New Grad Experience at a CCRC - OTA/PTA Powerback Employee Review

While as a new grad, the company seems great to me, I’m starting to discover it is possibly because I don’t know any better at this point in my career. Working at a CCRC was always a goal of mine, as I want to specialize in geriatric and neurological disorders as I develop in my career. Something extremely difficult about working at a facility with med A, med B, and private insurance is that the administrators at PBR really harp on the minutes billed and unit optimization in order to get the most money from insurance. With a productivity expectation of 90-95% for therapist assistants, you must choose between sacrificing your quality of care, quality of documentation, or your work-life balance. But don’t think about documenting off the clock or going into over time in order to get your notes done! That’s grounds for immediate termination, and they mean it. While my clinic director and one of the supervising PTs at my facility are very supportive and willing to give me time for my learning curve as a new grad, the administrators (regional manager) are already harping on my productivity. Mind you, I have only been employed for 1 month and was told I’d have a comfortable ramping up process. That was not the reality, though I also have a tendency to over exert myself and not say no to more responsibilities when given the chance. I do believe it is every company’s culture to take advantage of new grads like me. I have been asked to do all but sign progress notes and discharges. One of the supervising PTs at the facility was offended when I asked them for feedback (seeing as how in Maryland PTAs aren’t really supposed to be doing those types of notes, and I’m a new grad so it was my first time doing them at all), and instead complained that I was just putting more work on their plate and I just needed to use the Builds and figure it out. The other supervising PT was much more helpful and allowed me to only contribute to the parts of PNs/DCs that I was comfortable with, I.e. the summary of objective measures/progress/current status of goals, and even thanked me for my contributions and gave me feedback. The pressure of productivity makes me worry about shady billing practices along with having PTAs do PNs and DCs, because that puts more documentation on us because we need to complete separate daily notes as well, further affecting my productivity having to write double notes. Bonus/raise structure is unclear at best, nonexistent in general. Our facility does all of our scheduling analog style with date book and pencil, and there is no structure in appointment slots for OP vs IP, meaning I am running around trying to get SNF/ALF/MC patients eating into my treatment time and often interrupting their meals or medication times because of how the schedule shakes out. The company doesn’t credit the clinician if there are missed visits, even if it’s a no show or the patient was taken to the hospital, meaning in a setting with mostly fragile patients whose statuses are constantly changing we have a decent amount of missed visits which hurt productivity. The onus to fill those missed visits is on the individual clinicians, but it’s not a guarantee you’ll be able to fill the slot or get already scheduled pts to be able to move their appointment up to fill the dead time. Overall, there are definitely stressors, but I don’t think they necessarily outweigh the pros. It definitely depends on your clinic/rehab director, the patients, and your fellow clinicians whether you feel valued and supported vs taken advantage of. So far I’m more in the valued and supported camp, with little trickles of the taken advantage when I’m writing PNs/DCs.