James M. Berklan

Most of us have at least dabbled in seeking suitable entertainment and safe distractions over the last 12 months.

Pandemic protocols have likely led you and unseen neighbors to thrust new concoctions in the oven, torque your body into odd configurations or scour for unseen series to binge watch.

There’s also another innocent-sounding diversion that much of the long-term care population might not find so harmless, however. It could lead to some of the highest drama not directly related to COVID-19 over the last 17 months.

We’re talking professors brandishing keyboards, which could lead to the exposure of some uncomfortable truths.

Take, for example, the release of a study Monday that showed licensed therapy staffing dropped about 5% overnight when the Patient-Driven Payment Model began Oct. 1, 2019. The figure was closer to 10% for more easily sacrificed therapy aides.

It was the first time hard numbers had been used to describe what was previously anecdotally driven. Lead researcher Brian McGarry called them moderate losses, and possibly a case of right-sizing. That could make sense in an industry that had gotten fat on a Medicare payment system that was flawfully founded in the first place.

The researchers’ analysis, however, could consider only the first three months under PDPM. Those numbers were calculated from mandated Payroll-Based Journal reporting, which was temporarily made optional starting in January 2020, when about one-third of providers opted out. 

As a result, no one really knows whether the 5% and 10% staffing drops were simply one-time cutbacks or the start of a much bolder trend. 

We’re left with a “cliff-hanger,” as McGarry put it, thanks to the all-encompassing pandemic. It could take a year to clear up, since that’s about how long it will take hospital discharge and admissions data to catch up.

PDPM is a fascination and distraction at a time when everyone needs something different to focus on.

The next intriguing episode should come into focus later this spring when the same researchers release a study examining the use of therapy minutes after PDPM. It’s safe to assume the number went down, possibly way down. But nobody knows for sure just how much, or — and this is the big key — what effect the moves had on patient outcomes. 

Because the pandemic put a halt to almost everything normal starting in March 2020, the PDPM saga lingers like a hot TV drama experiencing a yearlong (and counting) hiatus.

Viewers are left to sit and speculate. Were providers en route to more massive therapy reductions? Were they going to eventually increase direct nursing staff? Or were they planning on pocketing savings? Just where will the money go?

When providers get back to operating more the way they want to, will stakeholders be amused or will they feel like they’re watching an unfolding tragedy?

Viewer ratings should only climb as this Netflix-worthy drama continues to age. Stay tuned.

Follow Executive Editor James M. Berklan @JimBerklan.