I advocate for long-term care organizations, including skilled nursing facilities. I collaborate closely with executives and nursing teams to guide them in getting the most out of their relationships with contract therapy providers.
A valuable contract provider goes beyond simply attending to needs like pressure ulcers and falls, going a step further to consider more in-depth expertise and implementation for residents. For example, the provider may partner in interdisciplinary programming for the reduction of antipsychotic use or behavior systems through such programs as Activity Prescription for residents experiencing Alzheimer’s disease or another type of dementia.
As the long-term care industry prepares for 2025, the impact of the discharge function score on the Quality Reporting program will continue to be influenced by the quality of contract rehab services.
By establishing clear expectations and enhancing communication channels, you can improve your facility’s operations and guarantee that the needs of your residents and clients are met with the highest standards of care, subsequently positively impacting your star rating.
As you consider how your contract therapy provider will influence your rating, here are some questions you can utilize to measure their effectiveness and quality.
Are the lines of communication as open as they can be?
Resident status updates are ever-changing, so it requires an interdisciplinary, collaborative approach to care plans. The rehabilitation team is an integral member of the process. Often, the organizations I counsel have a daily meeting where an interdisciplinary team — including the rehab director — attends.
However, since the initiation of Patient Driven Payment Model (PDPM) and the COVID-19 pandemic, I have seen a shift to where some providers are stepping back and saying they can no longer devote the time to be part of these sessions.
You must continue finding ways to include your rehab director in regular meetings. Some staff, like nursing team members, may check in periodically to administer medications. But, if your resident is receiving an hour of therapy a day, that’s undivided time that allows for deeper discovery. Those observations and insights from your therapy providers are worth sharing with the team.
Additionally, what is the staffing and presence in your physical building? Some rehab providers offer five days a week, others seven days a week. Are your providers available later in the day to offer a range of hours? These are all important questions to consider when evaluating the partnership.
Are they assisting in program development?
Your rehab service provider is an important partner in helping to analyze the needs in your long-term care organization. Partnering with your therapy provider to examine your community population trends will assist in providing specialized interventions geared to your recipient’s profile and the outcomes you wish to see.
The second layer of program development is knowing how to build the systems around that — does your therapy provider know how to build the program, document the process, and bill it correctly?
If a new service is launched, can the provider assist in communicating that to current and prospective recipients? The provider’s specialty insights into these offerings are invaluable.
How are they measuring success and outcomes?
Regular visits by a regional support team are one of the biggest criteria for accountability for a therapy provider. A collaborative partner will offer a quarterly business review, a comprehensive review of outcomes, reimbursement, staffing and more. This is an area that is often forgotten or neglected and can make a difference over time.
A second indicator of accountability is the administration of some type of customer satisfaction survey, including a critical look at outcomes. These findings should also be communicated to your leadership teams to discern areas for improvement.
Are they optimizing reimbursements?
A rehab provider should be helping to optimize services for reimbursement.
Regarding billing and documenting, it can be a costly mistake to assume that these processes are happening as they should. Compliance audits can help ensure that a therapy team is billing and documenting appropriately.
These safeguards will mitigate risks in claim reviews, or denials of nonpayment. It is important that you have a contract provider that will make this process as easy as possible.
Ask the right questions, today.
Considering these points will help your long-term care organization work with contracted service providers successfully, ensuring a seamless experience for residents and a positive reflection on your quality rating.
Do not let busy schedules stand in the way of quarterly meetings, reviewing quality surveys, and persisting in compliance committee schedules. Instead, work alongside your leadership team to ensure you are asking the right questions of your contract providers and not letting uncertainty or perceived limitations hold you back.
And, more importantly, remember that while your organization bears some responsibilities, selecting the right contract provider means they will have their measures in place to ensure quality service delivery.
Selecting the right contract provider impacts more than billable units or therapy minutes. It is about maintaining and improving the reputation of your long-term care facility, ensuring that when prospective residents and families find your name in an online listing or hear about it from a friend, it is associated with positive reviews and experiences.
Michelle Hediger, M.S., OTR/L, has 25 years of experience in operations and clinical experience across the post-acute continuum. In her current role, she is a compliance specialist with Friends Services Alliance in the Compliance Collaborative Team in Blue Bell, Pennsylvania.
The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.
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