the aquatic therapist

Great download: The APTA answers your frequently asked billing questions

Answers to these questions (PDF) and more:

[Editor's note: The APTA answer to the question about whether therapists must have exclusive use of a community pool for Medicare patients is no longer accurate. Since this audioseminar took place Medicare has changed its policy to allow therapists to use a PORTION of a pool for their clients.]

SAMPLE QUESTIONS ANSWERED IN THIS PDF:
Q: Is the 2008 therapy cap of $1810 the allowable rate or actual payment received?

Q: Why do the therapy caps not apply in outpatient hospital departments?

Q: Is it okay to offer Medicare patients an “aftercare” program if they use up the cap at a
reduced rate or flat fee? What if the PT or PTA is also certified as a Personal Trainer or
CSCS?

Q: If a Medicare beneficiary has therapy in an outpatient hospital department (exempt
from the cap) and later goes to a private practice, does the private practice have to include any money spent by Medicare at the hospital based facility?

Q: Does the Medicare program require a referral/prescription/order for outpatient
physical therapy services?

Q: Are physical therapists allowed to bill for the plan of care? Is the code the same as a
progress note?

Q: Does the 90 day recertification period apply to both Medicare A and Medicare B
residents in a SNF? Does the fact that we bill for the services provided to our outpatient
beneficiaries on the UB-04 form make a difference?

Q: Can you tell me if there are any Medicare regulations or policies on whether or not a
private practice can determine how many Medicare referrals they will take?

Ask ARN: Must therapy pools supply lifeguards during aquatic therapy sessions?

The Aquatic Resources Network gets questions from clinicians each day. We think everyone should learn from the answers!

 

Question: What kind of policy should we have regarding posting a lifeguard on duty at the pool? Are therapeutic pools held to the “public pool” standard?

Answer: There are over 100 bathing codes in effect in the U.S. and no two of them have identical wording concerning lifeguards. In most states, therapy pools are considered "public" pools and are subject to all the same codes and regulations as any other public pool in the state.

Some states have a “semi-public" or "special pool" or “therapeutic pool supervised by a licensed medical practitioner" category. Since surveillance requirements vary from state to state depending on the categorization, each practitioner should make himself aware of the requirements which pertain to his state or locality.

Regardless of whether or not a state code requires that lifeguards be posted, the facility is still required to provide a safe environment, and to provide rescue assistance and necessary First Aid.

The prevailing standard that public pools must hold to includes the following requirements:

• The standard of care in the industry (in the U.S.) is the "10/20 Supervision Rule". Trained and qualified lifeguards must be posted in a way that they can observe and scan their entire area of responsibility once every 10 seconds, and respond to and manage an emergency situation within another 20 seconds.
• Lifeguards should be properly dressed in uniforms (provided and paid for by the employer) and readily identifiable to patrons.
• At least two certified or licensed lifeguards should be in attendance at all public pools at all times the pool is in operation.
• Lifeguards should have no duties to perform other than the close general supervision of participants in water contact activities.
• Lifeguards should be alert, rotate to a new position at least once every 40 minutes, and be given frequent relief breaks from surveillance duties.
• The number of lifeguards should be adequate for the activities being conducted, the size and shape of the facility, and environmental conditions which might limit the ability to provide supervision.
• Lifeguards should be at least 18 years old, medically fit, have good eyesight, be physically capable of meeting the demands of the job, possess current certifications or licenses (in lifeguarding, CPR, and First Aid) from a recognized training agency, have adequate specific training for the facility, and be qualified and practiced in emergency procedures and other job aspects including use of rescue equipment (a minimum of four hours/month inservice training).

Source: Osinski A. Aquatic Therapy Listserv. Aquatic Consulting Services: San Diego, CA; 2001. For more information: Aquatic Consulting Services, Phone (619) 224-3100, Hotline (900) 446-6075 x 820. Web: www.AlisonOsinski.com

Skin Shield for Aquatic Therapists

One of the most common questions we get at Aquaticnet.com is: How can I keep my skin from getting dried out and itchy.

Well, there are two products on the market to help you from aging before your time. The first product was introduced in yesterday's posting. More on the second option below.

The Chimal Skin Shield protects against various allergies and infections. The nonoxynol-9 cream is an invisible non-greasy shield. Just a small amount is needed for application. The lotion is so safe, it can even be applied on infant's bottom or to form a barrier against poison ivy, acetone, etc. Sizes: 4 oz. ($7), 8 oz. ($12.95), or 26 oz dispenser ($40). Refills $55.

Read more information about aquatic therapy, aquatic fitness and aquatic exercise...

Aquatic therapy jobs board

In the past, it has been extremely difficult to locate aquatic therapy jobs.

When you are a "water person," you don't want any old job. You need chlorine!

Want to find (or post) an aquatic therapy job? Click the "View all Jobs" button in the right-hand column on this site>>>>>

Or, go directly to: Aquatic Therapy Jobs Board (once there, select "Jobs").

Lessons from the Back 40: How a Farmer's Wife Can Help Your Aquatic Therapy Business (Part 1)

Until our recent house fire, my husband Lee and I lived on a 60 acre farm. We grew strawberries and raspberries and had a houseful of kids all summer long. We sold fruit and sweet corn for 10 weeks each summer — and you couldn’t turn around without friends dropping off their children for some “good old fashion hard work”.

We never told parents about the late night tours of the haunted barn, or the round-robin chess tournaments, or the chocolate cookie bake-fest (6000 cookies in under 6 hours). We pretended it was all slave-labor so parents would keep sending their kids.

I learned much as a strawberry farmer — and only a very little was about farming. Take a moment to listen to this farm-hand’s wisdom. Maybe you’ll learn a little more about the business of aquatic therapy.

Pick Your People Well

When we first started out, we knew we wanted to sell our fruits and veggies at farmer’s markets and road-side stands. We checked out the competition and found a WIDE variety of business models in effect. One farmer obviously believed that 16 year old hormonal boys were the #1 target market for fresh fruit. He employed the “hot girl in the bikini top” method. The stand was always swamped, but I never saw actual commerce taking place.

Another competitor felt that the buying public would believe the vegetables were “direct from the field” if he employed a crusty-looking curmudgeon who would hand over melons in between spitting chaw. For obvious reasons, I couldn’t bring myself to buy his wares. So, when my husband and I first began to interview for summer help, we looked for three things.

1.        We wanted self-driven people who never needed a kick in the butt to make our stand look fabulous. We did not want competent people who would do whatever we asked; we wanted people who got excited and came to us with their “latest idea”. We held competitions and rewarded brilliance, but none of it would have worked if our people were not internally driven.

2.        We wanted clean-cut, well-groomed, and engaging people. Our staffers were constantly conversing with the people who stopped at our stands. They were so good at it, we had regulars who came just to talk. One octogenarian came to our New Richmond stand every morning at opening time and bought a 1/2 pint of raspberries from Jessica. He would go home and put all 25 raspberries on his cereal, just so he could come again the next day. Jessica once told the man that he could buy a pint of raspberries for a cheaper price and then come every second day (fresh-picked raspberries last 1-2 days). She saw his crumpled face and quickly added that she hoped he wouldn’t, because it made her day to see him waiting for the stand to open.

3.        We needed honest, trust-worthy help. In the farmer’s market business, you deal with a lot of cash. At any given time, there might be $1,000 in cash sitting on the table. But that wasn’t the only way honesty showed itself. Our employees worked independently; they were on their own much of the time. They could cheat us a million different ways; by leaving early, by taking home unsold fruit, by giving away produce to friends. And honestly, we’d never know. But, by hiring people who we could trust (and firing 1 we didn’t!), we never experienced angst over our staff. If an employee came late and said her car broke down, we could take her at her word. If the till was off $70, we believed our employee had nothing to do with it — we just had a day where we lost some fruit to spoilage. It is such a relief to trust the people you work with. It makes you able to accept everything at face-value.

Pay Your People Well

If you expect to get good help, you’ve got to pay them well. When we placed an ad in the local paper for our summer staff, we said exactly what we wanted: “Wanted: Summer help to work at fresh-fruit and veggies stand. Must love people, love talking, and enjoy sitting outside in the sun. Must be great handling money. $10/hour plus weekly incentive bonuses.” For the most part, we ended up hiring high school and college students whose friends were working for $6.25 at Subway. We advertised for — and paid — a higher wage, because we planned to be picky with the hiring process. We received 80 phone calls in response to our ad, interviewed 30 on the phone, interviewed 8 in person, and hired 5. And we got what we paid for.

In addition to a decent wage, we offered $50 weekly incentive bonuses. Each bonus was tied to a specific objective for the week. The first week, our 3 stands competed for “cleanest stand”.  The stands were located in the parking lots of very busy gas stations and the lot could get dirty fast. We wanted our stands to look CLEAN and inviting — and a pile of cigarette butts did not say “buy your produce here”.

Our second week, the stands competed for “best sign campaign”. The staff came up with slogans to draw in the public. They would invent them, then I would put them up along the road like Burma Shave signs. The signs were always funny and quite often drew people in who would not have otherwise stopped. Our best received campaign was one that played on the “Wisconsin Packers” versus “Minnesota Vikings” football rivalry.

First sign: Buy our Green Bay Packer sweet corn

Second sign: It’s green and gold

Third sign: And doesn’t choke mid-season

(For those of you not from Minnesota, this third sign referred to the Vikings annual mid-season implosion). We even managed to lure the father of a Vikings running back to the stand. He couldn’t decide whether to laugh or complain, but he bought $5 of corn.

The world of business is the same whether you are hawking berries or providing therapy. Get the best people — then pay them well. These were two of the most important things I learned as a strawberry farmer. In my next blog, I will discuss product, pricing and marketing as they relate to the world of aquatic therapy.

Excerpted from The Aquatic Therapist Magazine.