Therapy Staffing in Skilled Nursing Facilities Declined After Implementation of the Patient-driven Payment Model

Authors: Rachel Prusynski, DPT | Natalie Leland, PhD, OTR/L | Tracy Mroz, PhD, OTR/L

Topics: Behavioral Health, Nursing, Staffing, Workforce Demand, Workforce Supply

Research Center: University of Washington Center for Health Workforce Studies

May 18, 2021

The Patient-Driven Payment Model (PDPM) is a new reimbursement policy for skilled nursing facilities (SNFs) that was implemented by the Centers for Medicare & Medicaid Services in 2019. PDPM disincentivizes provision of intensive physical and occupational therapy, which has caused concerns that declines in therapy staffing may negatively impact patient outcomes. Therapy staff includes physical therapists (PTs), occupational therapists (OTs), physical therapy assistants (PTAs), occupational therapy assistants (OTAs), and therapy aides. Little is known about the employment of therapy staff within SNFs relative to market needs.

This article compares wages and patterns of employment among SNF therapy staff to estimate immediate and gradual effects of PDPM implementation.

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University of Washington Center for Health Workforce Studies