When it comes to interviewing as a Physical Therapist Assistant, it’s important to know what job and setting you are interviewing for. Each setting has distinctions, requirements and expectations that are specific for you to complete and fulfill the demands of the job.

Skilled Nursing Facility/ Assistive Living Facility

Let’s begin here. In a SNF & AFL we usually see significant improvements in our patients’ quality of life. Working in this setting can be rewarding but its often comes with hard work and downright frustrating with fluctuations in caseload. Some facilities are downright dreary and depressing while others might have more of a home-like feel. When it comes to working at a SNF & AFL, sometimes the company under reports the productivity requirements and the extent of your autonomy which is frustrating. I would make sure if you are looking to work in this setting, prepared yourself with questions to ask to get a clear idea of the work environment and job requirements before you say “Yes.”.

Here’s a great start:

1. How Many Therapists Will I Be Working With? What is the Ratio of PT/PTA?
2. What Is The Payer Mix with Medicare A vs Medicare B?
3. What Are Your Productivity Expectations? Is there Co-Treats and Group sessions?
4. Who gets involved with PDPM (Patient Driven Payment Module)?
5. Who Attends & is involved with your Care Conferences?
6. How Are Patient’s Scheduled? Is There A Trend Of When Patient’s Prefer Therapy?
7. What Would Be The Work Shift? Is There The Expectation Of Working Holidays And Weekends?
8. What Is There EMR System and Expectations For Progress Note/Discharge Notes?
9. What continued education or mentoring is given?

It’s important to review and know these answers prior to jumping in with both feet. You don’t want to sign a contract saying “Yes” if you don’t know the rules of the game. If there is any red flags for you or uncertainty, this setting might not be the one for you.

Acute Care

Acute Care is a setting where you have to determine the next step for your patients. Usually your patients are here for 2-7 days before you assist in the determination of which setting they should be transferred to for their rehab. Majority of patients in this setting have had a stroke, post operative care after a joint replacement, amputation, a trauma or infection, and even sometimes cancer. Each patient has a different diagnosis but the care is still the same, trying to maximize function and get them on the road to recovery with independent living if possible. Depending on the company and their services, the following questions are good starting points to discuss during your interview.

1. What is a typical caseload? What are their most common diagnoses of their patients?
2. What are the different units in the setting that are offered? What does the hospital have with certifications or specialties?
3. If you are applying for a PRN position, what is the specifics and expectations of the position? What is the pay rate?
4. What standards do they have for chart reviews?
5. How does the caseload distribution work? Will you be working with a specific therapist or patients each day?

Working in this setting can be challenging and a blessing. Majority of these patients are here for the short term before moving to their next destination. This means that you get a short amount of time to bond with your patients, the good and the bad. When I worked in acute, I liked the fact that after a joint replacement and recovery, I could help in the decision of where this patient would succeed in the next setting. Determining if a patient was safe to return home to receive home health, or they needed a long term rehab facility to help them get stronger, independent since they don’t have the support at home. It was rewarding to be part of their journey, even if it was for a little. If you like this aspect, this might be the place for your skills as a clinician.

Home Health

Home Health is a different animal compared to other settings mentioned above but majority of clinicians enjoy it the most. This setting puts more on you as the clinician then the patient because this services are for homebound patients. Let’s dive into the pros and cons. This seems to be the area that people want to know about the good, the bad and the ugly.

Here are the the Pros:

1. Decreased frequency of patients no shows
2. Patient’s are homebound so they shouldn’t be driving or not home, more consistent visits and available for their session
3. You can see the patient’s home environment which is helpful for your treatments
4. Usually higher pay compared to other settings

Vs. The Cons:

1. Having the confidence with your treatments to be able to treat alone
2. Dealing with traffic and time management, cost of wear & tear on your car
3. You have to bring your equipment with you & carry it in/out of their homes
4. Being on top of your own schedule to not get behind
5. Working in not the best living environments or circumstances

With home health, you are bringing the service right to their doorstep without the hassle of the patient having to bum a ride, coordinate a pickup, gather all their equipment and AD’s to get out the door to their treatment. They have less excuses to come up with and that’s a good thing! It’s not perfect but it is an improvement compared to outpatient who has a high cancel and no show rate.

Additionally, it’s not a bad choice since the reimbursement for gas and pay per visit varies depending on the company. I would take the time to reflect on your goals, your comfort level and the requirements for this setting. If you feel it’s a good fit with everything that is discussed during your interview, this might be the setting for you!

