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OT

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Occupational Therapist

www.scolariconsulting.com

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Welcome to Your Course!

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This course is designed to be interactive and engaging. To get the most out of it, please remember:

  • Listen carefully to the audio and video instructions.
  • Click through each section and explore the interactive features.
  • Follow the prompts to complete activities, quizzes, and exercises.
  • You cannot fast forward through content: Navigation arrows will appear to guide you forward once each section is complete.

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Enjoy your learning journey—we’re here to support you every step of the way!

Purpose of the Course

Welcome to the Occupational Therapist Training for PACE.In PACE, you’re a lifeline—a protector of function, a translator of subtle decline, and a key voice in keeping participants safely at home, where they want to be.Every transfer, every utensil, every hallway navigated with or without a walker—it all tells you something. Something others might miss.This course was built for you—the OT who doesn’t just focus on rehab, but on preserving dignity, preventing crisis, and making sure that no red flag slips through the cracks.You’ll walk through the real decisions that define your day:

  • When do you speak up in the IDT?
  • How do you document function, not just facts?
  • What do you do when a participant says “I’m fine”—but their body says otherwise?

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Module 2
Module 1
Module 3
Module 4

Module 1

Role Overview & Daily Practice

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introduction

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A Day in the Life of a PACE OT:

Being an Occupational Therapist in PACE means bringing function, safety, and dignity into every space a participant lives — from the day center to the home.

You build independence with tools and trust.

You ask the questions others don’t.

You spot the functional red flags.

You document what matters.

You go where the risks live.

You speak up in the IDT.

You observe. You interpret. You act. And you collaborate — so your insights lead to team alignment and participant safety.

In the home, you see the gaps: cluttered hallways, unsafe transfers, overwhelmed caregivers. You adjust environments, teach techniques, and recommend the right equipment.

Title

You bring the real-world lens. You translate struggles with dressing or bathing into care plan updates, safety recommendations, and caregiver training needs.

A modified spoon, a grab bar, a morning routine that works — small changes create big wins when they’re matched to the person, not just the diagnosis.

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“How are mornings at home?” “What’s hard that used to be easy?” You listen, not just assess. Because what participants can’t say often shows in what they can’t do.

Skipped hygiene. Trouble with buttons. A new hesitation with the walker. These aren’t just habits — they’re signals. And you catch them early.

Subtitle

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MODULE 1
Role Overview & Daily Practice

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learning objectives

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By the end of this module, you will be able to:

Describe the core responsibilities of the OT role in a PACE program.

Identify key touchpoints in a typical OT workday across home, center, and team settings.

Recognize how the OT supports participant-centered care and interdisciplinary teamwork.

MODULE 1
Role Overview & Daily Practice

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What Is the 4C Formula?

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What Is the 4C Formula?

As an Occupational Therapist in PACE, your documentation is more than a clinical log — it’s a reflection of your clinical reasoning, your participant-centered approach, and your role in keeping participants safe, functional, and independent. The 4C Formula helps you structure your notes so they speak clearly to the care you provided and the team decisions it supports.

The 4C Components

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MODULE 1
Role Overview & Daily Practice

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complete vs incomplete documentaton

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Vague Note:

“Participant needed help with dressing. Caregiver present.”

4C Note:

“Participant required max assist for dressing; unable to initiate task and confused by steps (Clear Observation). Likely cognitive decline impacting ADL sequencing (Clinical Interpretation). Provided task breakdown with visual cues; caregiver educated on pacing and prompts (Care Action). Concern escalated to IDT for cognition re-evaluation and home support review (Collaborative Next Steps).”

Click to Learn a Pro Tip

MODULE 1
Role Overview & Daily Practice

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What Is the 4C Formula?

Compare the itemsin this table

Participant: Mrs. Chang – Post-Stroke Home Visit

MODULE 1
Role Overview & Daily Practice

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Common Mistakes & Red Flags

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Impact
Impact
Impact

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Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Increased risk of falls or injury.

Delayed care plan updates.

Unsafe home care or readmission risk.

Mistake

Mistake

Mistake

Fix
Fix
Fix

Assuming DME was delivered and used correctly.

Documenting observations but not alerting the team.

