New STGs during POC

[David Lind]

Hi, just wondering how others have been handling this situation :

Working in a SNF, we have 2 OTRs and 3-4 COTAs depending on census. After a week of treatment, we write a weekly note summarizing progress or lack thereof, and address all STGs. The COTAs will write the weekly note for their caseload and forward it to me for co-signature.

We have been operating under the policy that the COTA can progress an established goal to the next assistance level (i.e. from MAX A to MOD A when MAX A has been met), but the COTA cannot generate a new STG (such as Pt has met dressing and toileting goals independently, and we need to move on to tub transfers and cooking).

A new hire states that she was taught in COTA school that she IS allowed to generate a new STG in the POC.

Discussion?
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David Lind, OTR/L
Dove Healthcare, Eau Claire Wisconsin

[mmot]

A facility, or company, can have guidelines that are more stringent than those of a state. As long as they don't contradict, of course.

I'm working for two companies that don't have COTAs do any documentation other than interdisciplinary notes. Things like "Nursing reports patient is unable to participate in therapy today." Or if a client doesn't show up or refuses, they note that in the chart.

Weekly progress notes are written by the therapist with input from the COTA. Goals are progressed then, if needed.

[Tina Champagne]

I would look to your state association to see what the standards are for COTAs and goals, in your state. As far as I am aware, COTAs do not write new goals.

Sincerely,
Tina
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Tina Champagne, OTD, OTR/L