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COVID-19

COVID-19 Pandemic and Medicare Payment Reform Significantly Affect Skilled Nursing Facility Therapy Staffing

Strategic Insights

— 1 min read

A study published in the Journal of the American Geriatrics Society revealed that the implementation of the Patient Driven Payment Model (PDPM) in skilled nursing facilities (SNFs) resulted in immediate declines in physical and occupational therapy staffing. The research, conducted by researchers from the University of Washington, analyzed Medicare administrative data from a national cohort of SNFs between January 2019 and March 2022. The study found that PDPM resulted in a 6.54% decline in total therapy staffing, with larger declines for assistants and contractors.

Key Takeaways:

  • The Patient Driven Payment Model (PDPM) resulted in a 6.54% decline in total therapy staffing minutes per patient-day, with larger declines for assistants and contractors.
  • The COVID-19 pandemic led to fluctuations in per-patient staffing, but PDPM-related staffing declines persisted two years into the pandemic, especially in rural SNFs.
  • SNFs with rural, for-profit, chain-affiliated, and higher census characteristics had larger staffing declines during PDPM implementation.
  • SNFs that historically engaged in profit-maximizing behaviors had larger staffing declines during PDPM compared to other SNFs.
  • Therapy staffing fluctuated during COVID-19, but PDPM-related reductions remained significant.

Statistics:

  • 6.54% decline in total therapy staffing minutes per patient-day due to PDPM.
  • Larger declines in staffing for assistants (7.36%) and contractors (8.21%) compared to therapists (4.71%).
  • Per-patient staffing fluctuated by 14.51% during the COVID-19 pandemic.
  • SNFs with rural characteristics had a 9.31% larger decline in staffing during PDPM.
  • SNFs with for-profit characteristics had a 7.12% larger decline in staffing during PDPM.
  • SNFs with higher census characteristics had a 6.59% larger decline in staffing during PDPM.

Sources:

  • Journal of the American Geriatrics Society
  • University of Washington, Dept. of Rehabilitation Medicine
  • American Physical Therapy Association Health Policy & Administration Section Research
  • Foundation for Physical Therapy Research
  • NIH National Center for Advancing Translational Sciences (NCATS)
  • NIH National Institute on Aging (NIA)

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