer

refrain from actions causing harm -abandon,avoid cause harm, exploirtation, sex, remedy personal problems -avoid undue influences -professional boundaries --compromising clients rights or well being - based on adminsitrative needs -autonomy and confidentiality -consent -respect the right to refuse questions that have non-maleficience as the right answer pose a scenario like "administration needs you to work with this client because census is low and they need units. but after evaluation you've noticed that the client is not a good candidate and their desires are only for rest and relaxation."

question

Social justice

answer

common good educate the public advocate for fair justice of all patients pro bono aka.. anything in the exam that has group related factors, it may be social justice

question

procedural justice

answer

rules... local, state, federal and international laws code of ethics seek to understand and abide by instutional rules AOTA laws and policies hold appropriate credentials think lawyer on this one. its the law, do the right task and its relation to whats in the books.

question

veracity

answer

accuracy!! record and report in accurate manner

question

fidelity

answer

treating colleagues and other professionals with respect, fariness, discretion, and integrity -preserve, respect and safeguard private information take adequate measures to discourage, prevent, expose and breaches of the code of ethics -

question

ethical distress

answer

therapist knows the correct action- but an existing barrier prevents from taking the course action.

question

ethical dilemmas

answer

two or more potentially morally correct ways to solve a problem.

question

do you have to report abuse or neglect?

answer

yes

question

the NBCOT

answer

certies OTRS and COTAS- written exam. maintains them through voluntary cert program

question

SRB's

answer

state body- created by legislature to make sure patients are seen by certified and credentialed practicioners -the people who issue a license, are the state require the license verification from NBCOT. but the NBCOT does not govern you. the SRB does they communicate, but are not the same entity. =

question

the various actions that can be taken if you mess up

answer

1.) reprimand: private communication of agencys dispproval 2.)censure: public statement of agency's disapproval 3.)ineligability: remove membership, cert or license 4.)probation: make the clinician undergo certain conditions to retain membership 5.)suspension: lose your license for a period of time 6.) revoke license

question

OT aide non-skilled jobs

answer

Transportation prepare clnic area contact guard during transfers (really?) ONLY IF... anticipated result of task is known clearly established no adatpationm judgement patient has been seen previously aide has been trained

question

below are the various methods of supervision

answer

..

question

direct

answer

face to face contact between supervisor and supervisee co treatment, observation, instruction, modeling and discussion

question

indirect method of supervision

answer

electronic, written and telephone communications

question

Close supervision

answer

daily, direct contact at the site of work

question

Routine supervisions

answer

direct contact at least every two weeks at the site of work, interim sueprvision occuring by other methods such as telephone or written communication

question

general supervision

answer

at least monthly direct contact with supervision available as needed by other methods

question

mimimal

answer

only on a needed basis, and may be less than monthly

question

formal supervision can be supplemented by functional supervision

answer

provision of information and feedback to coworkers (a sharing of expertise)

question

supervision is dependent upon

answer

practicioners knowedge and skills complexities of client needs and caseload characteriscis and demands state laws, licensure requirements, and other regulatory madates practice settting type and facility procedures

question

ot aide supervision must be

answer

intermittent or continuous dependeing on the task being performed

question

intermittent supervision is good for

answer

non patient related tasks, periodic discussion, demonstration

question

continuous superivion for the aide

answer

for client related tasks OTA or OT must be within auditory or visual contact in the immediate area of the aide during the aide's task performance

question

what kind of supervision do you think a COTA needs if they are treating an actuely ill person with rapidly changing status on an inpatient unit?

answer

muchcloser than providing stable clients ina long-term care residential facility i would say close supervision

question

the following is from a table that states the type of personell and the recommended supervision

answer

...

question

entry level OT

answer

no supervision required, but close supervision by an intermediate or advanced level OT a good idea they supervise all aides, techs, OTAs, volunteers and level I students

question

intermediate level

answer

routine or general supervision by an advances level OT can have Level II students

question

advanced level OT

answer

recommended by min superivision by an advanced OT

question

entry level COTA

answer

close supervision, aides, techs, volunteers

question

intermediate level OTA

answer

routine or general supervisions by all levels

question

advanced level OTA

answer

general supervision

question

the "team"

answer

all health care professionals, the family, the patient

question

factors that influence effective team functioning

answer

skill and knowledge stability commitment to team goals good communication membership composition common language effective leadership

question

types of teams

answer

...

