Abstract
This study examines the relationship between mobility and self-care outcomes, focusing on therapy duration, treatment length, and rehabilitation intensity in a skilled nursing facility setting. Results show significant differences in outcomes dependingon insurance type.
Primary Author and Speaker: Christine L. Kroll
Additional Authors and Speakers: Elaina McMullin, Amanda Carmosino
Contributing Authors: Daryn Hyneman, Alise Morin
This study examines the impact of healthcare reform on the relationship between mobility and self-care outcomes documented in Section GG and multiple independent dependent variables, including time receiving occupational and physical therapy, length of treatment, and rehabilitation intensity. Researchers completed a retrospective data analysis was completed using SPSS Version 29.0. The data was gathered from Traditional Medicare and Medicare Advantage beneficiaries discharged to the community after an SNF Part A stay. The data was collected from 73 SNFs across Indiana and Kentucky from October 2022 to September 2023, N=1516. Researchers employed descriptive statistics, correlations, and linear regression analyses to examine the relationship between variables. Researchers checked for linear relationships and multi-collinearity before running a regression analysis. Initial analysis indicates differences between the Traditional Medicare (TM) and Medicare Advantage (MA) beneficiaries. The MA beneficiaries received significantly shorter length of stay, 15 days vs. 25 days (TM), p<.001. Correlational analysis indicates a strong relationship (p<.001) between the Insurance payor and decreases in occupational therapy and physical therapy treatment time, the shortened length of stay, and less functional improvement in self-care and mobility. The data shows the importance of reimbursement changes and their effect on client services. The importance of section GG data collections and their use in functional assessment outcome measures means that accurate data collection is important (Sandhu et al., 2018); however, Medicare beneficiaries’ choice of insurance type may significantly affect their access to services (Prusynski et al., 2021). Occupational therapy practitioners (OTPs) in skilled nursing facilities should consider the payor source and shortened length of stay in their plan of care. OTPs advocate for changes to Medicare Advantage plans and client access to care.
Sandhu, S., Furniss, J., & Metzler, C. (2018). Using the New Postacute Care Quality Measures to Demonstrate the Value of Occupational Therapy. The American Journal of Occupational Therapy, 72(2), 7202090010p1–7202090010p6. https://doi.org/10.5014/ajot.2018.722002
Prusynski, R. A., Leland, N. E., Frogner, B. K., Leibbrand, C., & Mroz, T. M. (2021). Therapy Staffing in Skilled Nursing Facilities Declined after Implementation of the Patient-Driven Payment Model. Journal of the American Medical Directors Association, 22(10), 2201–2206. CINAHL Plus with Full Text. https://doi.org/10.1016/j.jamda.2021.04.005