A Certified Occupational Therapy Assistant (COTA) at On With Life provides skilled, person-centered occupational therapy services to individuals receiving inpatient neurological rehabilitation following conditions such as stroke, spinal cord injury, traumatic brain injury, and other neurological diagnoses. Under the supervision and direction of an OTR/L, the COTA implements individualized treatment plans designed to maximize functional independence, promote safety, and support participation in meaningful daily activities.

The COTA collaborates with the interdisciplinary rehabilitation team, Persons Served, and their families or caregivers to support functional recovery, develop compensatory strategies, facilitate skill acquisition, and promote successful transition to the next level of care. The COTA contributes to a rehabilitation environment that prioritizes evidence-informed interventions, meaningful therapeutic engagement, and functional outcomes within the available length of stay.

Essential Duties and Responsibilities

1. Occupational Therapy Intervention

• Implement individualized occupational therapy treatment plans established by the supervising OTR/L in accordance with professional standards, applicable laws, and organizational policies.

• Provide skilled interventions addressing activities of daily living (ADLs), instrumental activities of daily living (IADLs), upper-extremity function, fine motor coordination, functional cognition, visual-perceptual skills, sensory processing, balance during functional tasks, and other areas within the established plan of care.

• Facilitate participation in meaningful, goal-directed activities that promote independence and functional carryover.

• Incorporate restorative approaches, compensatory techniques, adaptive equipment, and environmental modifications to improve safety and independence.

• Provide opportunities for repetitive, task-specific practice to support motor learning and functional skill development.

• Adapt treatment activities to the Person Served's abilities, medical status, learning needs, goals, and response to intervention.

• Promote the use of learned skills during everyday routines and functional activities outside scheduled therapy sessions when appropriate.

2. Neurological Rehabilitation

• Apply knowledge of neurological conditions and their functional implications, including stroke, spinal cord injury, traumatic brain injury, and other acquired or progressive neurological disorders.

• Address functional limitations associated with weakness, impaired coordination, altered sensation, abnormal tone, visual-perceptual deficits, cognitive impairment, reduced activity tolerance, and impaired motor control.

• Implement interventions that support upper-extremity recovery, positioning, range of motion, functional use of the affected extremity, and prevention of secondary complications as directed by the OTR/L.

• Incorporate appropriate strategies for attention, memory, executive functioning, problem-solving, and safety awareness during functional activities.

• Support independence through adaptive techniques, assistive devices, splinting or positioning programs, and environmental adaptations as directed by the supervising OTR/L.

• Recognize and communicate changes in functional performance, medical status, behavior, or safety that may warrant modification of the treatment plan.

3. Person Served and Caregiver Education

• Educate Persons Served and caregivers on established treatment strategies, adaptive equipment use, safety techniques, positioning, and functional routines within the COTA's scope of practice and under OTR/L direction.

• Reinforce strategies that support consistency and carryover across therapy sessions, daily routines, and transitions between levels of care.

• Participate in caregiver training and discharge preparation to support safe performance of daily activities and appropriate assistance needs.

• Encourage active participation in goal setting and treatment, respecting each Person Served's preferences, priorities, values, and desired outcomes.

• Communicate barriers to learning or carryover to the supervising OTR/L and collaborate on appropriate strategies.

4. Interdisciplinary Collaboration

• Collaborate with physical therapy, speech-language pathology, nursing, rehabilitation technicians, recreational therapy, music therapy, social services, medical providers, and other team members to promote coordinated care.

• Communicate functional progress, safety concerns, assistance levels, and recommendations to the supervising OTR/L and relevant team members.

• Participate in interdisciplinary meetings, care conferences, discharge planning, and other team activities as assigned.

• Coordinate interventions and reinforce consistent approaches across disciplines to maximize functional practice and reduce barriers to progress.

• Identify opportunities to incorporate therapeutic activities into meaningful daily routines in collaboration with the rehabilitation team.

5. Documentation and Regulatory Compliance

• Complete timely, accurate, and objective documentation of interventions, Person Served response, functional performance, progress toward established goals, and other required information.

