Do Intentional and Unintentional Increases in Patient Acuity Present a Problem for SNFs in 2021?
One of the best ways to educate ourselves and prepare to plan for success is by studying the data we have available to look for trends and opportunities to grow and preempt potential pitfalls. For those of us in the SNF industry, a 2020 trend that stands out as a prime candidate for analysis is the rise in overall patient acuity.
While much of the data on rising patient acuity makes sense as an expected byproduct of the COVID-19 pandemic, there is more we should look at to ensure we’re prepared for some potential hurdles this trend may bring (or may already be bringing) in 2021.
Let’s Start with the Numbers
PointRight, a Net Health data analytics company serving the skilled nursing industry, recently analyzed the changes in rate driver percentages year-over-year within its SNF customer base from FYQ4 2019 (pre-PDPM and pre-pandemic) to FYQ4 2020 (post-PDPM and post-pandemic).1
Here were the results:
- Extensive services (which includes isolation, trachs, and vents) increased nearly 5x – (2.2% to 10.2%)
- Depression increased over 2x – (4.9% to 11.3%)
- Cognitive Impairment increased 4x – (13.0% to 52.2%)
- Restorative Nursing increased almost 2x – (1.6% to 2.6%)
- Swallowing Disorders increased almost 4x – (4.7% to 17.4%)
Not only does this confirm the rise in patient acuity, but it shows just how dramatic it really was. The cause of these rises is surely a mix between the effects of COVID-19, as well as some SNFs pivoting their resources and capabilities to alter their patient mix to capitalize on higher reimbursements from more medically complex patients.
The Challenges We May Face
Now that we understand the rise in patient acuity and have a good grasp on why it’s happening, we can start looking at the potential challenges we may already be facing or will soon face in 2021.
Logistical and Staffing Considerations
More medically complex patients drive a higher reimbursement because they require higher levels of care. This means that we need to be prepared to better allocate our resources, schedule the necessary training for our staff, and address any staffing concerns to handle the higher level of care. Throw in the fact that we may find ourselves unexpectedly short-staffed at times due to COVID-19 quarantines, and the need to be prepared grows.
While the Centers for Medicare and Medicaid Services (CMS) have been busy with COVID-19, it’s an organization that’s never too preoccupied to address compliance concerns. While many of the increases in patient acuity logically make sense, it’s hard to ignore that some of the jumps are pretty sizeable.
Increased Needs for Documentation
Here’s the good news. As has always been the case for SNFs, if you have the documentation to back up your care, you have nothing to fret about. And while we already all strive to have the most complete documentation on our patients, that all gets infinitely more important when we see rises in patient acuity and potential indicators that CMS and providers might be preparing to ask questions.
The Solution: Data-Driven Decision Making
A lot of this can feel overwhelming. We’re in uncharted territory, there’s a lot on the line, and all we just want to offer the highest level of care for our patients, keep our staff taken care of, and keep our businesses moving forward.
Thankfully, we don’t have to go it alone. One of the most powerful tools we have at our disposal that’s devoid of being impacted by the noise is data. And for the SNF concerns we’ve outlined, it’s the perfect remedy.
If you’d like to take the next steps to begin reacting to rising patient acuity, we have some additional resources. First, we’d encourage you to check out our free e-book titled 4 Biggest Challenges Facing SNFs in 2021 that digs deeper into this topic.
Second, we’d encourage you to see how PointRight may be able to help you better capture the data you have available and turn it into easy-to-read information for more effective data-driven decisions.
- PointRight, “PDPM Year 1 – Dive into Your Rate Driver Data”, Maria Arellano, MS, RN, RAC-CT.