ALLIED HEALTH CLINICAL SKILLS CHECKLIST Occupational ...
ALLIED HEALTH CLINICAL SKILLS CHECKLIST Occupational ...
ALLIED HEALTH CLINICAL SKILLS CHECKLIST Occupational ...
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<strong>ALLIED</strong> <strong>HEALTH</strong> <strong>CLINICAL</strong> <strong>SKILLS</strong> <strong>CHECKLIST</strong><br />
<strong>Occupational</strong> Therapist / Certified <strong>Occupational</strong> Therapist Assistant<br />
Chronic<br />
BTE<br />
Orthopedics 1 2 3 4 5 Discharge Planning 1 2 3 4 5<br />
Fractures/dislocations/amputations<br />
Home assessment (OT only)<br />
UE joint repair/replacement<br />
Home modification/adaptation<br />
LE joint repair/replacement<br />
Home exercise program<br />
Spinal injury/surgery<br />
Functional maintenance program<br />
Traumatic hand injury<br />
Driver re-education<br />
Hand Therapy<br />
Community reintegration<br />
Certified Hand Therapist (OT only) Yes No Documentation 1 2 3 4 5<br />
Modality Certification Yes No PPS (Part A Reimbursement)<br />
Orthotics/Prosthetics 1 2 3 4 5 Medicare Form 700<br />
Static splinting Medicare Form 701<br />
Dynamic splinting<br />
Part B Reimbursement<br />
Serial inhibitory casting<br />
MDS Form<br />
UE prosthetics assess/train<br />
IEP<br />
LE prosthetics assess/train<br />
Goals (objective/measurable) – Short-term<br />
Pediatrics 1 2 3 4 5 Long-term<br />
Cerebral palsy<br />
Patient/family education<br />
Congenital anomalies<br />
OASIS (home health)<br />
Learning disabilities<br />
Electronic Medical Record<br />
Pervasive developmental disorders<br />
Please list any limitations or comments you may have on a separate sheet.<br />
Please list any certifications or additional experience held:<br />
I affirm that all information given on this page is true and accurate. Initials Date © CHG Management, Inc. 2014<br />
Page 2 of 2 Revised 2014<br />
APP329
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