Nobody wanted home PT this week. Rough.

Hey all,

Just a bit curious about something recent that happened with me, and what it could mean.

I'm extremely active (gym, sports, etc) but dont throw much. I joined a dodgeball league, and during our games on thursday, i was throwing as hard as i could. After 3-4 games my elbow region started flaring up, and by the end of the night I couldn't put any snap on the ball. My bicep hurt and all the musculature around the elbow were on fire, as if I dove into the deep end of pitcher's elbow, with every symptom checked off.

On Friday the area had a constant dull pain that would get sharp during certain contraction angles. The area itself felt deflated" and I spent all day rubbing it (felt nice). Was able to do a push day at the gym, but couldn't do bench press with dumbbell, as gripping the weights sent pain through the elbow.

Yesterday it was still pretty bad... until I cleaned the kitchen? For about an hour I used a sponge to deep scrub all over, varying the angles I scrubbed with, but applying a lot of pressure the whole time while scrubbing. I was genuinely tired by the time it was done (but man did the kitchen look good).

About 15min after, I noticed that the only thing I felt in my elbow was a little soreness in my lower bicep. Elbow pain? Gone. Limited rom? Gone. Tendons/ligaments flaring up? Done.

It's now Sunday and my bicep feels fine, no lingering pain or anything. So... what happened? What could have been wrong with my elbow that was relieved through generating constant pressure in the area?

Just want to know if I am wrong in requesting to speak with a PT currently working for the company that just offered me a job.

Currently a little unhappy in my position, A lot of driving, low census causing me to use PTO, don’t like the office leadership all that much. Big company, salaried, good benefits, decent salary. Currently use Homecare homebase (HCHB) documentation

New offer. PPV, less PTO, medical similar. They “claim” I will have a smaller territory, and I will be very busy, the leadership team seemed ok, only had 1 zoom interview and they offered. they use kinnser ? Documentation and claim it’s much better than HCHB and claim I can do a start in 1.5 hours because they use AI to assist with starts.

I asked to speak to a peer, PT, before accepting, and got this answer. “Our PT’s time is very valuable and their schedules vary as yours is and does. If you have any further questions, we would be happy to answer any for you”.

My gut says run…. My friend who is an administrator for a clinic for police and fire, that employs PT, ATC, counselors, and MD’s said he would never tell a prospect they could not speak to the staff, but he added he includes his staff in the interviews…. This makes sense because they will be working side by side. I will not be working in a “clinic” with my peers, but I just wanted to ask about work life balance, documentation, and if they liked working for this company.

Appreciate any thoughts

UPDATE: thank you all, you were all correct, and I sometimes wonder why I don’t always listen to my gut, but your reinforcement helped me. Additional update after reaching out to all my former co worker clinicians, friends in healthcare, former classmates, I found out that this company would definitely NOT be a good fit for me. They ended up “taking back” the offer, which I find quite comical since they probably found out I got answers to questions from people who currently work or have worked for this company and administrator. “Sketchy” was a common theme… lol. The good news, is it made me appreciate my current position much more and I have decided to treat my current position with a renewed attitude and energy. The grass is not always greener, do your research, focus on the positives with your current position. I have never felt like things are “sketchy” in my current position, and that is so important. They have hired a new AE, so I’m hopeful census will pick up.

Ok, so I’ve got like 20+ years working out patient and sports med. I’m at a point in life that full time may not be ideal, and while I don’t want to work for free, I’m not looking for the unicorn of unicorns. I’ve been dabbling in linked in, and got sent this from a recruiter:

This is a homecare position traveling house to house doing intermittent care. You are paid $75 per visit and $110 for SOC. Discharges $60. Case Conference, CEU and in-services $50. You pick your own schedule and pick your travel with that so typically people set it up as one zip code one day and another zip code the next. You get reimbursed for your miles at $.50 per mile. 25 visits per week is what our full-time PTs do. Full-time employees are eligible for health insurance. Part time is an option if you have a set schedule. Would be open to PRN if you have more than 1 day. Training in the first week will be in the office to learn the ins and outs of everything. Then you will accompany another clinician in the field for your second part of the training. You will not go to the office besides when you train or do any in-services. SOC is done by nurse USUALLY unless it is a therapy only case which would be a PT starting care. Axxess is the software they use. Medicare A & B mix of patients.

I don’t NEED medical, I could go through my wife’s job and be only family plan. Just curious what you people out there think. This is Ohio/kentucky/Indiana area. Thanks in advance.

