Supervision Visits & Co-signing

Co-signing SLPA visit notes happens through QA.  Please review the following video to learn how.  

• Tip:  we encourage you to filter/search by the clinician whose notes you are co-signing vs. by patient in order to avoid grouping in your own notes for the same patient.  Please do not QA your own notes.  Thanks!

There is a second video in the comments section of the video below from Cubhub, also a review of QA, but not specifically in the context of SLPA visit note - yet the process is the same.  

Entering your password to "finalize" a note through QA is adding your electronic signature to the visit note. 

What is new for Routine Visits?  

Assistants in Physical, Occupational, and Speech therapy will now leave their routine visits as billable.  Moving forward, Supervisors will place a non-billable Supervisory Visit onto the patient's calendar at the same time your visit is occurring.  Most often, supervisory visits will now occur during your routine 30 minute or unit-based visit.   

What is new for Re-Evaluations? 

Previously, a nonbillable routine visit could be added/completed at the time of the re-evaluation.  As of 5/19/24, these routine visits can be completed outside of the re-eval session as a standalone visit. For patients with BCBS (Commercial, SSI, CHIP, STAR), Community Health Choice, Molina (STAR, CHIP), or United Healthcare (SSI, CHIP, STAR), coordination with the evaluator will be important to not exceed 2 visits per week unless your routine visit is marked as a “Make Up” session.  For all other insurances, 2 routine visits and a re-evaluation can be completed in the same week.  Should Assistants need to support the evaluator during a re-evaluation due to interpreting and/or a child’s level of activity (evaluator is via telehealth), you will now be adding a “meeting” to your calendar for that interaction.  Please refer to the resource list below for the “How to Add a Meeting to your Calendar”. 

How will a supervisory visit look? 

You will notice that the form for a supervisory visit is shorter.  It is important to state what supports and/or training were/will be provided.  Other information that can be provided includes goals addressed; observations of the types of cues/prompts provided; techniques observed/used; parent support; home education provided. Below you will find examples of ST, OT, CF, and PT Supervisory Visits: 

Example Notes 

SLPA Sup Note -1 

Satisfaction Comments: Mother indicated she is happy with the services and glad they have started again.  She coordinated with SLPA to conduct a second session this week.  She likes the flexibility of the clinician to meet her work schedule.   

Supervision Comments: SLPA commented that no articulation goals were included based on the most recent evaluation conducted by COFK staff.  Mother reported that they recently had an ARD meeting at the school.   CLIENT is receiving inclusion services, but she does not believe they are working on articulation skills. SLPA selected a Boon Card activity appropriate to addressing irregular plural forms of nouns.  She gave good instruction and examples to start the activity.  CLIENT still needed several cues to understand, so SLPA modified the activity to give her 2 auditory choices to choose from.  SLPA noticed CLIENT was not correctly producing /th/final in some words, which has been a previous goal.  SLP is monitoring to determine if this may need to be added into goals again.  Errors were also noted on initial sounds.   

SLPA Sup Note -2 

Satisfaction Comments: Parent reported satisfaction with services provided by this licensed assistant on initial visit via follow up phone conversation post-treatment session.  

Supervision Comments: Clinician utilized pairing strategies to establish rapport with patient.  The clinician reviewed goals on POC with the caregiver.  Session centered on establishing rapport, answering WH questions and producing 3-5 word phrase sentences.  Patient required min-mod assist to complete tasks.  Assistant was recommended to allow for greater wait time prior to providing correct response, as well as to complete teaching trial prior to targeting new goals.  Overall, clinician demonstrates the adequate skills and clinical experience necessary to treat this Patient.  

CF Sup Note 

Satisfaction Comments: MOC is satisfied with pt’s progress.  

Supervision Comments: SLPI conducted session at daycare while providing good redirection to tasks throughout sessions. Pt required assistance to transition to session, which SLPI provided good support for.  SLPI provided good activities and strategies to increase accuracy.  SLP recommended various strategies to increase patient’s compliance during session (ie bringing one item out of the bag to catch pt’s interest, increase variety of activities), and incorporate words into activities so patient is practicing artic words without having to transition between “fun” task and “work” task.   

OT Sup Note 

Satisfaction Comments: Caregiver feels they are aware of goals and POC that is being worked on.  CG is pleased with the client’s progress.  

Supervision Comments: Pt is observed to have mastered don/doff EWB pants and socks independently.  OTA worked with patient on taking turns to string beads on a round shoelace.  Pt required min to no assist.  Therapist and patient worked to scoop cereal for 8 scoops.  Pt did well with no spilling and using BUE movements.  Per CG, child requires minimal cueing to self-regulate and follow directions.  Pt has not been observed to elope, hit, or bite when playing with peers.  Supervisor and OTA discussed session and upcoming re-evaluation.   

PT Sup Note 

Coordination of Care/teaching with PTA – Recommended to use visual cues such as spot marker to help Pt jump from one place to another to encourage jumping forward.  Recommended to continue encouraging functional play activities such as using 3 wheeled scooter or tricycle, providing assistance as needed.   

PTA Response to Coordination of Care/Teaching - PTA agrees it is a good idea to help with visual cues to guide him to move from one spot to another in jumping forward farther.  

Coordination of care/teaching with caregiver – MOC likes to encourage Pt to use the scooter and tricycle to help him move around more actively, and to encourage ball play activities. 

Caregiver response to coordination of care/teaching - MOC in agreement with recommended HEP.  

Skilled intervention provided this visit with assistance of PTA – gross motor activities, strengthening, coordination and balance activities.   

Are current interventions provided by assistant with child/family needs and plan of care – Yes 

Is the caregiver pleased with care provided by assistant? -  Yes.