rehab department

How Would You Rate Your Rehab Department?

If your answer isn’t a solid 4-Star or better, it might be time for a long discussion, or possibly a change or overhaul of how your services in your rehab department are being delivered.  If you can’t give them at least the high school equivalent of a B+, you’ve got some valid issues to discuss and work to be done.

Amidst the enormity of never ending and changing federal and state policies, issues, mandates and initiatives that affect our long-term care industry, we must begin to expect our partners (a.k.a. our vendors, business associates and internal departments) to accept a portion of the burden and help our SNF facilities move forward.

I’ve spent the last 26 years working both directly for SNF’s and other providers, as well as the last sixteen years in contract rehab, auditing and risk management. I have seen a lot of great…and not so great therapy departments. I have assisted in cleaning up a fair amount of therapy programs, and I’d like to share just a few pointers on what to look for, and how to begin.  In essence, what qualities or attributes should you look for?

I’m sorry, but fancy equipment, lovable therapists, low rates and glossy sales binders simply don’t make the difference between success and mediocracy these days. I hear it all the time. Let me share a verbatim statement from one of my old cases.

“Oh, we just really love Ruth Ann, our therapy manager.  She is just wonderful.  I don’t get any reports or hear anything from the corporate office, but I love our therapy team.”

Not. Good. Enough.

It’s 2017 people!  7 days a week is a standard expectation.  Therapy managers in the morning meeting and care plans should be a given. Competent therapists that are skilled in the treatment of older adults is a no-brainer. This is basic stuff. What I am asking you to do is dig deeper. Look at the systems, look at the foundation of this partner. What have they done for you lately? And what are they doing for you tomorrow to compliment the objective and vision for the future of your building?

Here is what your therapy provider should be doing for you…

  • Complete transparency as a Partner; if a reimbursement changes, address it then so you aren’t on the losing end, such as in Managed Care contracts.
  • Case mix support. They should know your state’s system, and identify routes to help improve and maintain this.
  • Extensive programming and protocols, especially for those diagnosis most prominent in your mix.
  • Full auditing services (and not by someone with a vested stake for it to look “good”).
  • Complete ADR and Denial support.
  • Marketing, and not just talking about it, but doing it.
  • Tracking and reporting your Outcomes. Value based is coming, it’s time to be prepared.
  • Provide you with hospital reports for your feeder hospitals, including re-hospitalization numbers.
  • QM and QAPI active participants.
  • NOT turn a blind eye on your behavioral and dementia patients. They have needs, too, and the therapists should be trained on programming and techniques.
  • PUF analysis and a plan of correction if they are putting you at risk.
  • PBJ uploads.
  • Management of the Program and Staff! If that Regional or Manager above the building level isn’t there regularly, there is an issue.  Not everything can be seen, completed or corrected remotely.

A culture of stewardship and servitude involving real people that are  true partners that exhibit  forward thinking, progressive and strategic ideas and with the momentum for actual implementation, are the cornerstones that effectively help drive SNF providers forward and upward in service and success . This success is triggered and facilitated by not only your internal team but also your vendors, especially rehab. These areas are what can truly, ultimately make the difference between being a 3-star building and a 5-star building.  It determines being financially viable or struggling with odious and resource-draining factors such as audits, tags and/or reduced census.

If you take nothing else away from this short statement, please just take the time to look closely, seek outside help or assistance, or at least review your current status in all areas.  You may be surprised at what a difference a few changes can make.

HTS is your partner in therapy. If your facility or company would like a free financial and clinical analysis or consultation, contact us.


Kerry Wright, OTR/L
Executive Director of Business Development and Southern Operations
Healthcare Therapy Services, Inc.


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