Man practicing walking during physical therapy

Rehab therapists have often been lauded not only for their skills, but also for some powerful bonds they’re able to forge with residents. Workforce shortages inside nursing homes today are inspiring therapists to also forge stronger ties with their nursing colleagues. It’s an effort to do more with less, while also strengthening and improving how care is provided.

1. Understanding how the easing of the pandemic positively changed rehab care is an important first step.

The challenges of COVID and then-new PDPM rules forced therapists to look at different ways to provide high-quality therapy outside of the usual rehab gym setting, observed Karen Welsh, vice president of clinical and reimbursement excellence for Functional Pathways Rehab.

That was an eye-opening period that will have a lasting, creative impact.

But treatment interventions outside of the patient’s room have returned to near pre-pandemic levels and therapy teams can now resume group activities to allow patients to offer support and suggestions to their rehab peers, said John Pauley, northwest regional vice president for Consonus Healthcare. 

“In a sense, the human connection between therapist and resident has been restored, with changes in masking and isolation policies,” he said. 

2. Therapists can play important roles mitigating the impact of workforce issues.

“As we work together for continued industry stabilization, contract physical therapy companies and skilled nursing providers can efficiently improve patient outcomes and foster a positive and collaborative environment to increase facilities’ marketability for more effective community partnerships and increased census,” said Stephanie Parks, chief development officer for Reliant Rehabilitation. “Work together to develop personalized treatment plans for each patient. Encourage input from the contract physical therapy company and the skilled nursing provider to ensure a comprehensive approach considering the patient’s needs, preferences, and overall care plan.”

Kristin Hoffman, senior customer onboarding specialist for iN2L, suggests scheduling group therapy sessions with activities staff or volunteers if there are caregiver shortages. 

“This can help therapists see a broader range of abilities of their residents’ physical and cognitive abilities without having them on caseload, maybe sparking a need for an eval while still completing their group therapy session,” she said.

3. Develop mechanisms to help staff adapt to  changes that make them better at what they do.

“Facility team members are still adapting to changes from the pandemic,” Pauley said. “It’s important to use clear communication for the reasons behind the changes — and how the changes will be implemented to minimize any concern among staff.”

Added Shelley Horst, director of strategic partnerships for Reliant Rehabilitation: “Addressing staffing shortages in therapy within skilled nursing centers is crucial for providing optimal care to residents.”

4. Many agree that therapists can benefit from understanding how and why workforce shortages are not only affecting the business of long-term care, but also the way they approach their work.

“The key to success with the workforce crisis for therapy and nursing is the ability for the interdisciplinary team to support one another and place the patient’s goals at the center of decision making,” explained Pauley. He noted that therapists are skilled in their ability to assess a patient’s environment, promote needed body positioning and transfers, and provide recommendations that  can reduce caregiver burden. 

5. Though it may seem obvious, experts advise tackling the biggest challenges first.

“Therapists are perfectly positioned to help nursing home caregivers provide the necessary functional tasks by ensuring treatment is delivered during times when it is needed the most — early morning or evening ADLs, all meal times, activities and weekends,” said Welsh. “It’s important for each therapy director to work closely with the leadership team and determine the best way to incorporate therapy into the daily schedule to assist at those times when it’s needed most for patient care.”

Hoffman believes giving patients increased independence by the end of the treatment sessions is another way therapists help reduce caregiver shortages. “The more a patient can do for themselves, the less assistance they will need,” she added.