Affiliation:
1. University of Washington, Seattle, USA
Abstract
Therapy staffing declined in response to Medicare payment policy that removes incentives for intensive physical and occupational therapy in skilled nursing facilities, with therapy assistant staffing more impacted than therapist staffing. However, it is unknown whether therapy assistant staffing is associated with patient outcomes. Using 2017 national data, we examined associations between therapy assistant staffing and three outcomes: patient functional improvement, community discharge, and hospital readmissions, controlling for therapy intensity and facility characteristics. Assistant staffing was not associated with functional improvement. Compared with employing no assistants, staffing 25% to 75% occupational therapy assistants and 25% to 50% physical therapist assistants were associated with more community discharges. Higher occupational therapy assistant staffing was associated with higher readmissions. Higher intensity physical therapy was associated with better quality across outcomes. Skilled nursing facilities seeking to maximize profit while maintaining quality may be successful by choosing to employ more physical therapy assistants rather than sacrificing physical therapy intensity.
Funder
Health Resources and Services Administration
Subject
Geriatrics and Gerontology,Gerontology
Reference53 articles.
1. Abt Associates. (2016). Nursing home compare claims-based quality measure technical specifications. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/New-Measures-Technical-Specifications-DRAFT-04-05-16-pdf
2. Arbaje A. I., Wolff J. L., Yu Q., Powe N. R., Anderson G. F., Boult C. (2008). Postdischarge environmental and socioeconomic factors and the likelihood of early hospital readmission among community-dwelling Medicare beneficiaries. The Gerontologist, 48(4), 495–504. https://doi.org/10.1093/geront/48.4.495
3. Burke R. E., Whitfield E. A., Hittle D., Min S., Levy C., Prochazka A. V., Coleman E. A., Schwartz R., Ginde A. A. (2016). Hospital readmission from post-acute care facilities: Risk factors, timing, and outcomes. Journal of the American Medical Directors Association, 17(3), 249–255. https://doi.org/10.1016/j.jamda.2015.11.005
4. Carnahan J. L., Slavens J. E., Callahan C. M., Tu W., Torke A. M. (2017). Transitions from skilled nursing facility to home: The relationship of early outpatient care to hospital readmission. Journal of the American Medical Directors Association, 18(10), 853–859. https://doi.org/10.1016/j.jamda.2017.05.007
5. Centers for Medicare & Medicaid Services. (2008). CMS manual system: Pub 100-02 Medicare benefit policy: Therapy personnel qualifications and policies effective January 1, 2008. https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r88bp.pdf
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献