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Nursing Home Staffing Best Practices

As a result of the recent changes inherent in FY 2012 PPS, many Skilled Nursing Facilities are feeling the strain of short-staffed therapy programs. Due to the downward reimbursement pressure at both state and federal levels, it might be a good idea to have a professional staffing assessment performed. A detailed assessment of how your therapy program is staffed in the context of patient acuity, length of stay, and the volume and intensity of therapy will give you the chance to identify staffing inefficiencies. Your program may in fact be short-staffed, or you might identify ways to create more efficient processes in order to achieve better results.

Below you will find a list of questions that can help you determine whether or not you need a nursing home staffing analysis. If you have trouble answering any of these questions or have concerns about your program’s performance, your facility would benefit from a nursing home staffing analysis.

1.)   What is the current productivity of the therapy department? 

2.)   What is the current productivity by discipline? 

3.)   What is the ratio of registered therapists to assistants in the therapy department?

4.)   How many contract/agency therapy staff does the facility utilize?

5.)   Does your Rehabilitation Director treat?  If so, how much?

6.)   Is therapy provided on the weekends?

7.)   How does the facility’s RUG mix compare to state and national CMS norms?

8.)   What percent of the LTC population is receiving therapy services under Medicare Part B?

9.)   Have you received any ADRs or denials on your therapy claims? 

10.)  How is your therapy department assessing whether a Change of Therapy (COT) or End of Therapy (EOT) assessment is warranted?  Do they have tools to identify risk ahead of time? 

11.)  How many days per week is therapy available?


Therapy Scheduling

Rehabilitation that follows a consistent schedule will ensure positive clinical outcomes. An organized schedule is also critically important when it comes to being able to capture revenue credit for the care you’re providing. With increased complexities in the FY 2012 PPS environment, a minimum of 6-7 days availability of therapy services is essential. 

Below you will find a list of questions that can help you determine whether or not you need a nursing home staffing analysis.

  1. How many days/week is therapy provided at your facility?
  2. How is patient scheduling for therapy treatment accomplished?  
  3. Is patient scheduling manual or done through a digital system? 
  4. How is scheduling adjusted for therapist call-outs or patient refusals?
  5. Do you often hear complaints from the Therapy Department that the Nursing Department does not have patients ready for their therapy treatments?
  6. Do you often hear complaints from Nursing that Therapy is not available during times that fit patient schedules?
  7. How many COT or EOT assessments did your facility complete in recent months? 
  8. How do these COTs and EOTs relate to the particular MDS books?  Is there a trend?


HealthPRO® - Experts in nursing home staffing

At HealthPRO® we specialize in the development and management of successful therapy programs. As a result, we know how to create positive work environments where therapists thrive and organizational goals are simultaneously met. All of our therapy managers, once Directors of Rehabilitation for single and multiple facilities, bring vast amounts of knowledge and best practices to the table. They also offer staff recruiting and retention expertise to ensure you retain the right staff for your business needs. For in-house programs, we offer FTE placement service, temporary therapy staff and per diem pool development so that you have access to the clinical staff you need when you need them.

Our staffing plan

Our staffing plans are completely customized to meet the needs of your facility and the changing needs created by census fluctuations and program development.

Intelligent, integrated technology

HealthMAX® is the proprietary therapy technology solution that we offer all of our clients. HealthMAX® automates therapy documentation, tracks clinical outcomes, and provides therapy-specific reporting for effective staff management and strong program performance. With this system in place, your staff can perform their jobs duties efficiently and effectively. Your Rehabilitation Director will also spend less time creating reports and more time managing staff and outcomes. Our team will help integrate HealthMAX® into your facility and train all staff members.

There’s still more

In addition to our staffing assistance, we offer a multitude of business services that can help your facility grow and increase revenue. Our progressive therapy solutions address the evolving operational challenges faced by many nursing facility managers. Some of these challenges include clinical program development and management, regulatory and corporate compliance, operational efficiency, technology, education and training, and financial integrity.

A unique approach

There are two ways we work with our customers. We offer In-house Therapy Management or Full Service Contract Therapy Management. If your program is in house, we provide a management model that offers:

  • Clinical, regulatory, and operational expertise
  • Training and education for therapy and nursing staff
  • Recruiting and temporary staffing as needed
  • Technology solutions that automate documentation, outcome tracking, and reporting to support positive performance
  • Improved clinical and operational performance
  • Enhanced documentation and compliance.  

We also offer a full service contract therapy approach where we supply the same services above in addition to employing the therapy staff. Our depth of experience and proven track record of success ensures that you get the results you want regardless of which model you choose.  

No matter what approach you take, one aspect of our business never changes - the quality of our work.  


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Tags: staffing