Uintah Community Hospital is looking to add physical therapy to its services.

This is due to the fact that the tri-county

area has a higher rate of cerebrovascular accidents (CVA), rheumatic diseases such as: arthritis and gout. There are
other needs for physical therapy due to possible injuries and accidents due to the occupational hazards of the local
industries.
Due to the reasons causing a need for physical therapy, as mentioned above, there will need to be several different
types of physical therapy provided. For cerebrovascular accidents the purpose of physical therapy is to facilitate and
enhance the functional recovery occurring in response to the resolution of neurologic changes (Pagliarulo, 216).
Rheumatic diseases such as rheumatoid arthritis can be treated with active range of motion, and pain can be relieved
through heat modalities. If the arthritis results in a total joint replacement, such as a hip or knee replacement,
strengthening and flexibility exercises would be used to get the joint back in working condition. Gait training would also
be a great factor in the recovery of patients with lower extremity joint replacements. Industrial accidents can lead to
amputations. Amputees can benefit greatly from therapeutic exercises, and those with prosthetics will often need help
with gait training and developing strength around the affected area.
Given the reasons for physical therapy, it could be seen that the age group for the therapy clientele would be anywhere
from early 20s to 60 and 70 years of age. The geriatric patients would have a higher chance of being seen for
rheumatoid arthritis than the younger population. The younger patients could be in for several reasons including
industrial accidents. There would not be to many pediatric patients seen at Uintah hospital, unless they were involved in
an industrial accident.
Because the need for physical therapy is so great, Uintah Community Hospital is willing to provide space within the
hospital for the physical therapy department. However they are unable to provide any funds for startup costs.
Fortunately in the area there is a student who is passionate about physical therapy and how the body works, who is
willing to help donate funds to help start the department. This student recently became the next American Ninja
Warrior, and won $1,000,000 in the contest. He has graciously donated 5% of his winnings, $50,000 to the cause of
starting a physical therapy department in the Uintah Community Hospital.
As the physical therapy department will be located in, and part of the hospital the leadership of the department will fall
under the leadership of the hospital, as shown in the diagram below.
Board of Trustees

Facility Director

Rehab Director /Senior

PT

PT Aide

Junior PT

PTA

PTA

The therapy department consists of 2 PTAs who are supervised by the Junior PT. The Junior PT is supervised by the
Senior PT who also serves as the Rehab Director and also supervises the PT Aide. It is important to note that although
the Senior PT supervises the PT Aide, the PT Aide still assists the entire therapy department with treatments,
preparation and other duties. The Facility Director is the supervisor over the other departments of Uintah Community
Hospital as well, but only the organization of the therapy department is shown.
The Rehab Director position requires more experience for the PT to successfully lead the department. That being said,
in order for an individual to qualify they must have at least 7 years of experience working as a PT. The junior PT position
will require at least 2 years experience prior to applying. Both PTA positions require graduation from a CAPTE
accredited program, but neither require any previous work experience. The PT Aide positon is completely open to
anyone who has an interest in the physical therapy industry. Formal job descriptions are provided below for further
clarification.
Rehab Director:
Position Qualifications:
1. Graduation from a physical therapy curriculum by the Council on Medical Education of the American Medical
Association in collaboration with the American Physical Therapy Association.
2. Current state licensure
3. Seven years of experience as a Physical Therapist preferred.
4. Ability to effectively communicate, problem solve, make decisions, and teach.
5. Ability to lead a team or group of people.
6. CPR certification
Physical Requirements:
Must be able to exert up to 75 pounds of force at times, as well as move and transfer patients and/or
equipment. Occasionally must be able to stand, sit, squat, bend or kneel for prolonged periods of time, while
working with patients.
Other Requirements:
The Rehab Director will be responsible for the department bookkeeping. No previous experience is required for
this, training will be provided.
Physical Therapist:
Position Qualifications:
1. Graduation from a physical therapy curriculum approved by the Council on Medical Education of the
American Medical Association in collaboration with the American Physical Therapy Association.
2. Current state licensure.
3. Two years of experience as a Physical Therapist.
4. Ability to effectively communicate, problem solve, make decisions, and teach.
5. Ability to lead a small team.
6. CPR certification.
Physical Requirements:
Must be able to exert up to 75 pounds of force at times, as well as move and transfer patients and/or
equipment. Occasionally must be able to stand, sit, squat, bend or kneel for prolonged periods of time, while
working with patients.
Physical Therapist Assistant:
Position Qualifications:
1. Graduation form a physical therapist assistant curriculum by the Council on Medical Education of the
American Medical Association in collaboration with the American Physical Therapy Association.
2. Current state licensure.
3. No previous experience required, but it is preferred.
4. Ability to communicate, problem solve, make decisions, and teach.
5. CPR certification.
Physical Requirements:

