Rehabilitation Therapy
2018 AHCA/NCAL Annual Convention
RT-1 - Raising the Bar on SNF Quality Outcomes. Rethinking the Role of PT, OT, and SLP in Interdisciplinary Approaches to Re-admissions, Restraints, Medications, Falls, and Management of Cardiac Conditions
Sunday, October 7
8:00 AM - 10:30 AM
CE: NAB: 0 | Nurses 0
Speaker(s)
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Sabrena McCarley, MBA-SL, OTR/L, CLIPP, RAC-CT
Director of Clinical Operations
RehabCare/American Occupational Therapy Association
Participants should be aware of the following financial/non-financial relationships:
Nothing to disclose
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Cathy Ciolek, DPT, GCS, FAPTA
President
Living Well With Dementia, LLC
Participants should be aware of the following financial/non-financial relationships:
Nothing to disclose
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Ellen Strunk, PT, MS, GCS, CEEAA, CHC
President, Principle Consultant
Rehab Resources and Consulting, Inc.
Participants should be aware of the following financial/non-financial relationships:
Rehab Resources & Consulting, Inc.: Consultant
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Deb Bielek, MS CCC SLP
Therapy Resource Education and Programs
Ensign Services, Inc.
Participants should be aware of the following financial/non-financial relationships:
Nothing to disclose
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Skelly Wingard, RN, MSN, PHN, CNL
Continuum Administrator
Kaiser Permanente
Participants should be aware of the following financial/non-financial relationships:
Kaiser Permanente: Salary
The American Health Care Association (AHCA) and National Association for the Support of Long Term Care (NASL) are AOTA Single Course Providers. As Single Course Providers, AHCA and NASL are authorized to offer .4 AOTA CEUs/4 Contact Hours.
There are no prerequisites to attend RT-1 or RT-2 but it should be notes that RT-1 is considered an Advanced Level Session.
Skilled nursing facilities serve a dual purpose of providing short-term nursing and rehabilitative post-acute care as well as providing long-term care to individuals unable to safely return to living in the community. Recent value-based payment initiatives, and the recently proposed SNF Patient Driven Payment Model (PDPM), are shifting the role of SNF therapists from an emphasis on service delivery to individual residents to a more interdisciplinary quality outcomes management and consulting role that benefits all residents. Rethinking the role of PT, OT, and SLP clinicians, and exploring opportunities where interdisciplinary contributions to the care team could be expanded to improve quality in key areas and to expand partnerships with physicians and hospitals, are keys to success moving forward.
The presenters of this session will share their experiences and insights into how they have been transforming the role of therapy professionals in a SNF to be successful in achieving quality outcomes in an environment of growing alternative payment models including Accountable Care Organizations (ACOs), Bundled Payments for Care Improvement Initiatives (BPCI), Comprehensive Care for Joint Replacement (CJR) bundled payments, and other innovative managed care models.
As an active participant on a SNF care team, our first presenter will share her unique OT perspective on lessons learned from participating in new payment models. She will describe concepts and experiences in implementing interdisciplinary change management processes to reduce hospitalizations and re-hospitalizations, as well as the priority of good communication and ensuring appropriate workflow within the care team and across a national SNF corporation.
Our next presenters will discuss the interrelated role of SNF quality measures and the recently updated Requirements of Participation (RoP) and the importance of interdisciplinary collaborations in addressing the unique needs of the nursing home population. Specifically, the measures related to physical restraints, antipsychotic medications, pain, and falls will be discussed. Each of these measures are inter-related and a thorough assessment of the patient is required for the therapist to advocate for optimal resident well-being. As the nursing home population increasingly has a diagnosis of dementia, understanding the relationship among falls, restraints, pain, and medication use will require therapists to simultaneously manage complex situations with a systematic and evidence-based approach that recognizes individual resident abilities and staff/facility practices.
Our final presenters will describe a program they developed that provides a comprehensive interdisciplinary approach to exercise, counseling and education designed to support patients with cardiac disease in achieving optimal physical, psychological, and functional status. The approaches are evidence-based and supported by outcomes data that demonstrates the overall effectiveness of the program, including improvement in functional outcomes, a reduction in the SNF length of stay and a reduction in return to acute, resulting in an overall reduction in cost to the system. Kaiser Permanente has recently awarded “Super-SNF” status to one of the facilities where the program was implemented. The program serves as a potential model on the road to outcomes-based care.
Learning Objectives:
- Describe the challenges and success of a company-wide interdisciplinary change management strategy to transition from volume-driven to value-driven payment models
- Evaluate your facility practices for managing physical restraints, anti-psychotic medications and falls in order to design a process for individual resident assessment for improving quality measures and resident well-being
- Articulate the key components of a multidisciplinary, evidence-based cardiac program for the skilled nursing facility including the resource needs and project scope necessary to implement a successful program