Jeri Lundgren

Who should understand wounds in skilled nursing facilities?

Wound care has historically been the responsibility of the nursing department, and many facilities employ specialized wound care nurses. Physical and occupational therapies have added important adjunctive wound care. Pressure injuries and their sequelae remain one of highest risk areas for litigation for these facilities. 

However, now there is also a direct financial impact of identifying wounds upon admission because reimbursement to the facility is directly tied to early and accurate wound identification and treatment.

With the initiation of the Patient Driven Payment Model in late 2019, there was a shift away from volume-driven care based primarily upon the number of minutes provided by physical, occupational and speech therapies during the MDS look-back period. 

Now, under PDPM, there is increased reimbursement for wound care services of specific types and severities of wounds that impact the bottom line for operators of skilled nursing facilities. More than ever before, recognition of wounds and their appropriate treatment have become important and not just to nursing services. It now behooves the entire interdisciplinary team to be cognizant of the importance of wounds and wound care. This is a good thing, as wound care and wound prevention benefits from the involvement of the whole team. In addition to the nursing and therapy teams, administrators, dietary, certified nursing assistants and others have valuable input in assuring that the costs of wound care are reimbursed appropriately. 

Morning interdisciplinary team meetings and at-risk meetings should carefully review all new admissions to make sure that wounds are correctly diagnosed and staged.