Must be able to exert up to 75 pounds of force at times, as well as move and transfer patients and/or
equipment. Occasionally must be able to stand, sit, squat, bend or kneel for prolonged periods of time, while
working with patients.
Physical Therapy Aide:
Position Requirements:
1. High school graduate.
2. Complete the training program
3. Some experience with scheduling preferred (but it is part of the training program)
4. CPR certification
Physical Requirements:
Must be able to exert up to 50 pounds of force at times, to help move equipment or help transfer patients.
Must be able to set up treatment rooms, requiring the movement of large equipment. Occasionally must be
able to stand, sit, squat, bend or kneel for several minutes while cleaning equipment or preparing treatment
rooms.
Other Requirements:
The aide is responsible for scheduling the treatment times of the patients with their therapists. This requires
some level of interpersonal skills, and organization.
Now that the department has been formed, they can, under the direction of the Rehab Director, compose a mission
statement, a department philosophy, and their goals of how to live up to the mission and philosophy.
Uintah Rehab Mission:
Excellence and professionalism, while providing quality services.
Uintah Rehab Philosophy:
Provide quality rehabilitation services by: increasing patient motivation, using evidence based practices and
maintaining a professional demeanor.
Uintah Rehab Goals:
1: Increase patient motivation by:
a. Providing quality rehab
b. Focusing on the individual
c. Making sure patients reach their own goals
2. Use evidence based practice:
a. use the education gained through CAPTE certified programs
b. keep up on current practice by maintain licensure through CEUs
3. Maintain a professional demeanor:
a. through quarterly reviews
b. on-site training
Uintah Rehab Dress Code:
Slacks/khaki pants are required. Shirts must have a collar. Shoes should be closed toed, and should provide
adequate support for prolonged periods of standing. Clothes should not appear ragged, but should not be you
nicest. The clothes should also be loose enough to provide room for movement while treating patients, but
should not be so loose that they appear to be falling off. In all things maintain a professional yet labor
appropriate appearance.
Policies and Procedures:
In the manual for the department one would expect to find information about the following topics:
Emergency, disaster, and hazard protocols
Equipment safety
Incident reports

Documentation
Benefit guidelines
STO
PTO
Medical, Dental, 401k
Complaint forms
Impact Plans
Purpose
Guidelines
Goal Setting
Patient Rights Summaries
Be treated with respect and dignity
Receive safe and appropriate care
Have procedures explained
Know the identity of health care providers
Choice in who provides their care
Refuse Treatment
Privacy and Confidentiality
Patients complaints or grievances
Disciplinary actions
Department Core Values
Accountability
Altruism
Compassion
Excellence
Integrity
Professional Duty
Social Responsibility
Treatment protocols
Orthopedic
Hip
Knee
Shoulder
Back
Chest
Foot
Hand
After developing the mission and philosophy, the department works together to put together a list of equipment needed
to start up the department. The space provided by the hospital is approximately 30 deep, by 100 wide, which is 3,000
sq. ft. Uintah Hospital is charging $20 per square foot in rent to the therapy department. But that total is due yearly.
$20 x 3,000 sq. ft. = $60,000 per year. This makes the monthly rent $5,000. Knowing this information, the department
composes the following list of equipment to fill their available space:
Litegait
Scifit StepOne Recumbent stepper
Scifit Pro 1 Upper Body Ergometer
Tuffstuff Stack Multi-Functional trainer
Sammons Preston Parallel Bars
Large Treatment Mats
Small treatment tables (for treatment rooms)
Hydrocollator (with 12 hot packs)
ColPac Freezer (with 12 standard Col Pacs)

$20000
$5995
$5375
$3799
$335
$600 x2
$350 x2
$1290
$745

Paraffin Bath
Bosu Ball
Exercise balls
Gait belts
Walkers

$125
$100
$30 x3
$5 x5
$33 x5

The above equipment totals just under $40,000. The remaining $10,000 from the startup donation will be used to get
some of the smaller and more expendable items, like: TheraBand, dumbbells, paraffin wax, slide boards, canes, and
office supplies. It will also be used for the first months rent for the gym space the hospital is loaning. Below is a sample
blueprint of how the therapy room will look once it is completed.
Scifit
recumbent
stepper

Parralell
bars

Scifit
Pro 1
Ergometer

Observation
&
Charting

Rehab
Director
Office

Large
Treatment
Mat

Large
Treatment
Mat

Tuffstuff Stack
Multi-functional
trainer

Stand for:
dumbells, theraband,
misc. items.

Treatment
1

Treatment 2

Door

Clean
Linen
Closet
Soiled
Linen
Closet

Bathroom

Continuing to look at the financial aspect of the department, an estimated financial statement would look like:
Therapy Director
$80,000
Junior PT
$65,000
PTA
$45,000
PTA
$45,000
PT Aide
$20,000
Benefits
$85,000
Equipment
$15,000
Supplies
$25,000
Utilities
$10,000
Direct Cost Total
$390,000
Fixed and Indirect Costs $234,000
Total Annual Costs
$624,000
Taking a quick look at the employee salaries, the Therapy Director is paid a bit above the average PT because of their
other responsibilities which includes the departments bookkeeping. The PT Aide is paid approximately $10/hour or
$20,000 per year, this is in part due to their responsibility to handle the scheduling for the department.
In order to maintain enough money to pay the bills, the department will bill $70 for an hour of therapy. Using the
approximated 8,000 patient days that would bring in about $560,000 per year. That is just from the inpatient
treatments. It is estimated that the outpatient treatments will accumulate on average an additional 25 treatments per
week that is another 1300 treatments per year, which will add $91,000 in revenue each year. When adding the
inpatient and outpatient revenue together it brings the annual revenue up to $651,000. That is enough to cover the
annual costs and provide extra funding for other departmental expenses such as CEUs for the therapists and assistants,
and enough to allow for department parties or get-togethers on special occasions, to help boost morale!