question

intradisciplinary

answer

one or more members of one discipline evaluate, plan, and implement Tx of the individual communication is limited. limiting persepctives "at risk" due to potential nrrowness of persepctive

question

multidisciplinary

answer

number of professionals from difference disciplines conduct assessments and interventions independent from one another -primary allegiance is to his/her discipline. some formal communications between each other lack of understanding of different persepctives ==competition develops

question

interdisciplinary

answer

all disiplines agree to collaborate eval and intervention independently greater understanding of each disiplines perspective members are working towards a common goal and not bound by discipline members work in group skills perfectly

question

transdisciplinary

answer

interdisciplinary teams are maintained and expanded upon (i guess better?) members support and enahnce activities and programs of other disciplines -commited to ongoing communication, collaboration and shared decision making evals and internventions are planned cooperatively, yet one member takes on multiple responsibilities

question

bottom line

answer

multi disciplinary works best in inpatient acute or sub acute rehabs-- we all have different goals but discuss how to help one another and work on areas that are best approached by each respective field something like adapting a home with each discipline, the groups are more like transdisciplinary. the lines are grey as to what person is responsible for each aspect

question

"lay team members and role responsibilities"

answer

consumer family/primary caregiver ---take into account the cultural, goals, etc

question

"paraprofessionals team members and role responsibilities"

answer

personal care assistants (PCA's/ HHA home health aides)

question

professional team members

answer

any health care profession you can think of trainers, chiro, MD, RN, NPR, job coach, PT, pTA, Optometrist...etc.

question

key components of ACA

answer

finance incentives for health care providers who integrate into inter and transdiciplinary workers patient centered medical homes-- PCMH mental/physical health via preventative, acute care and disability/chronic illness management the ACA makes health insurance compettitive. so that insurance companies have to compete with one another to keep costs low

question

The CMS

answer

develops rules and regulations pertaining to federal laws governing the medicare and medicaid programs if you bill medicare/medicaide be ready to be monitored regularly

question

facilities regulated by CMS

answer

Long-term settings-SNFS- medicare /medicaide pays for most if not all fee for service?

question

medicaide

answer

poor, children and pregnant women

question

OSHA

answer

safety and standards --U.S department of labo structural standards and building codes handling infectious materia;s, blood products, controlling blood borne pathogens, operating machinery and handling hazardous substances

question

to obtain accrediation for a health care facility

answer

state and local or county regulations must be followed

question

accredidation for facilities

answer

often voluntary... --JCAHO, CARF, all of these bodies who observe your notes and billing come in annually

question

beneficiary

answer

a person receiving services for SNF- the term resident is used

question

capitation

answer

provider is paid prospectively (monthly basis) a set fee for each member. the healthier the enrollees, the more the provider retains of the total PMPM Per Member Per MOnth fee

question

co-insurance

answer

monetary amount to be paid by a patient, usually expressed as a percentage of total charge

question

clinical/critical pathway

answer

standardized recomended intervention protocol for a specific diagnoses this sounds like a protocol. example: hand protocol has specific interventions for month s/p injury

question

deductible

answer

amount a patient must pay to a provider before the insurance benefits will pay

question

DRGS

answer

diagnostic related groups- CMS determins how much payment at a per case rate

question

fee for service

answer

provider is paid the same type of rate per unit of service, payer pays 80%, the patient pays 20%. this percentage is nice, its a silver plan. bronze plans are more like 70/30 or 60/40

question

health insurance marketplace

answer

ACA to allow consumers to compare the cost of insurance plans in their area---

question

HMO

answer

managed care-- can only see doctors in HMO obtain referrals before seeking specialty or ancillary care

question

managed care

answer

some control over costs and utilization of services. MCOs include HMO and PPO a general umbrella term for HMO and PPO

question

PPO

answer

greater choice of providers, however, percentage of payment from insurance decreases

question

procedure codes

answer

describe specific services (ICD 10)

question

providers

answer

the people delivering the services bill medicare, HMOS and PPOS for services rendered

question

third party payers

answer

agencies and companies who are the primary reimbursers for health care in the U.S (e.g Blue cross HMO and PPOs are also third party payers

question

TAR

answer

treatment authorization reques medicade form for a primary care provider. they must request this form

question

UCR

answer

usual and customary rate average cost of speicifc health care procedure in area maximum amount the insurer will pay for a service and covered expense

question

medicare

answer

largest single payer for OT services administered by CMS

question

who is eligable for medicare?

