evaluating Your Contract Therapy Partner

Outsourcing your therapy program to a third party provider shifts many of the responsibilities and challenges, which in turn allows you to focus on other aspects of managing your skilled nursing facility. While the daily responsibility for therapy has been shifted, it is still important to periodically evaluate the performance of your therapy provider. This has become even more important since the introduction of PDPM given the change in reimbursement and the introduction of new therapy contract pricing models.

When evaluating your therapy provider, you should focus on clinical outcomes for residents, how therapy supports MDS and nursing and the financial and operational costs associated with having a third party provider. Here are some questions to consider when evaluating your contract therapy provider:

  1. How has the delivery of therapy services changed since the initiation of PDPM?  Therapy services should be provided based on the assessment of the individual patient’s needs.  You want to look for trends regarding the delivery of services to determine if therapy minutes a patient is receiving are clinical need driven versus reimbursement driven and if these trend patterns have shifted since the initiation of PDPM.
  2. Is the level of therapy being provided supporting desired clinical outcomes?   Ask your therapy provider to provide you with outcome data.  Compare current data to historical data.  Also ask your therapy provider if their software allows for industry comparisons and request to see that data. Solicit feedback from residents and family members about their experience with the therapy team.
  3.  How is my therapy provider supporting my clinical team in accurately capturing and completing the MDS?  A well trained therapy manager and therapy team can provide valuable information through their clinical care and documentation to assist and support the MDS team in effectively and accurately completing the MDS.  Your therapy provider should have a plan in place to meet with and share the information that they have gathered through chart reviews, evaluations, and one on one time spent with your residents.
  4. What am I paying for the services being delivered? As an operator regardless of how your contract is written, you should translate your cost to a by the minute rate to determine if what you are paying is in line with the industry standards.  If not it could tell you one of two things—you need to renegotiate your contract rates s or possibly your therapy company is underproviding services that your residents may need.
  5. Is my therapy provider effectively addressing the needs of my long term care residents in the wake of this global pandemic?  Many long term care resident have been impacted by this global pandemic.  Your therapy provided should have a process of screening these residents to determine if they have experienced any changes and/or loss of function.  Your therapy team should act quickly to insure these residents quickly receive the services they need to maintain their maximal level of independence and quality of life.

Your therapy provider should strive to be a partner in the journey to your success.  If you find any of these answers lacking, I would encourage you to take a deeper dive into that relationship and how you can move forward and make the necessary changes to better manage this partnership for the overall clinical, financial and operational success of your organization.