The implementation of the Patient Driven Payment Model resulted in a huge drop-off in therapy staffing at nursing homes, a new study confirms. The findings have researchers concerned that the declines will have negative impacts on the workforce and quality of services that residents receive in the future.
The University of Washington-led research and findings were released in the Journal of Post-Acute and Long-Term Care Medicine on Friday. They found that total overall therapy staffing minutes per patient-day declined by 5.5% in the week immediately following PDPM’s implementation in October 2019.
That decline continued during the first six months of the new Medicare payment system — with skilled nursing facilities experiencing an additional decline of 0.2% per week over that time period. SNFs saw a total 14.7% decline in therapy staffing minutes per day by the end of March 2020.
Additionally, researchers uncovered an average decline of 80 therapy staffing minutes over the average patient stay.
Lead researcher Rachel Prusynski, DPT, said she was surprised how quickly therapy staffing was reduced under PDPM.
“Despite The Centers for Medicare & Medicaid Services (CMS) stating that they would monitor therapy provision after PDPM implementation, we did expect a decline in therapy after PDPM since it was specifically designed so that therapy services were no longer ‘money-makers’ for SNFs. But until we looked at the data we weren’t sure what the actual magnitude of decline would be,” she told McKnight’s Long-Term Care News on Friday.
Her team’s findings comes after a first-of-its-kind March study that found that nursing facilities experienced a 5% drop in employed licensed therapists and 10% drop in therapy aides after PDPM.
Prusynski said researchers will next try to ascertain whether patients were impacted by the decline in therapy staffing.
“I would certainly hope that providers keep patient and quality outcomes in mind when making staffing decisions,” she said.
“There are also remaining unanswered questions on what sort of impact these staffing declines have for therapy staff themselves and what PDPM layoffs mean for therapy professions and the therapy workforce in the future,” she added. “Therapy staff are an integral part of post-acute care services and we would hope that a loss in human capital investment in therapy staff doesn’t have a long term negative impact on quality of care in the future.”