Skipping caregiver training due to time pressure.

Always verify use during visits and document observations.

Use structured handoff or tag in EMR for urgent items.

Prioritize and document brief, targeted training sessions.

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Title

Title

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MODULE 1
Role Overview & Daily Practice

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best practices

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Best Practices for OT Daily Practice in PACE

Start your day with EMR review to catch overnight notes and care gaps.

Balance hands-on treatment with real-time documentation to avoid delays.

Observe beyond the physical task – emotional cues and environment matter.

Document clearly and tie interventions to care goals.

Use your voice in the IDT to connect functional status to safety and dignity.

MODULE 1
Role Overview & Daily Practice

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Instruction:True or False

question 1

MODULE 1
Role Overview & Daily Practice

Having Technical Issues?Click me

Instruction:Multiple Choice

question 2

MODULE 1
Role Overview & Daily Practice

Having Technical Issues?Click me

Instruction:Drag the Word

question 3

MODULE 1
Role Overview & Daily Practice

Having Technical Issues?Click me

Module 1Completed!

Click to Start Audio

Key Takeaways:
  1. You are a frontline protector of function and safety.
  2. Your role bridges clinical insight and daily living.
  3. Every routine task is a clinical opportunity.

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Module 2
Module 1
Module 3
Module 4

Module 2

IDT Participation & Collaboration

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LEarning Objectives

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By the end of this module, you will be able to:

Explain the role of the OT in interdisciplinary team (IDT) processes.

Identify key contributions the OT brings to collaborative care planning.

Apply best practices for IDT communication and care plan participation.

Recognize red flags and common pitfalls that may impact care continuity.

MODULE 2

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IDT Participation & Collaboration

core concept

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Your Voice in the IDT

As the OT, you bring a functional lens to every case. You see what others may not—how cognitive decline impacts dressing, how a cluttered home leads to falls, how fatigue turns cooking into a safety hazard.

These insights must be shared during IDT meetings and documented clearly. According to:

42 CFR §460.106

Care plans must reflect input from all IDT members, especially when there's a change in participant status.

You don’t just represent “OT needs”—you speak for the participant’s ability to live safely and independently. That perspective informs nursing, MSW, PCP, dietitian, and therapy decisions.

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MODULE 2

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IDT Participation & Collaboration

OT Contributions in the IDT

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MODULE 2

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IDT Participation & Collaboration

Best Practices forEffective Collaboration

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Best Practices
Why it Matters

Speak in clear, non-technical language

Ensures all team members understand your findings and their implications.

Frame your updates around function and safety.

Helps guide practical, participant-centered care decisions.

Be proactive in team meetings—not reactive.

Builds trust and ensures timely contributions.

Use structured notes to prepare before IDT.

Keeps your input concise, relevant, and tied to care goals.

Circle back after meetings if plans change.

Reinforces accountability and continuity.

MODULE 2

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IDT Participation & Collaboration

Common OT Mistakes in the IDT

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Consequence
Consequence
Consequence
Consequence

IDT is out of compliance if OT is not present and care plan may miss key safety risks or needs.

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Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

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Misses the bigger picture of function and independence.

Overestimates home support capacity.

Delays implementation or causes confusion.

Mistake

Mistake

Mistake

Mistake

Correction
Correction
Correction
Correction

Focusing only on equipment needs.

Not communicating caregiver barriers.

Skipping IDT meetings or providing minimal input.

Failing to follow up on team decisions.

Tie recommendations to goals, home environment, and safety outcomes.

Proactively raise concerns with MSW and nursing.

Confirm who is doing what after each meeting.

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Prioritize attendance or submit concise notes with critical OT updates.

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MODULE 1
Role Overview & Daily Practice

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Red Flags

Compare the itemsin this table

Red Flags That Warrant Escalation or Advocacy

Red Flags
Why it Matters

Indicates functional or emotional regression.

Participant stops using DME or refuses ADL support.

Caregiver reports feeling overwhelmed or confused.

Risk of injury to both caregiver and participant.

Unsafe home environment despite equipment delivery.

Requires reassessment and potentially increased services.

Suggests need for care plan review and revision.

Participant verbalizes fear of falling or being alone.

