Productivity pressures

This is a discussion for practicing OTs & COTAs. Please don't bash this post because it has negative issues related to OT. I want to know how the honest working practitioners out there cope with the billing game. I come so close to leaving the SNF area so may times, but at the end of the day I'm not sure where the grass might be greener. I despise the efficiency requirement and all that's involved with it. Every single day staff ethics are pushed. I honestly don't know how to do this job anymore and stay ethical. By ethical I mean staying within the billing guidelines for said payor source, and getting everyone seen on caseload during my scheduled time in facility. I truly don't think it can be done while maintaining your sanity /ethics/integrity. This is an issue for all disciplines in a SNF, not just OT. All comments/experiences/help is appreciated.

I agree with you. I haven't worked in SNF for a while, but all I can tell you is this - do what is ethical and right and demand to be paid for extra time for paperwork. Just remember that productivity expectations are something put there by the BUSINESS you work for. They won't care if Medicare investigates them, because they are making TONS of money. It is your license on the line. Stick to your guns.

I was a traveler working in a SNF. I told them I was an hourly employee, and they would have to pay me for my overtime. They refused, so I didn't do the paperwork. Later on they sent me the paperwork to fill out, and I replied that when they paid me my hourly rate, I'd be happy to fill it out. Never heard back from them.

Good for you Sara. Is this board mainly students? Most of the posts do seem to reflect that. Oh well, I was looking forward to hearing how others deal with these issues.

margaret1 in portland, Oregon said: This is a discussion for practicing OTs & COTAs. Please don't bash this post because it has negative issues related to OT. I want to know how the honest working practitioners out there cope with the billing game. I come so close to leaving the SNF area so may times, but at the end of the day I'm not sure where the grass might be greener. I despise the efficiency requirement and all that's involved with it. Every single day staff ethics are pushed. I honestly don't know how to do this job anymore and stay ethical. By ethical I mean staying within the billing guidelines for said payor source, and getting everyone seen on caseload during my scheduled time in facility. I truly don't think it can be done while maintaining your sanity /ethics/integrity. This is an issue for all disciplines in a SNF, not just OT. All comments/experiences/help is appreciated.

Have had numerous discussions with other PTs re: same subject. The other problem is that the type of therapy provided is subpar which is why progress is limited. It's not possible to be a supervising, evaluating therapist and maintaing 85-90% productivity. Would love to talk with the source of this business model, better yet. Let them try it and still provide quality care.