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Impact of Respiratory Therapy on PDPM
Respiratory therapy has emerged as a pivotal component in the evolving landscape of skilled nursing facilities (SNFs) and long-term care (LTC) settings, particularly in light of the Patient-Driven Payment Model (PDPM).
For post-acute patients in SNFs, respiratory therapy plays a crucial role in facilitating efficient recovery and rehabilitation. By providing tailored respiratory interventions and treatments, therapists can address multiple respiratory related conditions expediting the healing process and improving patient outcomes. Moreover, accurate documentation of respiratory therapy services under PDPM ensures that SNFs receive appropriate reimbursement for the care provided. Due to the clinical acuity and respiratory therapy needs there is an associated increase of daily skilled revenue of up to $100 per skilled day. As the post-acute healthcare climate has evolved over the years, SNFs continue to see more acute residents admitted daily, and their medical needs align with the increase in revenue opportunities, if captured and documented appropriately.
Similarly, in LTC settings, respiratory therapy contributes to optimizing case mix by managing chronic respiratory conditions among long-term residents. This proactive approach not only enhances quality of life but also mitigates the risk of exacerbations and hospital readmissions, thereby promoting cost-effective care delivery. Dependent on the state, the case mix acuity can have an immense impact on the financial viability of the facility. Long term care staff is often already providing the skilled acuity care to their residence, however without proper tracking, guidance, monitoring, and overall respiratory management your facility may be losing the accurate reimbursement you deserve. You could be leaving hundreds of thousands of dollars on the table depending on the size of your facility or chain.
What We Do
Through innovative program development and an interdisciplinary approach to respiratory therapy management, our team of post acute care and long term care experts provide respiratory therapy management. We meticulously review both short term and long term residents for care opportunities and changes in condition warranting respiratory therapy services. We guide your Respiratory Therapist to ensure medical necessity under Medicare and Medicaid guidelines as well as compliant documentation to justify respiratory therapy services. We coordinate with your interdisciplinary teams to ensure consistency of documentation and acuity capture. Our passionate team provides the systems and structure to execute the respiratory therapy operations and programming that your Respiratory Therapist needs in order to be successful.
