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PT Corporations
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PT Corporations - February 11, 2003 11:15:00 AM
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212engine
Posts: 5
Joined: February 10, 2003
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Besides HealthSouth, Select and Benchmark, who are the other major player in PT?
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Re: PT Corporations - February 11, 2003 5:22:00 PM
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mcap56
Posts: 619
Joined: October 26, 2002
From: New York, NY
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Novacare is a big one.
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Re: PT Corporations - February 11, 2003 7:37:00 PM
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Sam Betts
Posts: 37
Joined: January 30, 2003
From: Peoria, IL, USA
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Physiotherapy Associates, USPT ( franchise ownerships) are also big. Healthsouth, Novacare and Physio Associates are probably the big ones.
Sam B
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Re: PT Corporations - February 12, 2003 3:53:00 AM
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212engine
Posts: 5
Joined: February 10, 2003
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Thanks, if anyone else comes to mind please let me know even if they are only regional.
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Re: PT Corporations - February 13, 2003 5:06:00 AM
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PTupdate.com
Posts: 1478
Joined: October 8, 2001
From: Pittsburgh, PA USA
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NovaCare is owned by Select Medical. I recently heard Benchmark purchased Matrix, which also owns Eagle and other smaller companies.
John Duffy, PT OCS [URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
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Re: PT Corporations - February 13, 2003 9:36:00 PM
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goodlooks58
Posts: 425
Joined: October 21, 2002
From: CA
Status: offline
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212engine: Is there a class action lawsuit planning in the works?!
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Re: PT Corporations - February 14, 2003 5:08:00 AM
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212engine
Posts: 5
Joined: February 10, 2003
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Nope, just a salesman throwing poop on the wall hoping some of it sticks.
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Re: PT Corporations - February 14, 2003 8:16:00 PM
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Sam Betts
Posts: 37
Joined: January 30, 2003
From: Peoria, IL, USA
Status: offline
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212 Engine:
You said:
"Nope, just a salesman throwing poop on the wall hoping some of it sticks"
Are you trying to advertise these companies online for you as an indirect selling method by having PT's here say their names?
If so, which company do you work for and what does it have to offer?
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Re: PT Corporations - February 15, 2003 12:37:00 AM
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johnjfraser
Posts: 102
Joined: June 11, 2000
From: Staten Island, NY
Status: offline
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Corporate owned PT practice is illegal in the great State of New York. . . thank God. And we will continue to fight to keep it that way! (BTW, are we the only state that has this law? This was my impression from a listserve I belong to)
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John J Fraser, PT, MS
johnjfraser@yahoo.com
[URL=http://www.geocities.com/johnjfraser]http://www.geocities.com/johnjfraser[/URL]
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Re: PT Corporations - February 15, 2003 4:28:00 AM
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TLB
Posts: 353
Joined: September 13, 2002
From: Arizona
Status: offline
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Why is New York the only state that has such a law? Wouldn't the APTA be better served focusing on this issue?
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Re: PT Corporations - February 15, 2003 5:31:00 AM
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PTupdate.com
Posts: 1478
Joined: October 8, 2001
From: Pittsburgh, PA USA
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Hey John J. Fraser,
I never knew that about NY! How long has that been in effect? Who pushed for it? How has independent practice grown since implementation? Any threats to that changing?
John Duffy, PT OCS [URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
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Re: PT Corporations - February 17, 2003 11:28:00 AM
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johnjfraser
Posts: 102
Joined: June 11, 2000
From: Staten Island, NY
Status: offline
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TLB,
I dont know if NY is the only state that does not allow it, but I remember someone saying that this was the case. The same goes for physician owned PT practice. In regards to your question on the APTA, I dont know.
John,
The push for this legislation was through the NYPTA. I dont know how long the law has been in existance, but we have been fighting to keep it that way. A new opposing bill was brought forth 3 years ago (by HealthSouth I believe), and we knocked it down. That is why they tried to get away with renaming their practices Sports Physical Therapy of NY (Managed by HealthSouth). But they are going down like a fireball in the sky.
Just Say No to overutilization by corporate owned practice and PT mills.
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John J Fraser, PT, MS
johnjfraser@yahoo.com
[URL=http://www.geocities.com/johnjfraser]http://www.geocities.com/johnjfraser[/URL]
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Re: PT Corporations - February 18, 2003 5:36:00 AM
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PTupdate.com
Posts: 1478
Joined: October 8, 2001
From: Pittsburgh, PA USA
Status: offline
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John,
Remember that over-utilization can occur anywhere but anyone. I have never ever felt the pressure to overdo anything working for NovaCare, but I know there are some private practice PT's that milk the system for all they can.
