AOTA just wrapped up our 1-day specialty conference on the Patient-Driven Payment Model. If you’re an occupational therapy practitioner working in a skilled nursing facility, the PDPM will roll out on October 1 and it’s time to get prepared! Read below for a few quotes from our conference speakers. See more quotes and tweets here.
It's an Exciting Time
"This is an exciting time for occupational therapy. Change is hard. We are perfectly situated because we are adaptable. We got this. We should be able to implement all these changes and be very patient-centered."
- Sabrena McCarley
"I am excited about PDPM. I really am. All I ever wanted to do was make a difference in the lives of my clients. Occupational therapy under PDPM has the opportunity to raise our hands and say 'we are the experts at functional cognition.'"
There are amazing opportunities coming, we have to manage our fear and show and articulate what OT can do.
Working on PDPM for Five Years
If you feel like the Patient Driven Payment Model came out of nowhere, Natalie Leland, our keynote speaker, is describing how it's been 5 years in the making, starting with MedPAC.
"We heard occupational therapy loud and clear." A Medicare official told us when AOTA members activated grassroots efforts to write letters about the PDPM. Your advocacy helped! Thank you!
We've been working on this for years. Occupational therapy has been at the table of these discussions for five years. We have been strategic. This is our opportunity to flip the script - "this is what the patient needs."
- Amy Lamb
Document Your Services. Demonstrate Your Value.
"We need to make sure we're delivering evidence-based occupational therapy services in a standardized manner.
Demonstrate our value
Document our services
Show how we improve outcomes."
"If you work with a client and you address cognition, you have to document it.
As we move forward, what we do matters and you must document it.
I've been told, 'If you didn't document it, it didn't happen.'"
"Our documentation - are we truly documenting the things we are doing? This is the time to show what we are doing and how we are distinctly separate from other therapy professions."
- Melissa Tilton
The role of OTAs in SNFs is not changing under PDPM. We continue to need to be able to collaborate. Both OT and OTA should be intricately familiar with the evaluation and plan of care. Read it and be sure to document occupation-based care.
From Productivity to Patient
"Let's transition from the P of productivity to the P of the patient. We don't need to wait until October 1. We can begin on Monday."
- Sabrena McCarley
"Time is going to tell what will happen with productivity. I'm a rehab director and I don't know. My company doesn't know yet. Right now it's a time to advocate for the time that you need to do things that you don't currently have time to do."
Provide High Quality OT
As you provide occupational therapy services ask yourself these two questions:
Could someone with less skill (less expensive) do this instead of me?
Is this something that is unique and specific to OT to help the client achieve optimal outcomes?
"You don't do cognition? Then you don't do function very well."
Cognition plays an integral role in human development. Cognition drives function across the lifespan.
"Activity analysis sets us apart from any other profession. There are 13 steps to going to the bathroom. Each step is crucial!"
"My eye is on the discharge plan the whole time. I don't want to guess anymore about when someone can be discharged. The OT assessment of functional cognition allows us to estimate the amount & type of support individuals need to manage the activity demands of their life."
Individual Level and Systems Level
We need to talk at both levels: the individual-level and the system-level.
1) "I know what's important to you, you want to get home and be with your grandchildren."
2) "As an occupational therapy practitioner I can help our facility decrease our hospital readmission rates"
What Will Change on October 1?
How will the role of the rehab director change with PDPM?
Lori Daugherty doesn't think it will change much. "I know it's simplistic, but my role isn't changing." We need to keep doing what we do as occupational therapy practitioners.
"We always could do group and concurrent therapy in SNFs," says Kevin Brogley. "For operational reasons, we moved away from groups. But not for clinical reasons. I wanted to see the evidence - is there a clinical benefit of groups? And there is! It can be motivating to work with and see other people doing the same activity."
Hopefully you will be empowered to speak up.
You have resources. Lots of resources.
If someone shares info that's different from what you heard today, go and read what CMS is saying yourself. Bust the myths that you may be hearing.