1. education

Using Evidence-Based,
Standardized Tests
and Measures
 Check the Workshop You Will Attend:
 Augusta, GA - June 04, 2015
 Macon, GA - June 05, 2015
 Atlanta, GA - June 06, 2015
Receipts Sent Via Email - Please Print Clearly!
ATTENTION: Copy as needed for each attendee or print
additional forms at www.summit-education.com
EMAIL OR PHONE # REQUIRED!
Name*____________________________________________________
Email*___________________________________________________________
Profession/Job Title* ______________________________________________
Organization_____________________________________________________
Billing Address*___________________________________________________
Address2 _______________________________________________________
An Important Workshop for All SNF, Home Health, & Acute Care Professionals
 Alpharetta, GA - June 18, 2015
 Chattanooga, TN - June 19, 2015
 Knoxville, TN - June 20, 2015
Pricing* All prices are per person
Easy Registration!
EARLY
$199 | Single Person
$189 | 2-4 People
$169 | 5+ People
1. Online: www.summit-education.com
2. Phone: (800) 433-9570
3. Fax: (615) 376-8233
4. Mail: Summit Professional Education
PO Box 908 | Franklin, TN 37065
REGULAR
$219 | Single Person
$209 | 2-4 People
$189 | 5+ People
*Early registration must be received 14 days prior to workshop.
GROUPS: Registrations and payment must be received together
via fax or mail. You may also register online if payment is with a
single credit card.
City*_____________________________State*_______ Zip*_______________
Summit Professional Education
PO Box 908
Franklin, TN 37065
EMAIL OR PHONE # REQUIRED!
Phone*_____________________________________Ext._________________
(MM)
(YY)
(YRS)
CE Renewal Date _________
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Using Evidence-Based,
Standardized Tests
and Measures
PRSRT STD
U.S. POSTAGE
PAID
NASHVILLE, TN
PERMIT NO. 989
Payment Required For Registration
Check, credit card or company purchase order (PO#) MUST accompany
this registration form.
ESSENTIAL TOOLS FOR
Documenting Functional Progression
Supporting Medical Necessity
Validating Skilled Therapy Services
PRIORITY CODE:
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Benefits to Attending
PTESGM.0615.1
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Workshop Dates
An Important Workshop for All SNF, Home Health, & Acute Care Professionals
Using Evidence-Based,
Standardized Tests
and Measures
Workshop Dates
Augusta, GA
June 04, 2015
Macon, GA
June 05, 2015
Atlanta, GA
June 06, 2015
Alpharetta, GA
June 18, 2015
Chattanooga, TN
June 19, 2015
Knoxville, TN
June 20, 2015
ESSENTIAL TOOLS FOR
Documenting Functional Progression
Supporting Medical Necessity
Validating Skilled Therapy Services
Benefits to Attending
• Practice and review more than 50 objective
tests and measures with hands-on labs
• Learn to document, support and validate
functional progression as well as the
medical necessity and continuation of care
• Improve clinical documentation, pay for
performance, and outcomes data accuracy
• Justify skilled therapy interventions
and satisfy managed care and CMS
documentation requirements
• Sharpen clinical judgment and decision-making
• Administrators - Take home information to
educate your staff
REGISTER
www.summit-education.com or call 800-433-9570
• Practice and review more than 50 objective tests and measures
with hands-on labs
• Learn to document, support and validate functional progression as
well as the medical necessity and continuation of care
• Improve clinical documentation, pay for performance, and
outcomes data accuracy
• Justify skilled therapy interventions and satisfy managed care and
CMS documentation requirements
• Sharpen clinical judgment and decision-making
• Administrators - Take home information to educate your staff
PTs & PTAs
OTs & OTAs
Rehabilitation Directors
Nursing Home Administrators
Nurses & Nursing Assistants
MDS Coordinators
Social Workers
Athletic Trainers
REGISTER
June 04, 2015
Macon, GA
June 05, 2015
Atlanta, GA
June 06, 2015
Alpharetta, GA
June 18, 2015
Chattanooga, TN
June 19, 2015
Who Should Attend
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Augusta, GA
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Case Managers
Home Care Administrators
Acute Care Managers
Rehab Case Managers
Administrators
