1. Health Care Administration in Athletic Training
Chapter 2
Health Care Administration in Athletic Training

2. Planning an Athletic Training Facility
Most important thing is maximum use of facility and equipment
Size of facility is dependant on:
Size and number of teams
What sports are offered
It must serve as a health care center

3. The Athletic Training Room:
Must be at least 1,000 square feet in size
Should be located immediately adjacent to the locker rooms
Should have an outside entrance to fields or courts

4. Athletic Training Room Areas
Taping
First Aid or Wound Care
Hydrotherapy or Wet Room = GFI’s
Treatment = Tables and Modalities
Rehabilitation
Storage
Offices
List 3 athletic training room areas

5. Athletic Training Room Policies
No Cleats
No Game Equipment
No Shoes on Treatment Tables
No Food
No Roughhousing
SHOULD NOT BE A GATHERING AREA
Name two policies you would have for your athletic training room

6. Keeping Facilities Clean
The prevention of Infectious diseases is the direct responsibility of the coach
Must make sure everything is clean and that the athlete is practicing safe health habits
Must be aware of OSHA Guidelines (Occupational Safety and Health Administration)

7. Cleanliness Procedures
Have clean H2O fountains, toilets, showers
Air out lockers
Clean Mats
Wash Towels
Clean Water Bottles and Jugs
Clean floors
List 3 cleanliness procedures

8. Factors Regarding Health Care Coverage
When there are no health care professionals, the responsibility falls on a coach
Wherever you are working make sure that there is a policy established describing a plan of care for injured athletes
Emergency Action Plan (EAP)
Who gets covered first?
PREPARE

9. Pre-participation Health Exams
Is Athlete at Risk before they start playing?
PPE involves: Complete Medical History, Physical Examination and Orthopedic Screening
Could warrant disqualification from certain sports
Because of ADA a physician cannot legally disqualify athletes from competing because of an existing problem
They can recommend that the athlete voluntarily choose not to participate
One eye, kidney etc are cautioned against playing collision sports
Another name for pre-participation health exams

10. Record Keeping
In a time where lawsuits are the rule rather than the exception, record keeping is a must
Coach/ATC should have:
Insurance forms
Injury reports
Treatment logs
Personal information cards
Injury progress notes
Supply and equipment records
How often should injury reports be made?

11. Injury Reports For future reference
Injury reports should be in triplicate going to:
Physician
School Health office
One for personal records
What acronyms do we use for writing injury reports? HOPS and SOAP

12. Treatment Logs Do not write in pencil!!!
Should say what treatment athlete received
Can serve as legal document and can be used in:
Civil litigation
Insurance action
Criminal Action following Injury

13. Medical Records
A coach/ATC must NOT release an athlete’s medical records or information to anyone without written consent by the athlete (if a minor, parents must give permission)
If athlete wants medical records released they must sign a waiver with specifics such as who, when, what etc.

14. Developing a Budget Know what you need
Keep accurate records for following year
Expendable vs Non-Expendable
Expendable items are used once (band aids)
Non-expendable items are used multiple times
(ice machine)
Other Budget Concerns
Phone
Postage
Professional Liability Insurance
Travel expenses
Memberships to Professional Organizations
Clothing
Contracts with Physicians

15. Progress Notes
SOAP
Subjective- what the athlete tells you about the injury
Objective- what info the athletic trainer gathers from the evaluation that is measurable or observable
Assessment- opinion on injury and athlete’s status
Plan- how will the injury be managed

16. Legal Concerns and Insurance Issues
Chapter 3
Legal Concerns and Insurance Issues

17. What is Liability?
The state of being legally responsible for the harm one causes another person
Assumes that an ATC would act according to the standards of care of any individual with similar educational background or training
**Remember reasonable care**

18. Negligence Failure to use ordinary or reasonable care
An individual does something that a reasonably prudent person would not do
An individual fails to do something that a reasonably prudent person would do under circumstances similar to those shown by the evidence
Athletic Trainers employed by an institution have a duty to provide health care to athletes at that institution
A court will uphold waivers and releases of liability as long as there is no evidence of fraud, misrepresentation or duress

