Chapter 14: Treatment Settings & Models of Health Care – OT Study Notes

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30 Terms

1
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What are Public Agencies in the context of OT administration?

Financed and operated by governmental bodies, such as VA Medical Centers, state correctional facilities, or county hospitals.

2
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What defines Private Not-for-Profit Agencies?

Agencies granted tax-exempt status under U.S. Internal Revenue Code ext{501(c)(3)} that reinvest surplus revenue into their mission, often with religious or charitable affiliations.

3
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How are Private For-Profit Agencies characterized?

Agencies owned by individuals, partnerships, or corporate investors who seek a financial return, often specializing in areas like in-patient rehabilitation or SNFs.

4
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What is Acute Care in healthcare?

For sudden, new, or rapidly worsening conditions, characterized by short length of stay (LOS) due to cost pressures and Diagnosis-Related Groups (DRGs).

5
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Explain Diagnosis-Related Groups (DRGs).

Fixed payment based on diagnosis, regardless of services rendered, used to reimburse U.S. hospitals.

6
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What was the impact of the 1997 Balanced Budget Act (BBA) on OT?

Legislation from 1997 that tightened Medicare payments, leading to early discharge and requiring OT to demonstrate quick value through early mobilization and discharge planning.

7
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Describe Sub-Acute Care.

For clients no longer needing round-the-clock physician care but still requiring intensive therapy (OT, PT, SLP) to regain function, typically lasting 1 ext{–}4 ext{ weeks}.

8
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What are common settings for Long-Term Care (LTC)?

Nursing homes, residential group homes, the client's own home (with home health), and community-based programs for medically stable but chronic or progressive conditions.

9
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What is the primary OT role in Long-Term Care?

OT's role shifts towards maintenance, compensatory strategies, environmental modification, and quality of life initiatives.

10
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What is the focus of Biological / Medical areas of OT practice?

Addresses body structures and functions, such as orthopedic, neurological, and cardiopulmonary conditions.

11
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What is the goal of Psychological / Behavioral Health in OT?

Helps clients manage emotions, cognition, and psychiatric symptoms to enable desired occupations.

12
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What does Sociological / Community & Social Participation in OT involve?

Targets adaptation to societal expectations, roles, and routines, common in developmental disabilities and community reintegration.

13
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What are key characteristics of Home Health Agencies for OT?

Require client-centered care in natural contexts and adherence to Medicare Home Health Part A requirements, such as homebound status.

14
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Which legislation established the basis for OT services in schools?

The 1975 Education for All Handicapped Children Act, now the Individuals with Disabilities Education Act (IDEA).

15
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What key principles does IDEA guarantee?

Mandates Free Appropriate Public Education (FAPE) in the Least Restrictive Environment (LRE) for children with disabilities.

16
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What are "Related Services" under IDEA?

Assistance provided to children to help them benefit from special education, where OT, PT, and SLP are classified.

17
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What are Day-Treatment Programs?

Structured daytime programs for rehabilitation, life-skills, or mental-health groups, with clients returning home in the evenings.

18
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Provide an example of a Sheltered Workshop.

Beacon Group, offering vocational rehabilitation, pre-employment skills, and paid piece-work to adults with disabilities.

19
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Name some Non-Traditional OT settings.

Correctional facilities, hospice/palliative care, therapeutic riding (hippotherapy), aquatherapy, homeless shelters, and disaster relief.

20
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What does OT target in Correctional Facilities?

Self-management, job readiness, and adaptive leisure within secure environments.

21
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What is the emphasis of OT in Hospice / Palliative Care?

Comfort, dignity, legacy projects, and caregiver instruction, supporting clients at end-of-life.

22
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What is Hippotherapy?

Uses horse movement as a sensorimotor platform to improve balance, posture, and emotional regulation.

23
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Describe Aquatherapy in OT.

Warm-water exercise for range of motion (ROM) and pain management, where OT integrates aquatic ADLs like bathing and pool transfers.

24
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What accelerated the growth of Private Practice for OT?

Medicare Part B coverage expansion in 1988, allowing practitioners to bill directly.

25
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What is required for successful Private Practice in OT?

Advanced clinical expertise, business acumen (marketing, billing, documentation), and ability to negotiate payer contracts.

26
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List common niches for Private Practice & Consulting in OT.

Ergonomic consulting, driver rehabilitation, home modification, life-care planning, and wellness coaching.

27
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How does IDEA influence OT service delivery?

Guarantees OT access in public education and includes provisions for Individualized Education Program (IEP) team collaboration.

28
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What is the primary ethical concern in for-profit OT models?

For-profit models must avoid conflicts between shareholder returns and client-centered care, upholding the Principle of Beneficence.

29
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What is the practical implication of Early Discharge Pressures on OT?

It demands evidence-based, occupation-focused interventions that yield measurable gains quickly.

30
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Name two current trends in OT practice.

Population Health & Wellness, expansion of Tele-OT, Interprofessional Collaboration, Outcome Measurement & Value-Based Payment, and rising demand in Aging in Place.