answer

65 or older all ages with end stage renal disease long term disability- ALS, MS who have received disability benefits for 24 months may be eligable

question

Medicare Part A

answer

pays for inpatient hospital, SNF, Home health, rehabiltiation facilities and hospice care

question

DRGS

answer

per case rate covers all services fixed dollar amount for patient care regardless of length of stay LOS or number of services provided adaptive equipment

question

medicare part B

answer

pays for hospital outpatient physician and other professional services including OT services provided by independent practicioners supplemental and must be purchased by the beneficiary require 20 percent co-payment

question

criteria for OT services

answer

doc prescription licensed OT and OTA reasonable and necessary no diagnostic restrictions ot must result in , practical improvement in the persons level of functioning in reasonable amount of time

question

OT in SNFS is covered if...

answer

patient requires rehab minimum 5 days a week

question

according to this book. the primary difference between A and B

answer

the frequency in which the individual receives services in patient A requires services for 5 days a week B covers 3 days per week? i thought main difference was inpatient v outpatient

question

ot in home care (billed via med A) is covered if individual is

answer

home bound and need intermittent skilled nursing care PT, ST or nursing begin.. OT can come out if they refer us the person has to be confined to the house. anything other than medical or religious is automatic D/C

question

Home health agencies are payed underneath what type of payment system

answer

PPS- the prospective payment agency DME is excluded from HHA PPS Home Health resource groups (HHRGS) to determine an episode payment rate episode is something like 60 days OASIS MUST BE USED WITH THIS MODEL.

question

OT goals for hospice

answer

maintain functional skills. ADLS symptom control

question

Medicaide

answer

income below established threshold --at least half of their funding is from the federal government ==

question

switching to documentation

answer

...

question

in the federal world, do OTs have to co-sign OTA notes?

answer

no. in the state of NJ they do!

question

structure of goal statement (all of the things that need to be in the goal)

answer

1)person (client) who will perform 2) desired functional behavior 3) underlying factors (performance component) 4) the circumstances under which the behavior must be performed 5) degree to which behavior (so measurable data) 3 out of 4 times or level of assistance

question

SMART goal written rule

answer

Specific "develop ability to button shirt using non-dominant hand" Measurable -- number of times. percentage of success attainable- realistically achieve relevant- to roles and expected environment time- limited, anticipated time to achieve goals--- if they have 60 days to work on goal then write 60 days. if its a hospital and you don't know. write by discharge

question

switching to legislation related to disabilities...

answer

...

question

SSI (disability income)

answer

SSI- a monthly income to enable them to live in the community --its a long process to get. and once they have a job or an income they lose it. and it takes time to get back again if their job does not work out

question

Fair housing act

answer

-prohibits discriminatino on the bases of disability, religion, sex, color, race, national origin and familial status --this also makes landlords adhere to accomodations to the house to make them more handicap accessible

question

OBRA- omnibus budget reconciliation act of 1981

answer

no discrimination in all kinds of federally funded programs ---medicadie financing for community based services for people with IDD

question

ADA

answer

discrimination against qualified persons with disabilities in employment, transpo, accomodations, telecommunications and public services

question

Title 1 employment

answer

employers cant discriminate against disabilities

question

title II public services

answer

state and local governments cannot discriminate

question

title III

answer

public accomodations and services operated by public entities hospitals, health care providers, offices, schools, day care centers, may not discriminate

question

IDEA

answer

inidividuals with disabilities education improvement act

question

The following are all of the settings.. and a little info you should know about them

answer

...