• Document treatment in accordance with organizational procedures, payer requirements, applicable regulations, and professional standards.

• Communicate progress, lack of progress, changes in status, and recommendations to the supervising OTR/L to support ongoing clinical decision-making.

• Maintain accurate records related to treatment delivery, attendance, and other assigned responsibilities.

• Comply with applicable state and federal regulations, facility policies, confidentiality requirements, infection prevention practices, and ethical standards.

6. Safety and Quality of Care

• Maintain a safe therapeutic environment and follow established precautions related to falls, transfers, positioning, infection prevention, and other medical or behavioral risks.

• Monitor the Person Served's response to activity and recognize signs or symptoms that require intervention or communication with the appropriate team member.

• Use therapeutic equipment and adaptive devices appropriately and report equipment concerns or safety hazards.

• Promote dignity, privacy, choice, accessibility, and respect in all interactions.

• Participate in continuing education, competency development, quality improvement initiatives, and other activities that support high-quality neurological rehabilitation.

7. Additional Responsibilities

• Assist with maintaining an organized, clean, and appropriately equipped treatment environment.

• Participate in department meetings, staff education, student learning experiences, and other professional development activities as assigned.

• Perform other duties consistent with the position, qualifications, and applicable scope of practice.

Qualifications

Required

• Graduate of an accredited occupational therapy assistant program.

• Current certification through the National Board for Certification in Occupational Therapy (NBCOT), as applicable to employment requirements.

• Current Iowa occupational therapy assistant license or eligibility to obtain licensure before beginning practice, as required by applicable law.

• Current CPR/BLS certification, consistent with facility requirements.

• Ability to provide effective, respectful, and professional care to individuals with complex neurological and functional needs.

Preferred

• Previous experience in inpatient rehabilitation, neurological rehabilitation, acute care, or another medically complex rehabilitation setting.

• Knowledge of stroke, spinal cord injury, traumatic brain injury, and other neurological diagnoses.

• Familiarity with restorative and compensatory rehabilitation approaches, adaptive equipment, and functional cognition strategies.

• Experience collaborating within an interdisciplinary rehabilitation team.

• Commitment to evidence-informed practice, continuing education, and functional outcomes.

Knowledge, Skills, and Abilities

• Knowledge of occupational therapy principles and interventions within the COTA scope of practice.

• Ability to implement treatment plans and adapt activities within the established plan of care and under appropriate supervision.

• Strong observation, clinical communication, organization, and documentation skills.

• Ability to recognize changes in performance and communicate relevant findings to the supervising OTR/L.

• Effective interpersonal skills and the ability to establish therapeutic rapport with Persons Served and caregivers.

• Ability to prioritize treatment activities and manage time effectively in a dynamic inpatient rehabilitation environment.

• Ability to collaborate across disciplines and contribute to a positive, person-centered team culture.

• Commitment to safety, professional accountability, and continuous improvement.

Physical and Environmental Requirements

The position requires the ability to work in a clinical rehabilitation environment and perform essential job functions, with or without reasonable accommodation. Depending on assigned duties, requirements may include prolonged periods of standing and walking, assisting with functional activities and transfers within established safety procedures, reaching and bending, moving therapeutic equipment, and responding to changing clinical needs. Specific physical demands should be established by the organization based on the actual duties of the position.

Work Environment

This position operates within an inpatient neurological rehabilitation setting serving individuals with varying levels of medical complexity, functional impairment, and assistance needs. The COTA works closely with Persons Served, caregivers, and an interdisciplinary team to promote functional progress, safety, and successful transitions of care.

Scope of Practice and Supervision

The COTA practices under the supervision and direction of a licensed OTR/L and within the applicable state practice act, professional standards, payer requirements, and organizational policies. The OTR/L retains responsibility for occupational therapy evaluation, interpretation of evaluation findings, establishment and modification of the occupational therapy plan of care, and other duties reserved to the occupational therapist. The COTA contributes observations and recommendations to the supervising OTR/L and implements delegated interventions within the COTA's authorized scope of practice.