Remember how many of these corporations came to grow....purchasing private practices and making some PT's quite rich in the process. Greed can be and is everywhere. PT's aren't always angels with halos that do no wrong.
John Duffy, PT OCS [URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
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Re: PT Corporations - February 18, 2003 11:44:00 AM
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mcap56
Posts: 619
Joined: October 26, 2002
From: New York, NY
Status: offline
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John:
Is the issue that corporations can't own PT clinics or just that they can't bill Medicare? Just curious?????? Hopefully it's the former....
Best,
mcap
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Re: PT Corporations - February 18, 2003 1:18:00 PM
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johnjfraser
Posts: 102
Joined: June 11, 2000
From: Staten Island, NY
Status: offline
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MCAP,
They cant own practices period. No private pay, third party payment, Medicare, or anything else. I found this article that was written in 2001 regarding the issue of corporate ownership (it talks mostly about the exclusion of PTAs, but it has some good background info).
TLB,
I also confirmed that NY is the only state to have such a law. The APTA has addressed this issue, read the article.
John,
I am aware and completely agree with you. But hopefully the PTs who are ethical and provide "true" PT interventions will shine and put the low lifes out of business. But there tends to more pressure from management in corporate owned practices to meet financial quotas and not clinical outcomes (there is research out there, dont have specific references at present). I am personally aware of a bunch of them in Jersey.
John J Fraser, PT, MS
PTA Focus: Understanding RC-27
A new APTA position supports PTs as the owners and operators of therapy practices, but is it at the exclusion of PTAs? ADVANCE asks the experts [URL=http://www.advanceforpt.com/previous/aug27_01feature1.html]http://www.advanceforpt.com/previous/aug27_01feature1.html[/URL]
By Mike Le Postollec
Few PTs or PTAs have anything positive to say about corporate rehab chains. A common perception among therapists and assistants is that they're large, impersonal McClinics, staffed by overworked and underpaid employees, and managed by business executives who are more concerned with turning a profit than upholding professional ethics. Even some therapists who work for chain clinics will admit that if it were up to them, they'd work for a therapist-owned and operated facility where quality health care is always priority No. 1.
So it's not surprising that the APTA adopted a formal position on the ownership and operation of PT practices, RC-27C-01, "Physical Therapist Ownership and Operation of Physical Therapy Services." Approved by a House of Delegates (HOD) majority vote at PT 2001 in Anaheim this past June, the RC supports exclusive physical therapist ownership and operation of physical therapy services. The idea is that practices owned and operated by PTs are less likely to engage in unethical, incompetent or illegal practices than clinics run by non-PTs, who aren't bound by the same Code of Ethics.
Most PTs would agree with that point in spirit, but the position did spark some objections at PT 2001, notably from PTAs who were disappointed that RC-27 did not include any exception for PTAs in management or ownership positions. ADVANCE caught up with some of the key players at the HOD meeting to discuss RC-27 and its possible effect on on PTAs in leadership roles.
New York Rejects Corporation Rehab
Although RC-27 represents the APTA's first formal position on exclusive PT ownership and operation of physical therapy services, the motion actually stems from an older New York state law. For years, New York's Regents Rule 29.1(b)(4) has identified the following as professional misconduct: "Permitting any person to share in the fees for professional services," other than those authorized to practice the same profession, which includes business owners who are not PTs. The rule goes on to state, "This prohibition shall include any arrangement or agreement whereby the amount received in payment for furnishing space, facilities, equipment or personnel services used by a professional licensee constitutes a percentage of, or is otherwise dependent upon, the income or receipts of the licensee from such practice.11
A report from the Education Department, Office of Professions, presented at the September 1998 meeting of the New York State Board of Regents, further explained, "In other words, a licensee may not ordinarily share the profits or split fees with a nonlicensee such as a business corporation." Therapists who do so are guilty of professional misconduct, and are subject to penalties of anywhere from administrative warnings to revocation of their license, suspensions and fines.
In lay terms, what this means is that professional corporations licensed to provide physical therapy services, such as PT-owned private practices, licensed hospitals or skilled nursing facilities, are allowed to bill for therapy services provided by their PT employees, and are also able to retain a percentage of the profits from those services. On the other hand, unlicensed, general business corporations (i.e., rehab chains) are allowed to rent facilities and equipment and charge PT employees a management fee, but are not able to collect any profits from therapy performed. The rationale behind this law is to protect patients by ensuring that PTs aren't pressured by a nonlicensed third party to increase the number of therapy visits, use unnecessary expensive treatments or otherwise make clinical decisions for unethical reasons.