The treatment schedule plays a huge role in ensuring that enough treatments are met to bring in enough revenue each
year. The treating therapists and assistants will make the appointments and return appointments, and then
communicate this information to the Aide who will put all the information on the calendar so everyone can see what
their daily schedule looks like.
In general, the department will be open:
Mon Fri: 9am 6pm & Saturdays: 10am 2 pm; Sundays the
department will be closed, however the Rehab Director will be on call in case an evaluation needs to be performed on a
Sunday. Mondays through Fridays 9-4 will be reserved for treating inpatients and their lunch break. While 4-6 will be
reserved for outpatient treatment. Saturdays will be reserved specifically for outpatients. All employees will work
Monday Friday, while on Saturdays there will only be one personnel on site. The PTs and PTAs will alternate working
every fourth Saturday. The Saturday treatments will be reserved specifically to make up some of the missed
appointments from the previous 5 days.
Assuming on average that each employee can see 6-7 patients per day from 9-4, that provides approximately twenty
inpatient treatments per day resulting in 120 - 140 treatments per weeks and about 6240-7280 inpatient treatments per
year. This is a little low to start, but as the department gains more revenue over the first few years, they will be able to
hire on more personnel to gain more treatment days. With that as well not every patient will be seen for a full hour due
to insurance limitations, this will provide for some extra treatment days throughout the week as well. It is expected that
each employee will see on average 2 outpatients per day, resulting in 8 outpatient treatments per day, or 40 per week.
It is anticipated that on average 3 outpatient appointments a day will fall through, resulting in 5 treatments per day, or
25 per week which is the goal. The aim of the department is to exceed that goal however to provide opportunity for
future departmental growth.
Now that the Uintah Rehab department is up and running, measures need to be put in place to ensure that quality
service is being provided. The therapy personnel will be evaluated in many aspects. One aspect is from state surveys.
When the state inspectors come to survey Uintah Hospital the therapy personnel will be under that survey. The
information gathered from the survey will be returned to the Rehab Director, through the chain of command and the
Director will then be able to direct his employees on how they can improve. Another aspect in which the therapy
personnel will be evaluated is through their Professional Impact Plans. These plans consist of goals that each person
sets to help them improve their output. The goals are set with the idea that the plans will be reviewed every 3 months
with the Rehab Director. The rehab director can then use these plans to follow along with the employees to see what
progress they have made with their goals and to see if they are improving their quality.
For the services provided to be evaluated and improved upon there also needs to be information gathered from the
patients as well. Inpatients will be asked about the services provided as part of the state surveys. The information will
again be sent down to the Rehab Director so that he can make any necessary changes to which therapist sees which
patient, or what types of therapy are provided for patients. Outpatients will have the opportunity to fill out posttreatment surveys, to evaluate their experience and how they feel about the services being offered to them.
Using all the methods and all the information gathered from the various sources, the Rehab Director will be able to
teach and lead the department in a way that there is constant progression and improvement. This improvement will
lead to the growth of the department, by increasing the satisfaction of the patients, increasing the departmental
revenue, and eventually increasing the number of personnel. Within five years it is hoped that the department will have
at least one more PT and one more PTA, to help provide more treatments. This will allow all personnel to maintain the
traditional 35-40 hours per week. At the current moment, it is expected that all except the aide will be working in
overtime each week as the department starts up and aims to grow. It is also expected that within the first five years of
operation that patient satisfaction will be able to reach 85%, meaning 85% of patients are satisfied and happy with the
treatments they have received and results from said treatments. It is also projected that within next five years that the
productivity of the physical therapists will be up between 78-80 percent, and the productivity of the assistants will be
between 88-90 percent. It wont be perfect in the beginning as the department first opens. But the room for growth is
what will help provide motivation for all the personnel!

Sources
Karen Jones Regional Director of Therapy Services at Alta Health Services
Bill Lane Director of Operations at Alta Health Services
Steve Potts Rehab Director at Rocky Mountain Care of Hunter Hollow
www.prohealthcareproducts.com/chattanooga-mobile-12-pack-hydrocollator
www.medsupplier.com
www.4mdmedical.com
www.sourceortho.net
www.tensnet.com
www.rehabmart.com
www.homedepot.com
Introduction to Physical Therapy, 4th edition by Michael A. Pagliarulo
The Role of the Physical Therapist Assistant: Regulations and Responsibilities by Holly M. Clynch
Class Unit Lecture Notes