Home Health Professionals
Directors
www.summit-education.com or call 800-433-9570
Knoxville, TN
June 20, 2015
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Dates & Locations
Augusta, GA
June 04, 2015
Doubletree Hotel
2651 Perimeter Pkwy
Augusta, GA 30909
(706) 855-8100
Macon, GA
June 05, 2015
Wingate by Wyndham Macon
100 N Crest Blvd
Macon, GA 31210
(478) 476-8100
Atlanta, GA
June 06, 2015
DoubleTree Suites Galleria
2780 Windy Ridge Pkwy
Atlanta, GA 30339
(770) 980-1900
Alpharetta, GA
June 18, 2015
Hilton Garden Inn Atlanta North/
Alpharetta
4025 Windward Plaza
Alpharetta, GA 30005
(770) 360-7766
Chattanooga, TN
June 19, 2015
Chattanooga Convention Center
1150 Carter Street
Chattanooga, TN 37402
(423) 756-0001
Knoxville, TN
June 20, 2015
Holiday Inn Knoxville West-Cedar Bluff
9134 Executive Park Dr
Knoxville, TN 37923
(865) 693-1011
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Using Evidence-Based, Standardized
Tests and Measures
Functional Progression, Medical Necessity & Skilled Therapy Services
With pay-for-performance programs, skilled treatments and evidence-based medicine now firmly ensconced,
healthcare coverage and reimbursement systems are changing. Both public and private insurers are transitioning,
with more than half of commercial and managed care organizations using pay-for performance and current legislation
requiring Centers for Medicare & Medicaid Services (CMS) to adopt this approach. These changes are significantly
impacting how care is being delivered and covered in the rehabilitative fields of physical and occupational therapy.
This workshop will focus on how to use objective, evidence-based, standardized tests and measures to accurately and
appropriately document and justify overall function. These tests also track performance in the areas of motor, sensory,
perception, vision, cognition, pain and cardiopulmonary status. The use of these standardized measures will improve
and substantiate documentation, validating skilled services and justifying continued services by taking patient progress
out of the realm of guessing and hypothesis into the world of proven data. In one day participants will review many of
the tests and measures covered with hands-on practice labs that will improve clinical documentation and substantiate
sustained need while implementing evidence-based care. This workshop is beneficial for multiple disciplines,
populations, and settings and offers skills and techniques that can be implemented immediately.
About Your Program Instructor
Gerard Mounic, OTD, OTR/L, BCPR, C/NDT, COS-C, LSVT-C,
AOTA Board Certified Physical Rehabilitation. Gerard Mounic is a licensed and registered Occupational Therapist, AOTA
Board Certified in Physical Rehabilitation with more than 13 years of clinical experience. Dr. Mounic also holds certifications
in Neuro Developmental Treatment (NDT), FIM and OASIS-C, has completed advanced vision and vestibular training, and
is a private Medicare provider. His experience spans multiple settings including acute, sub-acute, inpatient/outpatient,
rehabilitation and home care. Dr. Mounic’s training includes providing home modifications for safety and functional needs,
wheelchair seating and positioning, ergonomic evaluation, fall prevention, stroke rehabilitation, and the use of robotics
in recovery. With extensive clinical research on upper extremity robotics and CIMT, Dr. Mounic is an experienced program
developer and neurology clinical expert, presenting nationally on topics such as vision, perception, and cognition as well
as wheelchair seating, positioning and postural control. Dr. Mounic currently holds a clinical Doctorate in Occupational
Therapy and is Board Certified in Physical Rehabilitation by the American Occupational Therapy Association.
Learning Objectives
2. Explain the meaning of Skilled Interventions, Reasonable and Necessary, Functional Progress.
3. Develop best standards of practice in evidence-based care and documentation.
4. Determine appropriate tests and measures for disease and/or patient specificity.
5. Apply standardized tests and measures in daily clinical practice to substantiate need, validate progress,
and improve care.
Help? www.tinyurl.com/qrhelp
Workshop Schedule
Your instructor will break
for 15 minutes in the
morning and afternoon at
appropriate times.
