PDPM’s variable per-diem rate and its affects on therapy services.

PDPM’s variable per-diem rate has the potential to significantly affect the delivery of therapy services provided to residents of SNFs.

Providers are expressing a concern over PDPM’s variable per-diem rate. Regardless of whether a resident receives a certain therapy type, he/she would be rated in that category to create an aggregate mix and determine the corresponding reimbursement rate. Under this new model, the rate shifts downward over the length of a stay starting after day 20 for physical and occupational therapy patients. The rate does not change for SLP and nursing case mixes. From day 21 through day 100, compensation is reduced by 2% every seven days. For example, if a patient is skilled for 60 days, compensation is reduced by approximately 11%. With that said, SNFs will need to determine their break even point.

Where does that leave therapy if a patient has not maximized their rehab potential by the time the SNF hits their break-even point? Will SNF providers permit therapy services to continue even if the facility is losing money or will they require the therapy professionals to discontinue services?

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