If you are thinking of working in a SNF/TCU…

I’ve had some students recently ask me about searching for work in the TCU.  I love the TCU setting – the medical complexity, the rehabilitation for all different diagnoses (ortho, cardiopulm, neuro), getting people back home.  If you are looking at TCU’s, these are some of the things I’ve considered when looking for work:

  1. The Medicare rating – 4 and 5 stars is a good starting point; I’ve worked at a 3 and where I was at until July was a 1 for a while (upgraded to a 2 currently) and I would still willingly work there, so I wouldn’t automatically cross one off your list because of this.
  2. In-house vs contract therapy:
    1. Productivity will probably differ; from my observation in-house productivity is relatively lower (see my blog post https://geriatricpt.wordpress.com/2016/01/28/thoughts-on-productivity/ ).   Find out what their productivity expectations are, and what they might have to help you achieve it.
    2. Employee satisfaction: I work at a place with low turn-over – we could get more pay elsewhere possibly, but at what cost?  What is employee satisfaction like? (ask current employees away from the interview time – if you know any prior grads at a TCU ask what they think of their company, or go to a PT Pub Night, or ask classmates what companies and locations they interned at and what they thought about the corporate culture).
  3. Will you be at one site, floating as needed between sites, or doing HH as needed?
  4. Get a sense of how important rehab is to the facility – if they put money into the rehab dept (as it is where a facility makes its money) it makes a real difference.  If the gym is in the basement with no windows and little equipment, it may be depressing to you and to the patients.
  5. What is the con-ed budget?  Companies may offer CEU’s through ACP (the modalities company) or Medbridge and have less of a discretionary con-ed budget.
  6. Mentoring – is there a PT you can turn to as a new grad if you have questions or need help?  Ideally an official mentor, but that doesn’t happen really in this setting (or rarely).
  7. Will you be all alone as a new grad?
  8. Will you be responsible for a PTA (or two???) as a new grad?
  9. What is the typical day like – treatment times, diagnoses generally seen, etc.
  10. How much is TCU vs LTC vs OP?  (I have been in a combined setting most of my career thus far).
  11. Holidays and weekend – how many do you have to work, or are you on call, etc?
  12. Dress code?
  13. Weekend pay differential if you are required to work weekends?
  14. Do they reimburse licensure? (pretty rare in TCU)
  15. What is the nursing: patient ratio (and the NAR: patient ratio)
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