I'm a homecare PT. Some local surgeons refer very level THAs and TKAs to home PT. Patient will have OP PT scheduled in 2-3 weeks. Patients was told they would get home PT in meantime. How do you handle these patients? Many are annoyed by depth and intrusiveness of OASIS but also want/expect home therapy. My company doesn't like it when I admit people with low OASIS scores and it really doesn't like LUPAs either. But gut is to not admit but patients don't understand why they won't get a service they were promised. A lot of people don't seem to understand role and purpose of homecare.

What do you do/say in these cases? Thanks!

I'm a 23 year OP vet, and I've heard some horror stories about HH docs system. I'm thinking of more dough/less stress in my life. Is doc'ing it really that bad? Documentation is my Achilles heel so I'm afraid to screw up. Also how many pts do I have to see daily to break..let's say $125k yearly for my family? Any good companies to work for? Thanks ahead for the help.

I’m about to try a home health contract after doing OP my whole life. Most wary about entering people’s home by myself. Do you guys carry anything for self defense just in case/for peace of mind? Maybe the patients aren’t much to worry about but ever any concerns about a caregiver or other housemate going berserk?

I’m in search of the best software for HH documentation. The company I work for uses Pointcare and that’s just not it. Apparently it’s used because it makes billing easy, but it’s not great as a clinician.

What do you use, and what’s the pros and cons?

Hi all, I’m ~9 months post grad working in outpatient orthopedics. A few of my classmates and other peers I know work in home health and really like it. I was thinking of transitioning to home health but was curious how other young small females working in the field protect themselves from any uncomfortable situations or if they’ve had any times where patients got too handsy. Reason I’m asking is I’ve had some trauma working with patients and worry about being alone in a patients home as a small female and if anybody had any tips or insight. I was also curious on any pros/cons to home health if anyone wants to share. I have an older vehicle and worry about the mileage I’d put on my car but not sure if it would be any worse than my current drive to work already. Also if you feel like being salaried or paid per visit is better.

Appreciate any feedback! Thanks!

I’m fairly certain I was told it was for PT exercises when I received it among other PT supplies however I’m not 100% certain and am totally clueless as to how it might be used or for what injury/repair regimens it would be useful for.

Obviously the holes are for the hands but other than that I am curious if anyone can explain why it is used and what muscles it isolates or innervates.

Thank you so much for any guidance! ank you so much for any guidance!

I tore my reconstructed ACL for the 3rd time quite some time ago and have been more or less gong on with my life, progressively increasing the amount of sport I do. Currently I am pursuing a personal trainer qualification, working out loads and doing plenty of hamstring strengthening (but also a bunch of yoga and legthening). I also climb at a decent level.

For reference I currently do sets of 12x RDL with 80kg weekly (+ accessory exercises), can fit my entire hand under my feet with straight legs and can pistol squat for sets of 8.

My question is: have you met people older than me with a simlar background? What are some successful long term knee management strategies they employed? Is maintaining stong upper and lower leg muscles the only hope for a long term functioning knee? Should I be looking to condition connective tissue in specific ways over the next 10 years?

I ask because I know i am still 'on the up' as far as physical develoment goes and would like to develop a sense of things to keep an eye on going forward.

I've moved into home health because I'm feeling like it is the only setting where you can make a living without killing yourself with work in this field. That being said, the salaries are still meh. But at least it is the average or above with less stress. I'm taking a 3-4 day a week position next. Are there any other fields you all have found where we can use our skills as a side hustle to make extra $?

Hello everyone, I recently got a position in a NGO as a HHPT for a 125k salaried position with benefits treating Med A patients only. I was 1099 HHPT treating Med B patients in a private company before, so I'm unaware of the new point productivity system. The new job requires 27 points per week. They told I'll be seeing 5-6 patients a day and any patient above 27 points will be 70$/point. Can anyone explain to me what is this points productivity system? Although they explained it to me, it has flown over my head over and over again. Thanks in advance!

I have a HH pt with PD who can walk 1000+ feet but with CGA due to frequent festination. My HH agency has recently been critical of my documentation when I show I've walked more than 400 feet with him (They feel 400 ft is the max distance a homebound pt should ambulate). They told me I can't include that I've walked more than this distance regardless of how I've documented the quality of his walking or amount of assistance he needs to walk that far. I was under the impression that Medicare doesn't have a specific distance a patient can walk before they are no longer considered homebound, as long as I can show it there is considerable and taxing effort needed for them to leave home (i.e, festination, need for CGA, need for assistive devices, etc). Has anyone experienced any push-back from their agency for something like this? Any guidance?