MODULE 2

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IDT Participation & Collaboration

Documentation Spotlight

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Scenario:Participant, Mr. Hernandez, recently returned from SNF after a hip fracture.

MODULE 2

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IDT Participation & Collaboration

Instruction:True or False

question 1

MODULE 2

Having Technical Issues?Click me

IDT Participation & Collaboration

Instruction:Multiple Choice

question 2

MODULE 2

Having Technical Issues?Click me

IDT Participation & Collaboration

Instruction:Drag the Word

question 3

MODULE 2

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IDT Participation & Collaboration

Module 2Completed!

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Key Takeaways:
  1. Your insight drives participant-centered care.
  2. Speak up when needs change.
  3. Document to drive action.

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Module 2
Module 1
Module 3
Module 4

Module 3

Care Coordination Acrossthe Continuum of Care

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LEarning Objectives

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By the end of this module, you will be able to:

Describe the OT’s role at each stage of a participant’s care transitions.

Recognize common risks and safety concerns during transitions.

Identify when and how to escalate functional concerns to the IDT.

Ensure continuity of care through effective communication and follow-up.

MODULE 3

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Care Coordination Across the Continuum of Care
  • Observations: 78-year-old PACE participant with arthritis, hypertension, and mild cognitive impairment.
  • She lives alone, enjoys her independence, but is becoming more physically limited.
  • Over the next few weeks, Carmen experiences a series of transitions—and you, her OT, are involved at every step.

It was just a limp...

Ms. Carmen

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MODULE 2
IDT Participation & Collaboration

Step 1: at home

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Prevention Starts Here:

Risks to Monitor

Key OT Responsibilities:

Escalation Triggers

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MODULE 3

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Care Coordination Across the Continuum of Care

Step 2:

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After-Hours Emergency

Risks to Monitor

Key OT Responsibilities:

Escalation Triggers

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MODULE 3

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Care Coordination Across the Continuum of Care

Step 3:

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Hospital Admission

Risks to Monitor

Key OT Responsibilities:

Escalation Triggers

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MODULE 3

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Care Coordination Across the Continuum of Care

Step 4:

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SNF Stay – Rehab & Readiness

Risks to Monitor

Key OT Responsibilities:

Escalation Triggers

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MODULE 3

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Care Coordination Across the Continuum of Care

Step 5:

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Return Home – Post-Discharge Integration

Risks to Monitor

Key OT Responsibilities:

Escalation Triggers

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MODULE 3

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Care Coordination Across the Continuum of Care

Instruction:True or False

question 1

MODULE 3

Having Technical Issues?Click me

Care Coordination Across the Continuum of Care

Instruction:Multiple Choice

question 2

MODULE 3

Having Technical Issues?Click me

Care Coordination Across the Continuum of Care

Instruction:Drag the Word

question 3

MODULE 3

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Care Coordination Across the Continuum of Care

Module 3Completed!

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Key Takeaways:
  1. Your role spans the full care journey.
  2. Transitions are high-risk—your insight matters.
  3. Home-based realities shape the best care plans.

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Module 2
Module 1
Module 3
Module 4

Module 4

Real-World Practice & Application

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  • Age: 80
  • Diagnosis: CHF, osteoarthritis, and early-stage dementia.
  • Living Situation: She lives with her daughter Maria, who works part-time.
  • Teresa values her independence, enjoys light cooking, and attends the center 3x/week. She uses a walker—but inconsistently.

Situation

Mrs. Ross

Continue

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MODULE 4
Real-World Practice & Application

learning objectives

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By the end of this module, you will be able to:

Identify and respond to real-world decision points across the care continuum.

Apply OT-specific strategies that promote safety, function, and participant dignity.

Use clinical judgment and documentation to influence IDT decisions and care transitions.

MODULE 4

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Real-World Practice & Application

decision point 1:

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Why This Matters

This is where you decide if your role is administrative or advocative.

OT-Specific Actions:

Reframe: “This isn’t about a bad day—it’s about a change in function and confidence.”

Highlight risk: “Avoidance of the walker and decreased meal prep suggest withdrawal, not just fatigue.”

Propose immediate action: “Recommend 3-visit OT plan focused on safe transfers and DME training.”

