Unrealistic productivity standards. 93% for PTA/COTA and 85% for PT/OT. This works out to 35 minutes in an 8 hour day for a PTA. 35 minutes per day to transport patients to and from their rooms, do documentation, communicate with nursing or social work, family meetings, and the hundred other things that therapists have to do every day that aren't billable.
The iPad rules our world. There are dozens of regulations regarding the iPad. Must see a patient within 10 minutes of punching in. Must be 2-5 minutes between each patient. Don't use the same cpt codes daily. Actual treatment minutes should not end in a 0 or 5. Treatment must be at most 5 minutes under or 15 minutes over what the planned treatment is that day, otherwise must justify why the minutes are different due to medical necessity. Data entry must be within 5 minutes of actual time. There has been no evidence presented that these measures improve quality of care for the patients. The productivity standards and the made up iPad regulations lead to fraud.
Over scheduling. I have been scheduled between 8.75 and 10.75 hours of treatment per supposed 8 hour day for the last 3 months. We are supposed to do group/concurrent treatment in order to do more treatment than there are hours in the day. The company preaches that point of service provides the best quality of care. Then, they schedule us so heavily that we cannot do point of service care. That is a clear, direct admission that quality of care is not the priority. The company has us do whatever sort of treatment makes them the most money, and then makes up some story as to how that benefits the patient. When our census is low, we are expected to leave early.
Management undermines clinical decision making. We are pushed to treat patients for as many minutes as possible, whether that benefits the patient or not. Evaluating therapists are expected to place patients on program regardless of necessity. If a therapist does an eval, and finds that the patient would not benefit from therapy at this time, management will have the patient evaluated again and again by different therapists until someone picks them up.
Essentially, all the company regulations make providing good therapy difficult. It is still possible, but the company is fighting against you instead of working with you to benefit patients.
