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Eli's Rehab Report

Inpatient Facility:
3 Ways to Make More Strategic Decisions For Your Rehab Facility

Making time for training pays off in unexpected ways.

Growing up in Kentucky, Renee Kinder spent a lot of time on the racetrack. She learned quickly not to bet on the horses wearing blinders, as those were the ones that could not pay attention to their surroundings, preventing them from adjusting their speed or position to come out on top.

Today, as a licensed Speech Pathologist, Resident Assessment Coordinator, and Director of Clinical Education at Encore Rehabilitation in Louisville, KY., Kinder tells therapy providers the same thing. If you want to thrive in today’s highly regulated market, she warns, you must remove your blinders. You can’t afford (literally) to ignore the changes that are headed your way in 2017 and just keep going about your day-to-day routines.

If removing your blinders makes you nervous, Kinder has you covered (pun intended). Follow her three tips on how to think critically about your facility and make strategic decisions to make sure you thrive financially and clinically next year.

1. Train your whole team. Consistent education of all of your employees — CNAs, SLPs, OTs, and PTs — is the best way to improve patient outcomes and improve job satisfaction within employees.

Consistent training is especially important in longterm care, where the nurses work in-house and the therapy team is typically contracted. Patients see multiple staff members throughout the day, but each staff member encounters the patient for only short periods of time. Because of this reality, care plans can become disjointed or accidentally ignored — at the expense of the patients.

The remedy? Education and collaboration. Your whole team needs to be educated on the diseases that your patients have so that they understand the importance of adhering to the patients’ care plans. When your whole staff gets the knowledge base of the conditions facing your patients, they’ll begin to view the instructions in patients’ care plans as therapy designed to help patients become more independent, rather than procedures that just keep patients alive.

Bright idea: To boost engagement, ask your staffers to train each other on what they see happening with patients. For example, if your physical therapist identifies the best technique to get a patient to walk, she needs to train the rest of your team on that technique.

“When you implement the strategies that therapy has trained you on that makes patients successful, that’s when the light bulbs go off,” Kinder says. Need more incentive for your staff to collaborate and provide consistent therapy to patients? “It’s mutually beneficial for all parties to keep patients independent. The caregiver burden decreases,” she adds.

2. Be proactive with new regulations. It’s tempting to ignore the regulatory changes heading for the rehab world in 2017 — and starting to affect rehab already. But that will only make it harder for your facility to thrive next year.

One of the biggest upcoming changes is the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, the quality reporting program that began in October 2016 and is slated to take full effect starting January 1, 2017. The IMPACT Act aims to improve communication as patients transition in care. It will gather standardized data — in the form of patient interviews — from post-acute care settings (long-term care hospitals, skilled nursing facilities, home health agencies, and inpatient rehab facilities) and give it to long-term care settings to determine the best treatment plans for patients.

Along with the IMPACT Act, CMS also finalized Comprehensive Person-Centered Care Planning, which includes the following:

  • Requires facilities to develop and implement a discharge planning process that focuses on residents’ discharge goals, and prepares residents to be active partners in post-discharge care, in effective transitions, and in the reduction of factors leading to preventable re-admissions.
  • Implements discharge planning requirements mandated by the IMPACT Act by revising or adding (where appropriate) discharge planning requirements for long-term care facilities.
  • Requires facilities to establish and implement a baseline care plan for each resident within 48 hours of admission and provide a summary of it to patients.

The other big regulatory change you need to know about is the new CPT® codes for physical and occupational therapy evaluations and re-evaluations. (See related article, p. 93). The new codes allow PTs and OTs to take into account the level of severity and complexity of their patients’ conditions. Instead of having just one code to choose from, PTs and OTs will have three codes for evaluation.

What do these changes mean for you? It means that you have to engage your whole team in preparing for the new regulations. For example, Kinder’s company, Encore Rehabilitation, is implementing a company-wide training on standardized testing. Encore is also poring over CPT® professional manual definitions to understand the new criteria and requirements for evaluation. And they’re conducting an internal audit of their coding and billing processes, which Kinder recommends to all facilities. “Knowing where you are now is a great way to prepare,” she says.

3. Appreciate maintenance-based care. Surrounded by grandparents and great grandparents as she was growing up, Kinder developed a passion for helping geriatrics with chronic conditions like dementia maintain levels of function. This is an often underappreciated element of rehab therapy, because it’s so easy to get caught up in the day-to-day routine of treating pain and ailments. But providing maintenance-based care has a huge impact on a patients’ quality of life. She recommends that providers begin opening their eyes to ways they can treat their geriatric patients.

The best ways to make your rehab facility thrive in 2017? Take your lead from Kinder and remove those blinders. Take a step back from the daily grind. Find ways to make your care teams work better together. Get educated and start preparing for regulatory changes. Identify how you can make a bigger impact on your patients’ lives. Doing all of this puts your facility in the best position to improve patient outcomes, capture all of the revenue you deserve, and keep growing.