Patient Functional Outcomes in Skilled Nursing Facilities: The Mediating Role of Declining Therapy.
Rachel A Prusynski, Andrew Humbert, Harsha Amaravadi and 6 others
PMID 41038421WHAT IT FOUND
Therapy minutes dropped sharply in skilled nursing facilities after payment changes and during the pandemic.
This decline accounted for nearly half of the increase in patients losing function and significantly reduced the chance of major recovery. Less therapy meant worse outcomes.
Key findings
01Declining therapy volume accounted for 47.9% of the increased probability of functional decline after PDPM implementation and 26.5% during COVID-19.
02The decline in therapy minutes was associated with a 2.9 percentage point decrease in the probability of high functional improvement.
03Average therapy minutes per day fell from 122.2 before PDPM to 96.5 after PDPM and 87.7 during COVID-19.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study is observational and cannot prove causation; unmeasured factors like patient willingness to participate or therapist expertise may have influenced outcomes. Therapy minutes were calculated differently before and after the 2019 payment change, which may introduce measurement error. The analysis excluded patients who died during the stay, potentially biasing results toward those who survived. Small skilled nursing facilities were often excluded from the public data used, so results may not apply to all settings. The 28-point ADL scale may not capture all aspects of function relevant to discharge quality.
Declared interests
All authors declare no conflicts of interest.
The easy way to misread this
Do not assume this proves that simply adding more minutes of any type of therapy will fix outcomes. The study shows an association between volume decline and worse function, but it does not evaluate the quality or type of therapy delivered, nor does it isolate the effect of physical therapy from occupational or speech therapy.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →