[PT11] Institutional Types/Practice Environments in Physical Therapy

ACUTE CARE

Treatment for a short-term illness or health problems

Average and usual patient length of stay for ACUTE CARE

PRIMARY CARE

Basic or first-level healthcare provided on an outpatient basis.

SECONDARY CARE

2nd level medical services which often require inpatient hospitalization or ambulatory same-day surgery. (e.g. hernia repair)

Medical specialists that do not have first contact.
- Cardiologists
- Urologists
- Dermatologists

Provides SECONDARY CARE

TERTIARY CARE

Highly specialized, technologically based medical services which may require surgical procedures. (e.g. heart, liver, lung transplants)

Highly specialized physicians
- Orthopedic surgeon
- Neurosurgery

Provides TERTIARY CARE

SUBACUTE CARE

Intermediate level of health care for medically fragile patients too ill to be cared for at home.

Within the Hospital or SNF setting

Where is SUBACUTE CARE provided?

TRANSITIONAL CARE UNIT

Hospital-based SNF

AMBULATORY CARE

Includes outpatient, preventative diagnosis, and treatment services which are favored by managed-care plans. Less costly than inpatient care.

SKILLED NURSING FACILITY

Provides care by continuous nursing, rehabilitation, and other health-care services on a daily basis

It can either be free-standing or part of a hospital

7 days a week of skilled nursing
5 days a week of skilled therapy

How does Medicare define daily care?

ACUTE REHABILITATION HOSPITAL

Provides rehabilitation, social, and vocational services to disabled individuals to facilitate their return to maximal functional capacity

Rehabilitation

Involves the coordinated services of medical, rehabilitative, social, educational, and vocational services for training or retraining

CHRONIC CARE FACILITY

Provides services to patients >= 60 days.

CHRONIC CARE FACILITY

a.k.a. Long-Term Care Facility

CHRONIC CARE FACILITY

Medical services provided to patients with permanent or residual disability caused by a nonreversible pathological health condition.

May require specialized care/rehabilitation.

CUSTODIAL CARE FACILITY

Not medically required but necessary for the patient who is unable to care for him/herself.

CUSTODIAL CARE FACILITY

May involve medical or nonmedical services that do not seek a cure.

CUSTODIAL CARE FACILITY

This type of care is usually not covered under managed-care plans.

CUSTODIAL CARE FACILITY

Daily care is delivered by nonmedical support staff

HOSPICE CARE

Care available for dying patients and their family at home or inpatient settings.

HOSPICE CARE

Medicare and Medicaid require at least 80% of this type of care to be provided at home

HOME HEALTH CARE

Health care provided to individuals and their families at their homes

Home health agency (HHA)
- Governmental
- Voluntary
- Private: profit or non-profit

Provides HOME HEALTH CARE

SCHOOL SYSTEM

The PT serves as a consultant to teachers who work with students with disabilities in the classroom

PRIVATE PRACTICE

Entrepreneurial PTs that work for or own a free-standing independent PT practice.

Sports Physical Therapy
Orthopedic Clinics
Rehabilitation Agencies
Occupational Health

Settings for PRIVATE PRACTICE

PRIMARY CARE

PTs support this type of care through examination, evaluation, diagnosis, and prevention of musculoskeletal and neuromuscular disorders

SECONDARY CARE

Specialized care

AMBULATORY CARE

Outpatient Care

SKILLED NURSING FACILITY

Extended Care Facility

PRIMARY CARE

Known as the "gatekeeper" to other subspecialists, including PHYSICAL THERAPY