I have been working in an outpatient hospital setting for about a year now where I also spend about 10 hours a week in acute. It’s not all that bad, productivity standards of 75%, decent pay, awesome coworkers, etc.. I have always been interested in home physical therapy and just received an offer to work with a company that pays hourly, guaranteed 72 hours/2wks plus mileage, $5 more an hour than I’m making currently, 40 mile radius treatment area, average 5 patients a day. I’m not sure if this is average or too good to be true or what. The company has a 4.2 star rating from its current and former employees on indeed. I’m unsure if I should accept it as my current position isn’t terrible, however I’m not a big fan of working 9-6 everyday. I’ve only been in the field for about a year now. Anyone have any helpful input?

I’m seeing a patient who is over two weeks out from surgery and her ROM has not improved at all. She did suffer a fall with periprosthetic fx as soon as she was released. We have been treating her for HH PT since she got back home the second time.

Sometimes I see a stubborn knee, but it still makes some slow progress. She’s been about 4-76 degrees the whole time.

She has been WBAT since starting HH. I’ve told her to do ROM and the typical early exercises, and to cycle through them spending a couple of minutes doing 1-2 of them hourly. We also started doing UE assisted chair squats at the sink to try to force knee flexion, and added this to HEP 2-3x a day. This week I started trying manual therapy as well.

Now I can assure you she hasn’t been doing exercises with the frequency I prescribed from us talking about it, but she’s also not the worst patient I’ve had in regards to HEP either. She was given orders for 3x weekly after her fall, so when I saw we weren’t going to be in a good spot by the end of the typical 6 visits I extended it several weeks.

This is the most stubborn ROM case I can recall seeing. Any ideas what else I can try?

I'm a PTA working in home health pediatrics for a small independent company that just started almost a year ago. The owners are a PT and an OT who have been doing home health for a while but not with peds. Per my state, in SC, you have to have patients reevaluated every 8th visit or 60 calendar days whichever comes first. That point came for my patients and my PT wasn't on the schedule with those patients and my PT never brought it up so I did. My PT said he had a hard time finding out what the time period was to re-evaluate patients and was just going off when insurance wanted him to do it which was every 6 months. I sent him the SCLLR board of PT page with the info saying it's every 8th visit/60 days. PT agreed and saw patients to re-evaluate. Now that time to re-evaluate has come up again and he's not on the schedule. I reach out to our scheduling department and they tell me that PT is only supposed to do it every 6 months for insurance. I'm so tired and confused about why it's this hard to just get my patients re-evaluated because I literally can't see them if they're not. Am I in the wrong or not seeing something or does my PT not care/know? PT's been in home health for 7 years so I have no clue how he wouldn't.

I'm planning to take some time off from work and travel cross country. What logistics would I need to manage/navigate to get a travel PT job while living in my car?

I would still have an active PT license and driver's license

Hey y'all. I just finished with an interview for HH in the Dallas area and they offered salaried for 110k. They mentioned I can do weekends if I want with PPV on top of my salary.

Thoughts on this?

The home health agency that I work for is making us take orthostatic blood pressures on every patient, at every visit. Also, they are having all clinicians listen to lung sounds at each visit. Is this happening at other agencies? They claim it’s to decrease the number of falls that happen while people are on our caseload (orthostatic) and to prevent hospital re-admissions, which I get, but it seems like we could be verbally screening people and possibly just doing these on people who are symptomatic (especially the orthostatics). Spending 15 minutes on vitals every visit is bonkers, IMO, unless someone is symptomatic or there are red flags.

I joined with a PRN HH agency back in the middle of last year to take supplemental visits to my full time agency. I started to take some random visits here and there, and one day I receive a re-evaluation visit for a patient.

After poking around in Kinnser, I discovered this patient has been being seen since APRIL 2023 with EIGHT 60-day episodes. No rehospitalizations, no chronic conditions, just one of those untreatable ortho patients. Obviously, this patient is straight Medicare. How on earth does Medicare let agencies do this? I most definitely hope that Medicare will audit this chart and un-bill like 6 entire 60 day episodes of care and ask for like 25 thousand back in medically unnecessary visits. Has anyone seen this kind of buffoonery in with their HH agency?

I am switching from Hospital-OP Ortho to Home Health, is there any questions I should be sure to ask regarding pt caseload, payment model etc? Thank you!