It sounds good in theory, but not much has changed since renewed interest in the Regents Rule back in 1998. "Theoretically [PT practice in New York state] is different in that rehab corporations aren't supposed to provide any clinical guidelines or mandate any activities on the part of PTs as to how they practice; all they're allowed to do is provide accounting services, billing" and other management services, said Gabe Yankowitz, PT, co-owner of Van Beveren and Yankowitz Physical Therapy, Syracuse, NY, and former speaker of the delegate assembly of the New York Physical Therapy Association (NYPTA). "But from what the NYPTA has been told, the way rehab chains operate isn't much different." Some rehab chains in New York sold clinics to therapists, but despite the Regents Rule, others continue to operate in much the same way they do in any other state.
The APTA Follows Suit
According to Yankowitz, the NYPTA adopted this position on ownership of therapy practices in response to the state education department's interpretation of the law in 1998. "[At that time], the education department sent a letter to all PTs and PTAs in New York, to let them know that if they were working for a corporation they were violating the law, and could be subject to prosecution and loss of their license," he explained. "When NYPTA members who worked for rehab corporations started contacting the chapter, the delegate assembly realized it would have to take a position." The NYPTA ultimately passed a position supporting the education department's decision.
As a delegate from the New York chapter, Yankowitz brought a version of this position to the floor at the HOD meeting at PT 2001, held in Anaheim in June. In its final form, the position reads, "Consistent with the 2020 Vision Statement of the American Physical Therapy Association defining physical therapists as autonomous practitioners, the APTA supports exclusive physical therapist ownership and operation of physical therapy services." The support statement for the RC goes on to state, "The interests of patients are best served when licensed physical therapists provide physical therapy services independent of influence by non-physical therapist owners of physical therapy services."
One reason the NYPTA brought this to the floor, Yankowitz said, is that rehab corporations have been lobbying to change the Regents Rule in New York state. "The NYPTA felt that if we could get the APTA to adopt a position that's in line with ours, it'd be helpful to us in fighting any attempts to change the law," he said. "So when we lobby our state legislators in Albany, we could point to the national association's support of [RC-27]." Yankowitz added, however, that "NYPTA also wanted to move the entire association and profession in this direction."
PTAs in Management
The RC was passed by a majority vote, but not before some heated debate. One particular point of contention was that a National Assembly motion to also endorse PTAs as clinic managers and owners was defeated. Some in attendance felt that by excluding PTAs from the RC, the APTA did not show support for the growing number of assistants moving into management positions or opening their own private practices. "[RC-27] doesn't address PTAs directly; what it basically supports is exclusive PT ownership and operation of PT services," Yankowitz explained. "The argument against an amendment to include PTAs was, 'How can a PTA be the owner of a practice, but also work under the direction of a PT employee?'"
According to Karen Ryan, PTA, president of the National Assembly, the real issue is the distinction between clinical and business management. For example, whereas an assistant may be qualified to manage personnel, set up compliance programs and handle other business aspects of a rehab department, it's in violation of state practice acts for a PTA to diagnose patients, set a plan of care or otherwise act in a clinical leadership role. The key, she said, is for the PTA manager or practice owner to know how to operate in this dual role.
"For the most part, I think the feeling is that PTAs understand their professional code of ethics and the supervisory laws in their state, so they can own and operate a PT business," she said. "The problem is that some people confuse business management with clinical practice. I feel comfortable saying there's a pretty distinct line between the two, but some PTs feel very strongly that only a PT should own or manage a PT practice." Ryan used the example of a PTA rehab director who handles the business decisions at her facility, but queries staff therapists in her department about clinical decisions.
Yankowitz agreed, adding that the intention of the position was to cut out corporate abuse, not to stifle PTAs' career growth. At this point, RC-27 is solely a position of the APTA, not a legal document. Whether states adopt this position into law to push business entities out of PT practice, and any effect on PTA practice managers and owners, remains to be seen.
Mike Le Postollec is on staff at ADVANCE and can be reached at mlepostollec@merion.com.
------------------
John J Fraser, PT, MS
johnjfraser@yahoo.com
[URL=http://www.geocities.com/johnjfraser]http://www.geocities.com/johnjfraser[/URL]
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Re: PT Corporations - February 21, 2003 9:17:00 AM
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212engine
Posts: 5
Joined: February 10, 2003
Status: offline
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In reply to Sam Betts, no I don't work for any...I just want to sell them Post-Its and paperclips. I thought it was an innocuous question, but apparently there are some pretty strong opinions regarding them.
Thanks for the replies
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