question

acute care

answer

medical or psych. CANNOT BE TREATED ON AN OUTPATIENT BASIS 1) initial onset -LOS is 1-7 days on average --longer LOS requires significant documentation quick and accurate screening-- major diffictulies --big thing here is discharge planning and after-care referrals --- know the vitals and medical stability

question

sub acute

answer

progressed from acute stage but not stabilizied enough to go outpatient LOS- 5-30 dAYS --more in depth than acute care --sub acutes can be found in hospitals or SNFS

question

LTAC

answer

long term acute care hospital chronic or catastrophic illnesses multiple Dx with major complications LOS is 25+ palliateive care-- prevention and treatment of complications --(positioning to prevent descubiti and contractures ---

question

rehab hospitals

answer

medicall stable but has residual functional deficits requiring skilled services LOS from a week to months documentation requiring LOS are dependent on institue, state, and thir party payer LOS ends when coverage is expended OT eval is most extensive

question

long term hospitals

answer

LOS month to years LOS in private long term hospitals is determined by insurance coverage OT eval is extensive

question

SNF

answer

chronic injury but needs skilled care aka medical care and rehab 1 month to an individuals lifetime

question

forensic settings

answer

psychiatric illnesses sexual predators, etc

question

community based practice settings

answer

...

question

early intervention programs

answer

at risk toddler birth complications delays in development failure to thrive maternal substance abuse during pregnancy birth to an adolescent/teen mother established diabilitiy/dx 33% delay in one area or 25% in 2 areas

question

supported education programs

answer

secondary/post-secondary education --psychiatric or mental health problem --

question

prevocational programs

answer

skills required for jobs and how they can be acquired attitude, social skills, aptitude tests

question

vocational

answer

specific work skills required for a job

question

developing your own therapeutic program

answer

directly meet needs of specific group/and or population -ex. outpatient cardiac rehabilitation. gives medicare and other payers a clear picture of the rehabilitation model you are using

question

four basic steps to program development

answer

1) describe the community 2) decribe the population you want to work with a.) the disorders, b) functional levels c) presenting problems 3) specific needs of target population a) physician needs for the population, felt needs as stated by the individual, 4) the whole intervention process aka. Mary's project

question

fiscal management

answer

basic terms... dont memorize just be familiar with

question

major fiscal management tasks

answer

develop revenue and vollume projectsion cost-effective charging procedures and fee structures manage payroll and staffing budgets

question

budget terms and concepts

answer

specific time period, costs of managing a program and anticipated revenue RATE OF RETURN a manager will look at how much it is to fund 4 therapy salaries, the cost of overhead and how much he/she can receive in return. (how many units he can pump out of the facility)

question

Capital expense budget

answer

permanent or long term purchases cuh as an ADL kitchen or for new facilities, such as new wing for a work hardening program anything over 500 dollars is considered a capital expense

question

operating expense budgets

answer

daily financial activity of a program or service --direct expenses-- therapy salaries, sick time, benefits indirect expenses include costs shared by the setting as a whole such as uitlities, housekeeping, and marketing

question

Full- time equivalent

answer

amount of hours a full time staff employee works, in the U.S 8hours a day, 5 days a week.

question

productivity standards

answer

established amount of direct care and reimbursable services each therapist is to provide per day managed care pressures have constantly increased

question

break even analysis

answer

volume of services needed to be provided for revenues to equal cost and profits to equal 0

question

accounts payable

answer

debts within a budget indicates payments that are due for purchases

question

accounts receivable

answer

the assets within a budget indicates payments that are owed to the program

question

true experimental

answer

classic two-group esign which includes random selection and assignment into an experimental group that receives treatment or control group that receives no treatment cause and effect. the gold standard of research very very hard to pull off

question

quasi-experimental

answer

independent variable- dependent- its effect on them BUT lesser degree over control group and or no randomization often used in health care because it is often unethical to withold interventions from a group of individuals

question

non-experimental/correlational

answer

no manipulation of independent variable, rnadomization and researcher control are not psosible study the potential relationships between two or more existing variables (attendeance at a day proram and social interaction skills) describe relationships, predicts relationships among variables without active manipulation of the variables NO cause and effect fails to consider all varaiables that enter into a relationship relationship is often expressed as correlational coefficient, ranging from -1.00 to +1.00

question

qualitative methodology/design types

answer

descriptive research, studies people, indiv or collectively, in their natural social and cultural context

Therapy Ed Nbcot Prep Chapter 4. (rita P. – Flashcards

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