January 15, 2021 | Tom Trice

3 Minute Read

With Cuts on Horizon, How Can SNFs Diversify Therapy Mix?

The good news for therapists in skilled nursing facilities (SNFs) is that they are now facing a lower pay cut in 2021 than expected. Adjustments to help rehab therapists during the COVID-19 crisis were included in the Consolidated Appropriations and COVID-19 Relief Act of 2021, signed December 27, 2020, that reduced the overall pay cut originally planned by the Centers for Medicaid and Medicare Services (CMS) by more than 50%. The bad news is that therapists still face an estimated 3.3% to 3.6% pay cuts, and it is unknown how long the reprieve will last and if the 9% pay cut will resume when the crisis has passed.1

Many of our SNF clients are wondering how they can minimize the effects this may have on therapists.  Since these cuts will undoubtedly impact nursing homes, it then begs the question: What can SNFs do to minimize the effects this may have on therapists? At a time when SNF occupancy is already at an all-time low due to the pandemic, how can these facilities diversify therapy mix in their environments?  Here are some suggestions:

Staff Appropriately

From a staffing perspective, facilities are encouraged to take inventory on what the roles and responsibilities are of therapists – such as evaluations and supervisory visits – versus assistants. SNFs can look at what they are doing and ask: Is there anything a therapist is currently in charge of that an assistant can tackle and take care of instead? Take strength training exercises, for example. An assistant may be more appropriate to help guide a patient with this form of exercise, while a licensed therapist focuses on skilled decision making for patient recovery plans.

Maintain Efficiency

One of the best ways to maximize efficiency within a SNF is to take inventory of how many therapists there are versus how many assistants. What’s the ratio? Know that number. Afterwards, look at what each licensed therapist is doing and ask the following: Are therapists doing things that assistants can do? If they are, then delve into work tasks and responsibilities, and see how they can be adjusted accordingly. 

Keep Track of Staff Productivity

Along similar lines, SNFs need to maintain a consistent level of productivity – this helps ensure a smooth workflow and that staff members are, in turn, delivering high-quality results. A good way to measure productivity is to look at the following: Are the clinicians and therapists on staff less than 80 percent productive? Are all team members operating at their best? How else can SNFs enhance and expand productivity? These are just a few questions that may be worth pondering in order to maintain optimal workflow and performance.

Focus on Cost

While analyzing different factors that can affect efficiency and staff productivity, skilled nursing facilities are also encouraged to think about how to reduce cost. In simple terms, therapists and assistants should be doing what they are expected to do. By making sure that team members are working at the top of their resume, this is how you can reduce cost. 

With many changes in the new year, it can be a nerve-wracking time for SNFs and therapists that are trying to keep their head above water, so to speak. Especially as we continue to navigate unpredictable factors related to COVID-19. The good news is, though, for any foreseeable challenges that may lie in the horizon, there are also solutions. And hopefully these proposed solutions can accommodate therapists who want to continue working in the SNF space. 

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1H.R. 133 (116th): H.R. 133: Consolidated Appropriations Act, 2021 (Including Coronavirus Stimulus & Relief)

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