Reductions in Therapy Provision in Skilled Nursing Facilities After Medicare Payment Reform and During the COVID-19 Pandemic: An Interrupted Time Series Analysis.

The study measured therapy minutes provided, not patient outcomes or functional gains, so it cannot confirm whether the reduction in therapy harmed patients. Twenty-six percent of the original sample was excluded due to missing data or overlapping policy implementation dates, which may skew results if certain facilities were systematically excluded. Pre-reform therapy minutes were estimated using lookback periods from assessments, which may not capture every day of therapy provided. The analysis could not fully account for changes in patient complexity or coding practices that occurred alongside the payment reform.

All authors declared no conflicts of interest.

Do not assume that fewer therapy minutes automatically equals worse patient outcomes. This study reports a reduction in service volume, but it did not measure functional recovery, discharge status, or quality of life, so the clinical impact of this decline remains unknown.