19. Torts Legal wrongs committed against a person
Wrongs may emanate from an act of omission where a person fails to perform a legal duty(refer an athlete to a doctor) OR
from an act of commission which is when one performs an act that is legally not his or hers to perform

20. Failure to Perform
An AT who fails to provide an acceptable standard of care has committed a breach of duty
***An athlete must prove that this breach caused the injury or made the injury worse

21. Additional Terms Injury- An act that damages or hurts
Accident: an act that occurs by chance or without intentions
Assumption of risk: The individual, through expressed or implied agreement, assumes that some risk or danger will be involved in a particular endeavor . In other words, a person makes his or her own chances.
Is subject to many interpretations especially with minors because they are not considered to be able to make a mature decisions
Why are athletes required to sign a waiver?

22. Statute of Limitations
A specific amount of time that an individual may sue for damages from negligence
These limitations vary from state to state
It is usually between 1-3 years

23. How Do You Avoid Litigation?
Supervise constantly
Proper instruction of skills
Ensure that proper and safe equip is used
Establish specific policies and guidelines
Develop and carefully follow an emergency plan
Keep good records that document the injury
List 4 ways to avoid litigation

24. Avoiding Litigation (cont)
Document efforts to create a safe learning environment
Obtain written consent for providing health care, especially when minor are involved
Maintain confidentiality of medical records
Don’t dispense prescription drugs
Don’t let injured players play without the written consent of a doctor

25. Avoiding Litigation (cont)
Work cooperatively with the team doctor to insist top care for your athletes
Purchase liability insurance
Know the limitations of what you know as well as state restrictions
Use common sense when making decisions

26. Product Liability
The manufacturers must make sure that equipment is made safe
All athletes must read NOCSAE
National Operating Committee on Standards for Athletic Equipment

27. What Insurance is Necessary to Protect the Athlete?
Medical Insurance is a contract between an insurance company and a policy holder in which the insurance company agrees to reimburse a portion of the total medical bill after some deductible has been paid
General Health Insurance, Catastrophic Insurance, Accident Insurance, Liability Insurance

28. General Health Insurance
Should cover illness, hospitalization, emergency care
Some institutions offer primary care insurance but most offer secondary insurance
Should send a form letter with insurance form to make sure that the paperwork is filled out appropriately
What is secondary insurance?

29. Third Party Reimbursement
This is the primary mechanism of payment for medical services in the US
Health care professionals are reimbursed for services performed by the policyholders insurance company
To cut health care costs many companies pay for PREVENTITIVE CARE
Managed care: involves a prearranged system for delivering health care that is designed to control cost while also providing good care.

30. Health Care Providers HMO-Health Maintenance Organization
must be pre-approved and is usually 100% covered as long as you go to a HMO facility
PPO-Preferred Provider Organization
Provide Discount Health but limit where a person can go for treatment
Are paid on a fee for service basis
Added services such as Physical Therapy may be obtained easier

31. Additional Information
Point of Service Plan
This is a combination of HMO and PPO plans
It is based on a HMO structure, yet it allows members to go outside of the HMO structure or service.
This is allowed only under certain circumstances
Definitions
Fee for service- Most traditional. Provider charges that patient or third party for services rendered. Charges are based on a set fee schedule
Capitation- Form of reimbursement used by managed care providers in which members make a standard payment each month regardless of how much service is rendered to the member by the provider

32. Accidental Insurance Additional insurance that a student can take out
It is limited in its payments and one does not have to acknowledge fault

33. Personal Liability Insurance
This will protect against damages that may arise from injuries occurring on school property
Will cover claims of negligence on the part of the individuals
**Its concern is if supervision was reasonable
Will cover you in a civil case but not a criminal case

34. Catastrophic Insurance
NCAA and NAIA have policies that deal with permanent harm
If cost is more than $25,000 and costs continue for a lifetime
NFSHSA(National Federation of State High School Associations) covers costs over $10,000

35. Insurance Billing
A coach/ATC must file insurance claims immediately and correctly
Done by having insurance on hand
Must stress that the parents insurance is first and the schools policy is second