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Wonder girl

Dear Andrea,

I took your Musculo Primer class in Eden Prairie last Summer with the people from Hong Kong. I am wondering if you can send/forward me a sample of one of your daily PT notes for pool therapy. We are getting more pool referrals from MDs and I am putting what I learned from your class to use :) but wanted to see an example or template for daily notes, especially to ensure I'm documenting all the correct things for reimbursement. I am hoping to take another of your courses in the upcoming year!  Thanks, Sarah L, Northfield, MN

Dear Sarah,

Thank you so much for the kind words. We are delighted to hear that your business is prospering. To that end, I have attached some samples to use for documentation. I am also enclosing library language that you are free to use in your assessments to justify aquatic therapy.

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Click on the links below and get open access to these resources:


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b2ap3_thumbnail_6a00d83453c2c669e201761789b11b970c-320wi.jpgQuestion:How do I start an aquatic therapy program in my facility?

Answer: Yikes! Big Question. Let's look at the highlights.

Renting. Are you planning to rent space in an outside facility pool instead of building? Here is a link to an article that might be helpful. (It lists the scary things to watch out for, so don't panic when you read it, but it will open your eyes to what to consider.)

To read more about renting (what is the going rate, etc), go here.

Medicare: If you are going to treat Medicare patients in that community pool, you have to rent exclusive use of a portion of the pool. Your client can't intermingle with the public during your sessions.

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b2ap3_thumbnail_6a00d83453c2c669e20177443fed89970d-500wi.jpgEight years ago Stacy Lynch of Summit Therapy Group, Phoenix, Ariz. was thrown into the aquatic therapypool and since then, he hasn’t looked back.

“I went from having just four visits in the pool in three months to being in the pool every day for two to six hours, constantly learning,” Lynch said.

And that constant learning process is what stuck with him. He says the more education and knowledge he gained about aquatic therapy, the more he knew it was something he wanted to be doing.

Lynch has been a physical therapy assistant for 17 years and works mostly with geriatric patients in aquatic therapy. But he didn’t always concentrate on aquatics. In fact, he didn’t always want to be a physical therapy assistant. It was in a college bookstore at McLennan Community College in Waco, Texas where Lynch met a man who sparked his interest in physical therapy.

“I saw this man in a wheelchair and I discovered myself just staring at him. I was watching him put his books on the counter with his feet, write his check with his feet and hand it to the cashier with his feet. I felt compelled to talk to him.”

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b2ap3_thumbnail_6a00d83453c2c669e201774400c0bf970d-320wi.jpgQuestion: We recently received a request from our Medicare Contractor asking for documentation that verified that the therapist was in the water during aquatic therapy session. We have never had this request before.

Most of our sessions, the therapist is in the water, but sometimes she is not. Under neither circumstance do we specifically document the location of the therapist. Is this a valid restriction or reason for denial? Does the therapist have to be in the water for it to be considered skilled care. Help!

Answer: OK, let's tease out the two issues being discussed here. 

Skilled versus Unskilled Care.

First, is the care "skilled"? The answer is: it depends. Certainly, a therapist who remains on the deck for part of a session is not automatically providing "unskilled" care. In fact, here are some examples of situations that I would argue the therapist should position him or herself on the deck specifically in order to increase the caliber of care provided:

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