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Therapy Screening

Neely Sullivan, MPT, CLT-LANA, CDP

May 25, 2021

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Question

What is the purpose of a screen and are there any practice tips for success when performing a rehab screen?  

Answer

The purpose of a rehab screen is for the therapist to attempt to identify clients' needs and possible rehab potential.  A screen may not result in a therapy evaluation.  It does not require a physician order.  The screen is used to support and provide additional documentation on the evaluation findings to support medical necessity.  No recommendations can be made other than evaluation or no evaluation. It is a hands-off review to ID those needing therapy intervention. 

Screening should focus on screening clients with a change in function and when appropriate these clients should be referred to therapy.  

For best practices, 

  • Screen will determine if an evaluation is needed
  • Evaluation will determine if further rehab potential and goals can be established 
  • Use clinical reasoning skills to determine if the client warrants a skilled plan of care

Tips for success:

  • Effective communication between nursing and therapy
  • Regular meetings with the nursing staff
  • Utilize a nursing referral form
  • Supportive documentation is present
  • Provide in-services to the multidisciplinary team
  • Obtain info from various sources

A screening chart review should include: 

  • Nurses notes-daily nursing documentation may illustrate a pattern which warrants a screen
  • MD notes
  • CNA flow sheets
  • Restorative nursing notes
  • Previous therapy notes and discharge summary

Example of clients to be screened are those who have:

  • Had a fall
  • Abnormal posture
  • Poor head, neck, or trunk control
  • Contractures
  • Problems with edema
  • Decreased safety awareness
  • Decreased transfer ability
  • Decreased ability to re-position self
  • Poor supported sitting balance
  • Poor skin integrity
  • Pressure injuries
  • Difficulty eating or swallowing
  • Decreased participation in ADL
  • Complaints of pain
  • Decreased ability to self-propel wheelchair
  • Difficulty breathing
  • Decreased socialization due to poor position
  • Difficulty maneuvering wheelchair in environment
  • Difficulty using motorized wheelchair or scooter

 


neely sullivan

Neely Sullivan, MPT, CLT-LANA, CDP

Neely Sullivan, PT, CLT-LANA, has worked with diverse client populations ranging from pediatric to geriatric in a variety of clinical settings.  These experiences and multiple courses on the topic have allowed her to treat and develop client care programs for clients living with lymphedema and wounds. She has served in multiple levels of regional and corporate management positions. In these positions, Neely has developed policies and worked closely with interdisciplinary teams to ensure that clients living with lymphedema and/or wounds have the opportunity to attain their highest level of function and quality of life. She is a certified lymphedema therapist and has most recently been responsible for the identification, implementation, and evaluation of clinical programs in long-term care settings.  Neely currently provides educational support to 13,000+ therapists nationwide as an Education Specialist for Select Rehabilitation. Neely has lectured nationally and at the state level on the topics of Lymphedema and Wound Care Management. She has authored publications focusing on edema and lymphedema management. 


Related Courses

Management of the Client with Compromised Respiratory Function
Presented by Neely Sullivan, MPT, CLT-LANA, CDP
Recorded Webinar

Presenter

Neely Sullivan, MPT, CLT-LANA, CDP
Course: #3931Level: Intermediate2 Hours
  'Current relative topic with pandemic issues'   Read Reviews
This seminar reviews the background and scope of respiratory illness (including COVID-19) and introduces strategies for assessing and implementing treatment interventions designed for clients with compromised lung function. Finally, this course includes reimbursement and documentation principles to ensure efficacy in this area by therapy providers. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Justifying Medical Necessity in Documentation: Screens to Skilled Services
Presented by Neely Sullivan, MPT, CLT-LANA, CDP
Recorded Webinar

Presenter

Neely Sullivan, MPT, CLT-LANA, CDP
Course: #3973Level: Intermediate2 Hours
  'Straight forward helped me understand more of what the eval is sonce im a PTA'   Read Reviews
Providing excellent client-centered services depends on documentation that clearly illustrates the medical necessity of the client. Participants in this webinar will learn how to evaluate and articulate the medical necessity of their client, illustrate the complexity of their skills to support the necessity of your treatment plans, and recognize through examples what constitutes appropriate documentation. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Swell to Well: Wound Management for Clients Living with Lymphedema
Presented by Neely Sullivan, MPT, CLT-LANA, CDP
Recorded Webinar

Presenter

Neely Sullivan, MPT, CLT-LANA, CDP
Course: #3666Level: Introductory2 Hours
  'very detailed'   Read Reviews
This seminar will describe the anatomy and physiology of the lymphatic system in relation to risks for developing wounds. This session will also focus on different types and stages of wounds commonly occurring and outline wound management interventions for individuals living with lymphedema. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Wound Care Staff Education: What Clinicians Need to Know
Presented by Neely Sullivan, MPT, CLT-LANA, CDP
Recorded Webinar

Presenter

Neely Sullivan, MPT, CLT-LANA, CDP
Course: #3945Level: Intermediate2 Hours
  'good course'   Read Reviews
A systematic approach to wound care staff training can result in a positive outcome for therapists, staff, their clinic, and most importantly, their clients. Using multiple examples, this course examines key elements (role of multidisciplinary team, documentation and reimbursement, prevention, wound assessment, and wound treatment) of effective education and introduces strategies for making wound care learning engaging and fun to support delivered wound care services. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

The Impact of Functional Interventions and Client Advocacy on Wound Healing
Presented by Neely Sullivan, MPT, CLT-LANA, CDP
Recorded Webinar

Presenter

Neely Sullivan, MPT, CLT-LANA, CDP
Course: #3772Level: Intermediate2 Hours
  'Reminder to continue to focus on functional goals and how we can utilize therapy to help patient's obtain those goals'   Read Reviews
This session will review the foundations of client advocacy for individuals at risk for skin breakdown and introduce strategies for implementing client-centered treatment interventions across rehab settings. Learners will review common wound management interventions and then apply components of advocacy to this client population using case examples. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.