Occupational Therapy Functional Assessment Report Generator
Generate insurance-compliant OT functional assessment reports from clinical data
What You Can Do
You can convert clinical observation notes, standardized assessment results (FIM, COPM, AMPAC, etc.), and patient history into professionally formatted occupational therapy functional assessment reports. The skill synthesizes raw data into cohesive narratives that document baseline function, identify specific functional limitations, justify interventions to insurance companies, and establish measurable treatment goals—reducing hours of manual documentation while ensuring compliance with insurance requirements and clinical standards.
Features
Converts standardized assessment scores (FIM, COPM, AMPAC) and raw observations into integrated clinical narratives
Documents measurable baseline performance across ADLs, IADLs, and functional mobility for objective progress tracking
Generates insurance-compliant language demonstrating specific functional deficits that support treatment authorization requests
Identifies functional limitations and compensation strategies to guide meaningful, patient-centered goal development
Produces standardized report layouts organized by functional domains (self-care, mobility, cognition, etc.)
Accommodates patient history, previous functional levels, and significant change documentation for re-assessment reports
Transforms hours of synthesis work into rapid report generation without sacrificing clinical detail
Example Output
Example 1: Acute Care Patient
Input: FIM scores (motor: 28, cognitive: 30), observation notes on bed mobility, ADL setup requirements, patient history of stroke
Output:
BASELINE FUNCTIONAL STATUS [Patient name] presents with significant functional limitations in bed mobility and self-care tasks secondary to left CVA. FIM motor score of 28 indicates moderate assistance required for most activities. Patient requires setup and minimal assistance for grooming (FIM 5) and maximal assistance for dressing (FIM 3). Functional mobility limited to bed-level activities; transfer training is medical necessity.
Example 2: Outpatient Rehabilitation
Input: COPM scores (self-care priority areas: cooking 4/10, laundry 3/10), AMPAC mobility scores, home environment observations
Output:
FUNCTIONAL GOALS AND MEDICAL NECESSITY Patient identifies meal preparation and laundry management as priority functional goals. Current AMPAC scores (6-minute walk: 150 feet) and observation of unsafe task sequencing during kitchen simulation demonstrate measurable deficits requiring skilled OT intervention. Treatment focuses on energy conservation techniques and activity adaptation to support independent home management.
What's Included
- SKILL.md instruction file: Complete skill configuration and clinical guidelines
- Report template framework: Standardized sections: Demographics, Functional History, Assessment Results, Baseline Functional Status, Goals, Medical Necessity Justification
- Assessment tool mapping guide: Translation reference for FIM, COPM, AMPAC, Berg Balance, TUG, and other common OT assessments
- Functional domain checklist: Prompts to capture ADLs, IADLs, mobility, cognition, safety, environmental factors
- Insurance compliance checklist: Medical necessity language, objective measurable findings, skilled intervention justification
Who It's For
- Occupational therapists conducting initial evaluations and re-assessments across acute care, inpatient rehabilitation, outpatient, and home health settings
- OT supervisors and program directors standardizing assessment documentation and reducing documentation time across clinical teams
- Therapy managers ensuring insurance compliance and consistent quality across multiple clinicians' reports
- Clinical educators teaching proper functional documentation and narrative synthesis to OT students and new clinicians
Best For
- Initial comprehensive functional assessments — Converting first evaluation data into standardized baseline reports
- Re-evaluation documentation — Comparing previous function to current status and justifying ongoing treatment
- Insurance authorization requests — Generating medical necessity narratives that support treatment approval
- Treatment planning preparation — Synthesizing assessment data into clear functional profiles that guide goal setting
- Rapid report turnaround — Accelerating documentation when time pressure delays treatment plan initiation
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