Coaching Tip:

Speak the language of risk and readiness. Be the bridge between stability and what’s actually happening at home.

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MODULE 4

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Real-World Practice & Application

decision point 2:

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Why This Matters

You’re the only clinician seeing her in her natural environment. This is where decline hides in plain sight—unless someone’s trained to look for it.

OT-Specific Actions:

Document what you see, not just what you’re told: “Walker not in use, participant demonstrating guarded movements.”

Treat this as functional regression, not just ‘aging’ or ‘fatigue’.

Notify the IDT with a clinical recommendation: short-term OT reassessment, DME recheck, and caregiver training.

Coaching Tip:

Don't downplay these “non-events.” This is where avoidable hospitalizations begin.

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MODULE 4

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Real-World Practice & Application

decision point 3:

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Why This Matters

Post-fall recovery is always harder than fall prevention. But this is your chance to redirect the narrative.

OT-Specific Actions:

Send a clinical handoff to hospital therapy: include functional baseline, DME used, cognitive concerns, and home barriers.

Highlight toileting risks and recommend early OT input on adaptive tools.

Request cognition screen and family engagement in rehab plan.

Coaching Tip:

You can’t undo the fall, but you can steer recovery. Don’t just “wait for discharge”—start shaping the path back now.

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MODULE 4

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Real-World Practice & Application

decision point 4:

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Why This Matters

The discharge plan is shaping up—and it's incomplete. You’re the only one who knows what she’s going back to.

OT-Specific Actions:

Call the SNF OT. Share your last home visit notes and ADL concerns.

Suggest adding adaptive strategies for one-arm hygiene, kitchen safety, and supervised toileting.

Request a cognitive screen if one hasn’t been completed.

Coaching Tip:

It’s not confrontation—it’s contribution. You’re not overriding their plan; you’re grounding it in real life.

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MODULE 4

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Real-World Practice & Application

decision point 5:

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Why This Matters

This is the last line of defense. You don’t control the discharge, but you control the safety net.

OT-Specific Actions:

Fix what you can: adjust equipment, train Maria in toileting assistance, and practice one-arm dressing with Teresa.

Document everything: equipment readiness, caregiver capacity, participant confidence.

Recommend an OT recheck within 48 hours post-discharge.(42 CFR §460.102)

Coaching Tip:

When the system rushes, your role is to slow down functionally—even if the calendar says “go.”

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MODULE 4

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Real-World Practice & Application

decision point 6:

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Why This Matters

This is the moment you turn therapy from a checklist into a lifeline.

OT-Specific Actions:

Start small: guided grooming, water at the table, brief hallway walks.

Reinforce safety verbally: “You’re doing this with support, not alone.”

Refer to MSW for emotional support.

Document clearly: functional withdrawal due to fall trauma, risk of self-isolation, plan for re-engagement.

Coaching Tip:

When fear replaces movement, rebuild safety through confidence—not just coaching.

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MODULE 4

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Real-World Practice & Application

Documentation Spotlight

Compare the itemsin this table

Participant: Teresa Ortega Event: Post-discharge OT follow-up

MODULE 3

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Care Coordination Across the Continuum of Care

The OT's Influence

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You made this happen…
You made this happen…
You made this happen…
You made this happen…

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Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

You reframed it as functional regression.

You voiced it with evidence and clarity.

You created a pause for safety.

You reintroduced choice, trust, and control.

When this happened…

When this happened…

When this happened…

When this happened…

The team minimized change.

Risk was hidden in plain sight.

The system moved fast.

The participant lost confidence.

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MODULE 1
Role Overview & Daily Practice

Having Technical Issues?Click me

Instruction:True or False

question 1

MODULE 4

Having Technical Issues?Click me

Real-World Practice & Application

Instruction:Multiple Choice

question 2

MODULE 4

Having Technical Issues?Click me

Real-World Practice & Application

Instruction:Drag the Word

question 3

MODULE 4

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Real-World Practice & Application

Module 4Completed!

Click to Start Audio

Key Takeaways:
  1. Your daily decisions shape participant outcomes.
  2. Collaboration is built through clarity and courage.
  3. When things go off track, your insight gets them back on.

