Occupational Therapist Primary Function:
The Occupational Therapist evaluates and provides family oriented services to the home health patient with neurological, musculoskeletal, orthopedic, and cardio-pulmonary impairments; fine motor, sensory motor, and developmental delays; as well as traumatic injuries and swallowing disorders. This includes patient and caregiver education; discharge planning; and consultation to other professionals, clinics or agencies.
Company Expectations of the Employee:
- Adhere to all Company policies and procedures.
- Demonstrate flexible and efficient time management techniques.
- Demonstrate flexible and efficient time management techniques.
- Prioritize workload so as to meet productivity standards and applicable deadlines.
- Communicate with Company owners on a regular basis about project status and issues.
- Communicate with subordinates on a regular basis about project status and issues.
- Establish and maintain positive interpersonal relations with internal and external customers.
- Maintain a positive and respectful attitude and demeanor.
- Report to work on time and prepared to perform duties of position.
Essential Duties and Responsibilities:
- Providing initial and ongoing assessment to determine level of functioning.
- A Occupational therapist gathers background data, reviews referrals, selects and modifies evaluation tools, and evaluates patients determining the level of patient’s physical and psychosocial functioning.
- Developing and revising the plan of care in consultation with the physician and other care-team members.
- Responsible for planning, evaluation, and treatment implementation of assigned caseload.
- Preparing clinical progress notes.
- Supervising therapy assistants and home health aides as appropriate.
- Evaluating outcomes.
- Planning Discharge.
- Educate patients and/or families about proper safe use and recommend methods for installation of adaptive equipment.
- Responsibilities may also include the training of students from university or community colleges assigned.
Requirements:
Education: Currently licensed by the Tennessee Board of Occupational and Physical Therapy Examiners.
Experience: Minimum of one year in an acute care setting. Two years experience in Home Health preferred.
Skills:
- Able to maintain strict confidentiality with regard to protected and sensitive information.
- Able to establish and maintain confidence of owners and employees.
- Must be able to solve problems independently and confidently by applying analytical and logical thinking.
- Able to use standard office equipment and software proficiently.
Language Skills:
- Able to read, analyze, and interpret reports, general business directives, policy and procedure statements, and governmental regulations.
- Able to write reports and correspondence at a professional level.
- Able to immediately respond to common inquiries and complaints from employees and regulatory agencies.
- Able to effectively communicate with individuals from diverse backgrounds and varying educational levels.
- Able to effectively organize and present information and respond to questions from employees and external groups of varying sizes.
Also referred to as:
Certified Occupational Therapist (OT) Home Care
Requirements and Responsibilities
Occupational Therapist – Home Care plans and conducts individualized occupational therapy programs in a home care environment to help patients develop, regain, or maintain their ability to perform daily activities. Teaches patients skills/techniques and how to use adaptive equipment for participating in activities. Being an Occupational Therapist – Home Care studies, evaluates, and records patients’ activities and progress. Requires a bachelor’s degree. Additionally, Occupational Therapist – Home Care typically reports to a manager. Requires certification as an occupational therapist. Occupational Therapist – Home Care’s years of experience requirement may be unspecified. Certification and/or licensing in the position’s specialty is the main requirement.
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1. Stay Informed
Home health occupational therapy services take place in the context of heavy regulations and a daunting set of rules. It is your responsibility to learn and know the rules, policies and regulations that govern home health services. Be sure to bookmark the Medicare, Centers for Medicaid and Medicare Services (CMS) and AOTA websites on your computer so you can stay abreast of all the changes that affect you, your role and the clients you serve.
2. Be HIPPA-Compliant
Adhere to the HIPPA privacy rules and safeguard your client’s privacy. For example, don’t leave your notes out and in the open while you’re getting gas or grabbing food. Don’t post information or photos of your client on social media or any internet site. Make time to call your client instead of communicating via text, as you can’t be certain who is receiving your texts. In everything you do, always consider what you must do (or not do) in order to protect your client’s privacy and confidentiality.
3. Infection Control
Learn to incorporate proper bag technique. It’s worth spending some time to understand proper bag technique to protect yourself and your clients from the spread of infection.
If you’re worried about offending your clients, you can always explain your rationale during setup:
“I want you to know that you and your family’s health and safety is top priority for me. As you can see from what I’m doing here, I take the highest precautions and safety measures during every home visit to make sure that we are keeping you, as well as all my other clients safe and protected. I appreciate your patience while I get set up here.”
ADDITIONAL SAFETY TIPS
- Don’t just sit on any surface, especially on any fabric furniture. If your client offers you to sit, either use your step stool or decline politely: “I’ve been sitting in the car all day and prefer to stand, but thank you.“
- Never place your bag on the floor without a barrier. You can use a step stool, paper towels, newspapers, plastic or other disposable barrier between your bag and a hard surface.
