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Therapy is not only a major expense for the SNF, it requires the coordination with and cooperation of other departements. ST may require a tray at a certain time, nursing needs to know when to have a patient ready and how (whether to get them up, or to keep them in bed for therapy to get them up), appointments need to be made outside of the therapy schedule, and lots of other stuff. Also, patients often decide what time of day they want therapy, or are at their best (physically or mentally) at a certain time of day. And patients may need to be pre-medicated for pain or anxiety. Also, therapists normally are on a tight schedule to keep the budget in check, so they aren't usually in the SNF at random. They also have specific treatment plans to follow, and tons of paperwork to complete at specific times for billing, progress notes, physician certification, and the MDS. A random therapy schedule would be chaotic, hugely wasteful and counter-productive.
I suspect what the DOR meant is that therapy can't be expected to be on a schedule that fits every patient's preferences? Or maybe it's possible your SNF doesn't have regular therapy staff, and has agency therapists- that could make for a random schedule, based on the availability of therapists. But a random/unscheduled therapy schedule would be as chaotic as a random mess pass- there would be too many variables to deal with.
An easy way to tell if your therapists operate at random, is to ask them. If they really do operate at random, without regard to meal times, med passes, nursing treatments, care plan meetings, appointments (such as dialysis), nursing staff ratios, MDS deadlines, therapist schedules, budgetary constraints, etc., then your SNF must be in a state of utter chaos?
TigerxLiLy
139 Posts
Does your facility have scheduled therapy time? Like does therapy have a time set that they see each patient on Med A or is it random ?