The following questions are ones I would ask if not discussed:

1. What EMR system do they use and their expectations for documentation? Do you have to use your personal computer or is one provided?
2. What would be your area of coverage?
3. Is there mileage reimbursement? If so, whats the rate?
4. What is the productivity expectation?
5. What is the company’s average census?
6. What is the ratio of PT’s to PTAs?
7. Is the job being paid hourly or per visit?

When it comes to working in Home Health things to consider are you should have reliable transportation and a good driving record, as your responsibilities revolve entirely around travel. Flexibility is also an important aspect of the job, as you may be traveling at different times in order to accommodate your patients’ schedules. If you feel you can handle that, accept that job offer and Good Luck!

Outpatient

The dreaded outpatient setting that everyone has something to say negative about. It’s not always that way but yes you will feel more of a strain, stress and burnout in this setting if it’s not the right fit. Each outpatient clinic can be different with having a caseload that might be all vertigo, neurological disorders/diseases, peds or even straight orthopedic. There are a wide range of what we can provide in the outpatient setting but finding the one that speaks to you, that’s the key. I’ve worked mostly in outpatient most of my career but have switches specialties from working with a PT who was doing an orthopedic residency/ fellowship, to all neuro caseload with vertigo, parkinsons, stroke, MS etc to working with just kids. You can find your skills to be more fine tuned in outpatient compared to other settings. This setting gives you the opportunity to see a wide range of ages, diagnosis, people’s personalities and use a range of skills such as modalities, manuals and equipment. If you feel you want to have a well rounded skill set, working outpatient will be that very opportunity. You might have to take some time to find the right one fitting your needs but it is possible.

As for when it comes to interviewing there are easy steps to prepare yourself. Before the interview, I always look over the company website to familiar myself further. And check in with previous employee review on glassdoor to see how those in the past felt treated and if there were any red flags. This is your chance to ask the questions that you really want to know-it’s not lead me wrong yet! They seem to be impressed with the research and honesty.

Questions to ask:

1. What does a typical caseload look like? At what frequency are patients scheduled throughout day? Who is responsible for scheduling clients?
2. What types of pts would you be treating? Will you work specifically with one PT?
3. Which documentation system do they use and how do they schedule patients? Will there be time set aside for documentation?
4. What are the opportunities for learning new skills? How long have the current therapists worked here? What level of onboard training can you expect? Do they have a mentor for you in the clinic?
5. Do they cover any of your expenses with licensure renewal or CEU’s credits?
6. If they do not treat a specific group of people that you are trained in, would they be open to training the others staff to be able to treat these clientele? If yes, that’s wonderful because they are seeing your skills as potential revenue and creating more of a footprint in the community. It’s a win-win.
7. How is the staff formed? Do they have technicians, front office staff etc to help with everyday tasks?

Usually outpatient is wide variety of team members, you can be in a clinic only by yourself and a PT or it could be a whole team approach with a front office, techs, other PTAs and PTs. Each company has their own philosophy and you just have to find the right one to match yours.

Other Considerations

There are always more things to consider when taking a job in healthcare. Mentoring is one of them. No matter how many years you have been practicing, everyone can benefit from mentoring. I would ask specifics on things that you are looking for to achieve in your career and see if they have the skills to get you there.

The biggest challenge with all of these settings is the productivity standard and the ins/outs of the job. Further questions to consider to bring up during your interview esp once you get the call back.

1. How will they measure your success as a clinician? Do they base everything off of your productivity or your outcomes?
2. Are there annual reviews where you can reflect and be given the chance to grow depending on feedback? How/when are raises administered?
3. What opportunities for job growth will there be in your future at this company?
4. What safeguards are in place to ensure dignified care for your residents? What is the CNA/resident ratio? What happens to your hours if census is low?
5. What is this company doing to prevent burnout and decrease turnover? What is the turnover rate for the therapy dept? For the building as a whole?
6. What is the PTO accrual policy? What type of benefits do they give?

In my mind, you never want to walk into a job not having the whole truth. It leads to confusion and poor communication between clinicians and superiors. It might come off as nosy or straightforward but its your job, time, and will to perform the job on the line. You don’t want to be coming to work hating every minute and trying to avoid the feeling of burnout/resentment.

Ask about what their “ideal employee” looks like. If they describe someone who works well beyond their pay (extra hours, takes on responsibilities such as QA without a pay increase), run. This’ll show if they value someone who they can exploit rather than someone that is good with patients and patient care.

If your interviewer is surprised by the questions you ask, I would just say, “I’m here to learn more about the opportunity and make sure I have a clear idea of the job, expectations and benefits of working for X company.” There is nothing wrong with being honest and open. It’s your career, not theirs.