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Therapy may be on your to-do list this year, but priorities shift…


As a leader in senior care, your strategic targets are set for 2018, but this is not your first rodeo. You are well aware that your priorities will shift each day like snow drifts across US-131 because…

  • Surveyors just walked into the building.
  • You’re short-staffed and calling “agency” more than ever before.
  • Mrs. Johnson’s family is highly perturbed because your care staff has lost one of her hand-knit slippers… again.
  • The fire alarm is going off for the third time today without any known cause.
  • And your DON now has the flu.

In a hectic world full of competing priorities, healthcare leaders must determine on the fly what needs immediate attention, and what can wait.  So, we ask ourselves every day, “Where can I NOT focus today? What can wait until next week… next month… next year?”

Because of this, any change to therapy is often put on the back burner. 

It’s easier to assuage your concerns and tell yourself that your therapy program does not need improvement for now. It’s “good enough.” Patients are accustomed to their therapists, and those therapists get along with your facility’s team. The care they provide seems fine. Sure, there are more ADRs than ever before, but that’s not therapy’s fault, right?

So what are the risks in tolerating a mediocre therapy program?

Unfortunately, the choice to continue working with a so-so therapy provider presents risks to your patients and your facility.  Here are 20 risks (in no particular order) for both patients and SNFs:

1. Your therapy provider has staffing issues and coverage is based on availability and preferences of therapists, not on patient needs.

2. Your therapy team puts productivity pressures above good clinical judgment.

3. Your therapy provider hires therapists who lack the knowledge to treat the geriatric population and don’t understand clinical pathways in the SNF environment.

4. Your therapists lack ongoing training and education – in trends, treatments, care, ethics, and compliance.

5. Patients are not discharged at the right time – too soon and they’re suffering and back in the hospital; too late and your ALOS is higher than other SNFs in your region.

6. Coding and billing issues caused by therapy trigger headaches for you and your team.

7. Therapy is not prepared for the big change from PPS to RCS-I (or something that looks like it), and they aren’t preparing your facility for what is to come.

8. Improper documentation is causing ADRs to pile up, and therapy isn’t much help in responding to them and getting funds back for your facility.

9. Your therapy team has no idea what to do when CMS walks in the door.

10. Your therapy team does nothing to help your facility with marketing to referral sources.

11. They provide you with program performance measures only when you ask, and even then the numbers seem fuzzy or aren’t helpful to your business decisions.

12. Your quality scores and star ratings decline, and recovery will be a long row to hoe.

13. Therapy and care are not optimized for complex, progressive illnesses (cardiac, pulmonary, cancer, neurologic, dementia, etc.).

14. Therapy is not optimized by type – preventive, restorative, supportive, palliative.

15. Intensity of rehab does not vary appropriately based on disease progression.

16. Patients are minimally engaged in decisions about their treatment.

17. Patient preferences and goals are neglected or forgotten.

18. Patients suffer preventable pain & fatigue due to too much (or too little!) therapy.

19. Patients are re-hospitalized after returning home, and they’ll likely return to skilled nursing.

20. Patients and their families are dissatisfied with the care they received at your facility. Your patient satisfaction scores decline. Your reputation in the community suffers.

Sorry for all of the doom and gloom. Perhaps your therapy program is performing at its peak, and patients are raving about their ability to rebound under your care? We sure hope so! But are you certain?

What if you didn’t have to worry about your therapy program in 2018?

On the patient side, great therapy can help patients manage symptoms, improve physical performance, recover function, recover independence, and maintain overall quality of life.  On the facility side, great therapy can improve overall patient care, satisfaction, star ratings, and your reputation in the community.

Let’s talk about how we can take one big concern (THERAPY!) off your plate in 2018 and for many, many years to come.  Email me or call 1-877-TMI-8171.