- Keep an extra change of clothes, shoes and hand sanitizer in your car.
4. Know How Your Productivity is Measured
With increasing demand and expectations to improve productivity, more and more home health therapists are experiencing burnout, ethical dilemmas and decreased job satisfaction. It is not uncommon for home care therapists to work off-the-clock for hours on end to meet unrealistic productivity standards and this is a common cause of therapy burnout.
In this environment, it is important that you know your rights as well as your responsibilities. First, understand how your productivity is measured. Are you given the necessary time by your employer or agency to complete paperwork and documentation between all the driving and patient visits? How about the time spent calling other team members and scheduling with your clients? If you sat down and really thought about everything you do between visits, you’ll realize how much work you’re doing that cannot be counted as “skilled” or “billable.” Now considering all this, ask yourself, “are these productivity standards fair or reasonable?”
ADVOCATE FOR A BALANCED CASELOAD
If you feel that you are not given a reasonable or accurate productivity standard, set up a meeting with your supervisor to find out how your productivity is being measured and seek his/her advice on what can be done or changed so that you can continue to perform ethically and efficiently without sacrificing quality care. Analyze your caseload and see how much time you’re spending on driving, documentation, evals, etc. If you’re having to do an overwhelming number of evals week after week, which can be time intensive, advocate for a more balanced and diverse caseload. Also, if you find that the majority of your cases require 100% supervision, request a more diverse caseload that is not so heavy with low-level clients so that you can incorporate Point-of-Service Documentation during some of your sessions. Otherwise, you may end up spending hours at home catching up on documentation. Bottom line: Don’t be afraid to speak up and advocate for yourself through an open and respectful dialogue.
5. Stay Organized
HAVE A SYSTEM IN PLACE
Keep your schedule and weekly planner easily accessible and editable. This may be your Google Calendar synced through your phone or a weekly planner you take with you in hard copy.
KEEP A LIST OF IMPORTANT CONTACTS
Be sure to keep a list of important contacts, including your client’s immediate healthcare team as well as numbers you can call in case of emergency. Consider keeping these contacts saved in your phone as well as having a hard copy in your folder as a backup.
TRACK YOUR MILEAGE
This is especially important if you are a 1099 employee. There are a few mileage tracking apps that make this process easy. MileIQ is one of the most popular and frequently used apps among home health therapists. In addition to your mileage, I would encourage you to find out which of the expenses are tax deductible.
Note: Since tax laws and rules are subject to change, it may be a worthwhile investment to hire a tax accountant to find out early what records you need to keep to get maximum deductions.
TRACK YOUR TIME
Learn to set boundaries with your client and their family. While family and caregiver education is an important component of home health, you must be able to draw clear boundaries on these family conversations to ensure you manage your time and productivity. You might even consider using a stopwatch to make sure you don’t go over the allotted time. Most clients will understand that you have a schedule you need to keep, so be sure to communicate your schedule clearly and politely inform them that you have “X” amount of time to do the session.
EXPECT THE UNEXPECTED
Keep an emergency kit in your car: Phone charger, jumper cables, tire-changing tools, portable air compressor, GPS, snacks, water and anything else you think you may need.
6. Get Familiar with OASIS
While some agencies may provide formal OASIS training, many clinicians get little support in developing good data collecting skills. Don’t be afraid to seek guidance and speak with your supervisor or team members if you need support. You can also utilize online resources from CMS and the OASIS Guidance Manual.
7. Master Documentation (Or at least try to)
Create a realistic plan and strategy for how you will complete documentation. Not just in your head, but an actual, structured system that you can follow. Without it, you will quickly become overwhelmed and end up spending hours at home completing paperwork off-the-clock. When creating your plan for documentation, you should consider your own work style and consider what location and time would be most conducive for you to efficiently complete your documentation on time. Your plan should also include a goal for how long you will be spending on documentation, depending on whether it’s an evaluation or treatment notes. Below are some examples from therapists who work in Home Health:
“I have a rule to never leave the driveway without completing at least 50% of my notes.” -Cindy K.
“My goal is to at least start my notes during the session and finish it in my car before I see my next patient. If I save my notes for later after seeing 5-6 patients, I’ll just forget everything.” -Sarah B.
“I typically spend the first and last 5 minutes of each session to do my notes. This definitely takes practice, but in time, it gets much easier and you’ll save yourself from going crazy at night trying to finish your paperwork.” -Kimberly R.
As you can see, some therapists choose to incorporate Point-of-Service (POS) Documentation, which means that you’re documenting at the same time you’re treating the client. It may not be appropriate for every client, but if done properly, POS documentation can help to improve the quality of your documentation, while also alleviating your burden to work off-the-clock to meet productivity standards. Be sure to check out my Point-of-Service (POS) Documentation article to learn how you can safely and ethically incorporate POS into your session.