End-of-Course Reflection

This final section isn’t just about checking boxes. It’s about stepping confidently into your role. You’ll walk through a mixed-format quiz that mirrors the decisions you’ll make on the job—spotting early risks, coordinating transitions, and advocating through documentation. There are no trick questions here—just real-world moments that demand your attention, your training, and your professional voice. Let’s see what you’ve mastered—and what you’re ready to lead.

Evaluation

Instruction:True or False

question 1

Final Evaluation

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PACE OT

Instruction:Multiple Choice

question 2

Final Evaluation

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PACE OT

Instruction:Drag the Word

question 3

Final Evaluation

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PACE OT

Instruction:True or False

question 4

Final Evaluation

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PACE OT

Instruction:Multiple Choice

question 5

Final Evaluation

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PACE OT

Instruction:Drag the Word

question 6

Final Evaluation

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PACE OT

Instruction:Multiple Choice

question 7

Final Evaluation

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PACE OT

Instruction:Arrange the Sequence

question 8

Final Evaluation

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PACE OT

Instruction:True or False

question 9

Final Evaluation

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PACE OT

Instruction:Multiple Choice

question 10

Final Evaluation

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PACE OT

Congratulations!

You’ve successfully completed your course—well done! Your commitment to learning, growing and improving your skills has truly paid off. By finishing this course, you’ve taken an important step in building new knowledge and strengthening your professional development. Keep up the great work, and remember that every skill you gain is an investment in your future.

Any questions?

👏

rosana.scolari@scolariconsulting.com www.scolariconsulting.com

Key OT Responsibilities:

  • Conduct home safety reassessment
  • Train participant/caregiver on new routines and equipment
  • Update goals and document outcomes
  • Communicate findings to IDT

Risks to Monitor

  • Incorrect or incomplete DME setup
  • Functional regression from hospital/SNF stay
  • Unprepared caregivers

Key OT Responsibilities:

  • Review previous OT documentation
  • Coordinate with after-hours team
  • Support root cause analysis the next business day

Risks to Monitor

  • Missed functional insights by after-hours staff
  • Equipment failure or misuse

Risks to Monitor

  • SNF therapy misaligned with home realities
  • Missed need for caregiver education

Key OT Responsibilities:

  • Review baseline functional data
  • Share home context and DME history with hospital team
  • Begin discharge planning lens early

Risks to Monitor

  • Functional decline, especially if unreported
  • Unsafe or unused equipment
  • Changes in cognition or mood

Escalation Triggers

  • Repeat fall or ADL failure
  • Participant expresses fear of returning to prior routines

Pro Tip:

Before you sign your note, ask yourself: “Have I documented what I saw, what it means, what I did, and how I connected it to the team?” If you are missing one of the 4Cs, add it – your note isn’t complete without it.

Why It Matters in PACE:

  • Ensures compliance with 42 CFR §460.104 documentation and care planning requirements.
  • Highlights your clinical thinking, not just the task completed.
  • Validates your role in prevention, not just recovery.
  • Strengthens interdisciplinary care through clear, team-aligned notes.
The 4C Components

Escalation Triggers

  • Fall from unaddressed ADL barrier
  • Repeated ER visits with no follow-up plan

Why It Matters in PACE:

Occupational Therapy in PACE isn’t just about tasks. It’s about helping people live the lives they choose — safely, confidently, and on their terms.You don’t just support function. You protect it.

Escalation Triggers

  • Discharge plan excludes OT input
  • Participant loses baseline function during stay

Escalation Triggers

  • Refusal to use DME
  • Rapid loss of mobility
  • Caregiver burnout or absenteeism

Key OT Responsibilities:

  • Conduct ADL/IADL assessments
  • Monitor equipment usage and home safety
  • Educate caregivers
  • Flag early decline to the IDT

Escalation Triggers

  • Unsafe discharge plan
  • Gaps in transfer training or equipment delivery

Key OT Responsibilities:

  • Share prior goals and progress with SNF therapy team
  • Monitor SNF notes and rehab goals
  • Coordinate discharge plan with IDT

Risks to Monitor

  • Functional baseline not shared with external providers
  • Hospital team unaware of home barriers