7:30am – Registration & Coffee
8:00am – Workshop Begins
11:30am - 12:30pm – Lunch On Your Own
3:30pm – Workshop Adjourns
Some facilities may charge for parking, which is at your own expense.
REGISTRATION, CONFIRMATION & CERTIFICATES
Confirmations of registration will be sent via email. A copy of your registration confirmation will serve as
Continuing Education Credit
I. Changes in Healthcare Delivery and Coverage
»» What is "Skilled Therapy"
»» What does "Reasonable and Necessary" imply and how is it documented?
»» Effective documentation vs. ineffective documentation
»» Reimbursable vs. non-reimbursable
Occupational Therapists - Summit Professional Education is an AOTA Approved Provider of continuing
education - provider #5873. This course is offered for 0.6 AOTA CEUs (6.0 contact hours). The assignment of
AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.
GA: This workshop meets the requirements for Georgia State Board of Occupational Therapy amended rule
671-3-.08(5) and (10) Renewal of License, Penalties, Continuing Education Requirements. This workshop is
offered for 6.0 hours.
II. Functional Performance
»» Activity Measure for Post Acute Care (AM-PAC) for G-Code Conversion
»» Functional measures
»» Performance measures
»» ADL measures
»» Additional tests and measures
R HANDS-ON LAB
III. Motor and Balance Performance Measures
»» Timed "Up and Go"
»» Motor Assessment Scale (MAS)
»» Chedoke-McMaster Stroke Assessment
»» Rivermead Motor Assessment (RMA)
»» Additional tests and measures
»» Berg
»» Functional Gait Assessment
»» Dynamic Gait Index
»» Tinetti Falls Efficacy
»» Dizziness Handicap Inventory
»» Fugl Meyer
R HANDS-ON LAB
IV. Pain and/or Back Measures
»» Visual Analogue Scale
»» Numeric Pain Rating Scale
»» Disability Questionnaire
»» Oswestry Low Back Pain Disability Questionnaire
R HANDS-ON LAB
1. Review clinical expectations in a changing environment.
THE SUMMIT GUARANTEE
Summit Professional Education is a national leader in high-quality educational products and services for
today’s professional. Our seminars and training programs are designed to help professionals achieve
improved performance and results in all areas. Our faculty is the “best of the best” in their fields of expertise,
providing programs that really make a difference to participants. If for any reason you are not satisfied with
the program, simply notify the registrar of your intent to withdraw from the program prior to the first morning
break, turn in your workshop materials and receive a 100% refund or credit on a future program.
Workshop Outline
V. Cognition
»» Montreal Cognitive Assessment
»» Test of Executive Function
»» Hopkins Test of Verbal Memory
»» Kettle Test
»» Contextual Memory Test
»» Additional Tests and Measures
R HANDS-ON LAB
VI. Vision and Perception
»» Neurological Vision Assessment
»» Varied Perceptual Assessments
Physical Therapists - AL: not available. GA: As per policy #7 (f) of the Continuing Competence Policy of
the Georgia State Board of Physical Therapy a program approved by another state board qualifies for class
I approval. This course has been reviewed and approved by the Arkansas Board of Physical Therapy, 6.0
hours. KY: Summit Professional Education is approved by the Kentucky Physical Therapy Association as
a continuing education provider. 6.0 contact hours, (Class I) will be granted for course completion and
the approved provider number is CS45-2008-KPTA. NC: As per North Carolina Board of Physical Therapy
Examiners regulations if this seminar is approved by another state PT Board or APTA chapter it is accepted by
the NCBPTE. This seminar has been approved by the Arkansas State Board of Physical Therapy, 6.0 hours. SC:
The South Carolina Board of Physical Therapy Examiners has determined that a program approved by another
state board qualifies as meeting state continuing education requirements. This course has been reviewed
and approved by the Arkansas State Board of Physical Therapy, for 6.0 hours. TN: As per the General Rules
Governing the Practice of Physical Therapy, Rule 1150-1-.12 of the Tennessee State Board of Physical Therapy,
workshops attended by the licensee which have been approved for continuing education units (CEUs) by
another state licensing board qualifies as course approval. This course has been approved by the Arkansas
Board of Physical Therapy for 6.0 contact hours. VA: Summit Professional Education is approved by the
Board of Certification, Inc. (BOC) to provide CEs for Athletic Trainers (NATA). According to rule 18VAC112-20-131
Subsection B-1.g of the Virginia Board of Physical Therapy this workshop can be offered to physical therapists
and assistants for 6.0 Type I CEUs.
