The SLP Component:
Speech Therapy’s Role under the Patient Driven Payment Model

Speech Therapy’s Role under the Patient Driven Payment Model

October 1, 2019 brought about the new Patient Driven Payment Model (PDPM) reimbursement system to skilled nursing facilities, which changed the methodology in which they are reimbursed for treating Medicare Part A patients. Because of the new SLP Component of PDPM, the importance of a strong nursing home speech therapy department has been elevated to an entirely new level. Language Fundamentals believes that optimizing the SLP Component of PDPM begins with having a highly trained speech language pathologist perform a speech therapy assessment on each new admission & re-admission. This approach will set your SNF up for PDPM success and ensure that you are capturing valuable reimbursement in the SLP Component.

Patient Driven Payment Model Speech Therapy Assessment

In recent years, CMS has recognized that there is a growing need for the expertise of the speech language pathologist in nursing facilities. By delivering clinically appropriate speech language & swallowing therapy to skilled nursing facility patients, they are less likely to suffer from aspiration and also have a higher quality of life. Therefore, SNFs with a robust Speech Therapy Department with strong clinicians who are passionate about treating in the SNF setting and understand the highly complex regulatory environment have a leg up on their competition.

Now that the SLP Component of PDPM has been created, more nursing home patients will have more access to speech therapy than ever before. The speech therapists of Language Fundamentals are trained to be excellent diagnosticians bringing a unique tool kit and a trained eye to the skilled nursing facility each day. This trained eye focuses on catching the valuable nuances that others could miss costing valuable opportunities under PDPM. Therefore, the importance of having speech language pathologists who function as part of the team and are specifically trained to focus on treating swallowing disorders, cognitive communicative deficits, and other medically driven issues has skyrocketed. With speech therapy involved with new patients earlier in their SNF stay, a true interdisciplinary approach is achieved to help the entire team focus on the patient as a whole.

PDPM SLP Component For Skilled Nursing Facilities

The SLP Component is now one of 5 case-mix adjusted components under PDPM (Speech Language Pathology, Nursing, Physical Therapy, Occupational Therapy & Non-Therapy Ancillaries) that are separately calculated and unique categories under PDPM.

It is important to note that the SLP category has the largest dollar variation from top to bottom (SA $15.86 to SL $92.81) than any of the other clinical categories.  Therefore, a premium has been placed on accurate coding of the SLP component. Having a speech department that understands proper coding of the PDPM SLP component will increase the accuracy of overall clinical reimbursement.

Patient Driven Payment Model Speech Therapy (PDPM Speech Therapy)

The PDPM SLP component contains 12 distinct levels of reimbursement that ultimately contribute to the overall Medicare Part A payment rate.  These levels are the result of the speech language pathologist effectively completing five critical questions, which are grouped into two separate (and differently weighted) groups.

Group One:

1. Does patient’s primary diagnosis fall under acute neurologic or non-neurologic?

2. Is there an SLP related comorbidity?

3. Is there a moderate to severe cognitive impairment?

Group Two:

4. Is there a swallowing disorder?

5. Is the resident on an altered diet?

The second group focuses heavily on eating, chewing, and swallowing, which is highly significant. This area is where a great medical speech language pathologist should shine. Since it is the philosophy of Language Fundamentals to place the patient on the safest, yet least restrictive diet possible, our speech therapists are constantly monitoring their patients to ensure they are on the correct diet.

Language Fundamentals is poised to deliver the quality care in an economical fashion that SNFs will need to be successful under PDPM.

With a strong and progressive speech therapy department, SNFs can optimize the SLP component, grow case load, and provide the clinically appropriate speech therapy services to patients in need of care.

View our article on Patient Driven Payment Model early returns and looking ahead where Matt McGarvey of Language Fundamentals explains the early trends of PDPM just 4 months after the implementation of the Patient Driven Payment Model.

Contact us at 845-897-3330 to discuss how we can help raise the level of Speech Therapy Services provided at your Skilled Nursing Facility to an entirely new level.

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