2. ACUTE CARE (SHORT-TERM HOSPITAL)
 Treatment for a short-term illness or health problem
 Average patient length of stay is <30 days. Usual length of stay is <7
days
 Provider may be a physician, physician assistant, nurse, physical
therapist, etc.
 Rapid discharge for next level of care makes the PT’s role in patient
and family education and in discharge planning increasingly
important

3. PRIMARY CARE
 Basic or first-level, health care
 Provided by primary care physicians
 Including primary practice physicians, pediatricians, internists, and
sometimes obstetric/gynecologic physician specialists
 Provided on an outpatient basis
 PT’s support primary care teams through examination, evaluation,
diagnosis, prognosis and prevention of musculoskeletal and
neuromuscular disorders
 Often the PCP is the “gatekeeper” to other subspecialists, including
PT

4. SECONDARY CARE (SPECIALIZED CARE)
 Second-level medical services
 Provided by medical specialists, such as cardiologists, urologists
and dermatologists, who do not have first contact with patients
 This care often requires inpatient hospitalization or ambulatory
same-day surgery such as hernia repair

5. TERTIARY CARE (TERTIARY HEALTH CARE)
 Highly specialized, technologically based services (heart, liver or
lung transplants and other major surgical procedures)
 Provided by highly specialized physicians in a hospital setting
 PT’s respond to requests for consultation made by other health-care
practitioners

6. SUBACUTE CARE
 An intermediate level of health care for medically fragile patients too
ill to be cared for at home
 Provided by medical and nursing services as well as rehabilitative
services; (PT, OT, ST) at a higher level than is offered in a skilled
nursing facility on a regular basis
 Provided within the hospital or SNF setting

7. TRANSITIONAL CARE UNIT
 Hospital-based skilled nursing facility (SNF)
 Care provided by medical, nursing and rehabilitation services on a
daily basis
 Patients are often discharged home, to assisted living facilities or
SNF’s

8. AMBULATORY CARE (OUTPATIENT CARE)
 Includes outpatient preventative, diagnostic and treatment services
 Provided at medical offices, surgery centers, or outpatient clinics
 Providers may be physicians, physician assistants, nurse
practitioners, PTs and others
 Less costly than inpatient care. Favored by managed-care plans
 Outpatient rehabilitation centers, or PT clinics, out-patient satellites
of instructions or privately owned outpatient clinics

9. SKILLED NURSING FACILITY (EXTENDED CARE
FACILITY)
 Free standing or part of a hospital
 Care provided by continuous nursing, rehabilitation and other
health-care services on a daily basis
 Medicare defines “daily” as 7 days a week of skilled nursing and 5
days a week of skilled therapy
 Patients are not in an acute phase of illness, but require skilled care
on an inpatient basis
 SNFs must be certified by Medicare, and meet qualifications
including 24-hour nursing coverage, availability of PT, OT and ST

10. ACUTE REHABILITATION HOSPITAL
 Facility that provides rehabilitation, social and vocational services to
disabled individuals to facilitate their return to maximal functional
capacity
 Rehabilitation involves the coordinated services of medical,
rehabilitative, social, educational and vocational services for training
or retraining

11. CHRONIC CARE FACILITY (LONG-TERM CARE
FACILITY)
 Long-term care facility provides services to patients equal or beyond
60 days
 Medical services provided to patients with permanent or residual
disability caused by a nonreversible pathological health condition
 May require specialized care/rehabilitation

12. CUSTODIAL CARE FACILITY
 Patient care that is not medically required but necessary for the
patient who is unable to care for him/herself
 Custodial care may involve medical or nonmedical services that do
not seek a cure
 This type of care is usually not covered under manage-care plans
 Daily care is delivered by nonmedical support staff

13. HOSPICE CARE
 Care available for dying patients and their family at home or
inpatient settings
 Hospice team includes: nurses, social workers, chaplains,
volunteers and physicians. PT and OT services are optional
 Medicare and Medicaid require at least 80% of hospice care to be
provided at home
 Eligibility for reimbursement includes:
Medicare eligibility
Certification by physician of terminal illness (less than or equal to
6months of life)

14. HOME HEALTH CARE
 Health care provided to individuals and their families in their homes
 Provided by a home health agency, which may be governmental, voluntary, or
private nonprofit or for-profit
 Patient eligibility includes:
 Homebound or has great difficulty leaving the home without assistance or
any assistive device
 Health risk leaving the ho9me
 Requires skilled care from one of the following services: nursing, PT, OT or
ST
 Physician certification
 Potential for progress
 More than housekeeping deficits

15. HOME HEALTH CARE
 Environmental safety is consideration of PT like proper lighting,
securing of scatter rugs, handrails, wheelchair ramps
 Supplemental equipment may be necessary like raised toilet seats,
grab bars, long-handled utensils, if delivered by a licensed durable
medical equipment vendor to the home at the time of discharge
from the hospital

16. HOME HEALTH CARE
 Adaptive equipment ordered in the home is not reimbursable except
for items such as wheelchairs, commodes, hospital beds
 Substance abuse should be reported immediately to the physician
 Physical abuse should be communicated immediately and directly to
the proper authorities specially if child abuse is suspected
 The laws that mandate reporting of abuse of an elder, disabled
individual or minor may vary from state to state

17. SCHOOL SYSTEM
 The PT serves as a consultant to teachers who work with students
with disabilities in the classroom
 Major goal of PT treatment is the child’s functioning in the school
setting
 Recommendations are made for adaptive equipment to facilitate
improved posture, head control and functions like using a computer
viewing a blackboard, improving mobility from class to class

18. PRIVATE PRACTICE
 Entrepreneurial PTs that work for or own a free standing
independent PT practice
 May accept all insurances if they have provider numbers
 Settings may vary from sports physical therapy and orthopedic
clinics, rehabilitation agencies, occupational health
 Must document every visit and complete reevaluation at least every
30 days for reimbursement purposes