Athletic Trainers - Summit Professional Education is recognized by the Board of Certification, Inc. to offer
continuing education for Certified Athletic Trainers. This program has been approved for a maximum of 6.0
hours of category A continuing education. Certified Athletic trainers are responsible for claiming only those
hours actually spent participating in the continuing education activity. BOC Approved Provider Number: P3785.
Nursing Home Administrators - Summit Professional Education is a Certified Sponsor of professional
continuing education with the National Association of Long Term Care Administrator Boards (NAB) and has
approved this program for 6.0 clock hours, approval # 14112015-6.00-11956-in. State licensure boards have
final authority on the acceptance of individual courses.
Social Workers - Summit Professional Education, provider # 1201, is approved as a provider for social work
continuing education by the Association of Social Work Boards (ASWB) www.aswb.org, through the Approved
Continuing Education (ACE) program. Summit Professional Education maintains responsibility for the program.
Social workers participating in this course will receive 6.0 clinical continuing education clock hours. SC: not
presented by a social worker.
Case Managers - This program has been pre-approved by The Commission for Case Manager Certification to
provide continuing education credit to CCM® board certified case managers. The course is approved for 6.0 CE
contact hour(s). Activity code: S0004651. Approval Number: 20137288.
Home Care, Rehabilitation and Other Professionals - This seminar qualifies for 6.0 continuing education
hours as required by many national, state and local licensing boards and professional organizations. Save your
course outline and certificate of completion, and contact your own board or organization for specific filing
requirements.
Nurses - 6.0 contact hours
This continuing nursing education activity was approved by the Tennessee Nurses Association, an accredited
approver by the American Nurses Credentialing Center’s Commission on Accreditation.
These events contain intermediate level content.
WORKSHOP HANDBOOK
Included with your registration you will receive a comprehensive manual compiled by the instructor.
DISCLOSURES: Guidelines exist whereby all speakers must disclose any relevant relationships. Gerard Mounic is
compensated by Summit as an instructor. He has no non-financial relationships to disclose.
SCOPE OF PRACTICE: Workshop content is not intended for use by participants outside of the regulatory
scope of practice of their license(s). You are responsible for knowing what lies within and without your
professional scope of practice.
Have continuing education credit questions? Please email our CE Department at
[email protected] for the latest approval status. Join Our Faculty
Please dress comfortably to allow participation
in practice sessions.
your receipt for fees paid at the time of registration. Walk-ins are welcome but must register onsite. Please notify
us at least thirty (30) days in advance if you have special needs or require assistance. Certificates are mailed
to the seminar location 5 business days in advance. If your certificate is not available the day of the seminar,
please complete a certificate request onsite and a copy will be sent to you. Hotel locations must occasionally be
adjusted. Please provide an email address and phone number to receive any important updates.
attendee. If the cancellation is made within ten days or less, refunds will not be granted for any reason. A credit
voucher will be issued that may be used toward a future seminar. Credit vouchers are transferable and do not
expire. In cases of inclement weather where the seminar is conducted as scheduled, you may request a credit
voucher toward a future seminar. If we must cancel or change the seminar for any reason, our liability is limited
to the cost of tuition. If you register and do not attend, you are still responsible for payment.
SUBSTITUTION & CANCELLATION POLICY
Substitutions may be made at any time. Requests for cancellation must be received in writing by fax or mail
ten (10) days prior to the seminar in order to receive a refund less a $20.00 administrative charge per canceled
W-9: To download a copy, logon to www.summit-education.com/w-9
FEID Number: 47-1189590
Summit Professional Education is currently seeking qualified
professionals to develop and teach workshops nationally. Visit
www.summit-education.com/instructor for more information.
800-433-9570 | www.summit-education.com