OT Analysis & Practice Management 4 — Questions and Answers
Question 1: Under Medicare Part B, an OT working in an outpatient setting must demonstrate 'skilled care' in documentation. Which statement BEST supports medical necessity?
- The patient enjoys the treatment sessions
- The patient's condition requires the expertise of a licensed therapist to achieve measurable functional goals (Correct answer)
- The patient's family requests continued treatment
- The diagnosis alone justifies the services provided
Correct answer: The patient's condition requires the expertise of a licensed therapist to achieve measurable functional goals
Medicare requires documentation showing that the patient's condition necessitates skilled OT to achieve specific, measurable functional outcomes.
Question 2: An OT is analyzing a client's ability to perform IADLs and notices the client has difficulty with money management due to cognitive deficits. Which analysis approach provides the MOST comprehensive understanding?
- Biomechanical analysis of hand function during bill handling
- Top-down occupational analysis starting with the role and context, then identifying performance barriers (Correct answer)
- Bottom-up deficit-based assessment of individual cognitive components
- Environmental analysis of the home setting only
Correct answer: Top-down occupational analysis starting with the role and context, then identifying performance barriers
A top-down approach begins with the client's meaningful roles and occupations, then identifies specific performance barriers, providing a comprehensive occupational picture.
Question 3: A pediatric OT clinic receives a grant to study sensory processing interventions. Which study design provides the HIGHEST level of evidence?
- Expert opinion and case reports
- Single-subject experimental designs
- Randomized controlled trial (RCT) (Correct answer)
- Cohort study without a control group
Correct answer: Randomized controlled trial (RCT)
Randomized controlled trials are at the top of the evidence hierarchy because randomization controls for confounding variables and reduces bias.
Question 4: A patient declines a recommended adaptive equipment recommendation. The OT documents the refusal and proceeds without the equipment. This reflects which ethical principle?
- Beneficence
- Justice
- Autonomy (Correct answer)
- Fidelity
Correct answer: Autonomy
Respecting the patient's right to make informed decisions about their own care reflects the ethical principle of autonomy.
Question 5: An OT manager notices that referrals to the department have declined. Which business management strategy is MOST appropriate as an initial response?
- Immediately reduce staffing to cut costs
- Conduct a root cause analysis to identify barriers to referral (Correct answer)
- Launch a marketing campaign without analyzing the problem
- Expand service hours without further investigation
Correct answer: Conduct a root cause analysis to identify barriers to referral
Root cause analysis identifies underlying reasons for the decline before committing resources to a solution, preventing ineffective interventions.
Question 6: When modifying an activity to grade its difficulty downward for a client with limited endurance, the OT MOST likely would:
- Add more steps to the task to increase challenge
- Reduce the duration or physical demand of the activity (Correct answer)
- Introduce a new, unfamiliar activity
- Increase the speed at which the task must be completed
Correct answer: Reduce the duration or physical demand of the activity
Grading an activity downward involves reducing complexity, duration, or physical demands to match the client's current functional capacity.
Question 7: An OT completing a job demands analysis for a worker with a rotator cuff injury should PRIMARILY assess which factor?
- The worker's job satisfaction and morale
- The frequency, duration, and intensity of overhead reaching required by the job (Correct answer)
- The employer's financial capacity for workplace modifications
- The worker's educational background and training history
Correct answer: The frequency, duration, and intensity of overhead reaching required by the job
For a rotator cuff injury, assessing overhead reaching demands directly determines whether the job is safe to return to and what modifications are needed.
OT Analysis & Practice Management 4
Under Medicare Part B, an OT working in an outpatient setting must demonstrate 'skilled care' in documentation.
Which statement BEST supports medical necessity?