Ethical occupational therapy practice in nursing home care

I teach ethical decision making to occupational therapy students.  One of the most common concerns that I hear from students each year is the pressure that they experience regarding productivity and 'meeting minutes requirements' in skilled nursing facilities.  Nursing homes receive higher rates of reimbursement based on intensity of rehab services that are provided, so there is an incentive for facilities to provide as much 'high intensity' therapy as possible.Typically, the students express ethical distress because they often believe that the recipients of these services are receiving marginal or no benefit from their participation.As a population, OT students feel disempowered about expressing concerns in this area during their fieldwork experiences becausea) they perceive that they are 'just students' and don't want to make wavesb) they feel confused because their clinical preceptors are all engaging in the behaviorc) they have competing pragmatic concerns, like graduating on time, having to find a new fieldwork, etcStudents report that many practitioners 'go along' with the push for more therapy because they become concerned with job security or that they simply accept these practices as 'being the way things are done.'The Wall Street Journal wrote an excellent investigative article on this issue that I encourage others to read fully and carefully.  The article can be found here: http://www.wsj.com/articles/therapy-is-for-helping-patients-not-...
Source: ABC Therapeutics Occupational Therapy Weblog - Category: Occupational Health Tags: health insurance OT Education OT practice Source Type: blogs