Therapy Services are a powerful yet overlooked driver of 5-star SNF ratings—boosting quality, staffing efficiency, and survey outcomes.
As the post-acute care industry continues to face increased regulatory scrutiny, Therapy Services are emerging as a critical driver of quality and performance, holding significant potential to elevate a SNF’s 5-star rating.
CMS’s 5-star rating system evaluates SNFs in three key areas: health inspections, staffing, and Quality Measures. While CMS does not rate therapy directly and there is not a specific therapy component that contributes to a facility’s 5-star rating, the impact of therapy is deeply felt across health inspections, staffing and quality measures.
Health Inspections – Prevention Begins with Therapy
While Therapy Services are not directly evaluated in the Health Inspections domain, Physical, Occupational and Speech Therapy have potential to influence this area in many ways. Therapy Services that are proactive can support better clinical outcomes, reduce the risk of citations, and protect the facility’s health inspection rating.
Therapy supports survey success by proactively reducing fall risk, pressure injuries, and hospitalizations – all common citation triggers.
When considering that falls with major injury and decline in ADLs impact Quality Measures and often result in survey tags, it is wise to recognize the importance of therapy’s strong involvement in Resident Safety and Fall Prevention, by ensuring therapy is providing timely assessment, identification of fall risk via objective and standardized measures, and intervention to improve resident balance, strength, mobility and safety awareness. Therapy plays an important role in determining the safest transfer and ambulation techniques, assistive devices, and resident-specific fall prevention strategies.
Physical and Occupational Therapists play a significant role in Pressure Injury Prevention via repositioning techniques, improving functional mobility and determining optimal seating systems.
Therapy’s involvement in optimizing residents’ functional independence and cognitive-communicative performance will support plans of care that reflect dignity, independence, and quality of life, as reflected in Quality of Life/Person Centered Care. Inadequate staff knowledge of therapy-related care, including safe transfer techniques, use of assisted devices, and swallowing strategies, can result in citations; thus, the therapist must regularly provide both resident-specific training and staff in-services to minimize functional decline and citation risk.
Unmanaged functional decline and poorly coordinated therapy often lead to acute events and hospitalization, some of which may be investigated during the survey, particularly if a result of a preventable cause, such as an avoidable fall or aspiration incident. Timely and high-quality therapy intervention may reduce such negative clinical events and hospital readmissions.
Additionally, therapy plays a strong role in resident satisfaction and complaint reduction. Therapy is often the service that residents base their post-acute experience on. Involvement in therapy enhances improved function and perceived quality of care, decreasing the likelihood of complaint-driven surveys. To maximize resident engagement and satisfaction, it is important that therapy delivers timely assessment, high-quality interventions and clear communication of therapy goals. By making therapy visible, personalized, and proactive, SNFs can promote a positive resident experience, thus mitigating the risk of complaints escalating to formal survey investigations.
Staffing – High Quality Rehab Supports Efficient Nursing
While the staffing component of the 5-Star Rating is strictly based on reported nursing hours, it is important for SNF leaders to consider the broader implications of therapy services on overall quality outcomes.
The impact of therapy on nurse staffing levels should not be underestimated.
High-quality, resident-specific, and goal-directed rehabilitation plays a vital role in both resident outcomes and operational efficiency within skilled nursing facilities. Effective therapy not only enhances resident independence, reducing hospital readmissions and increasing discharge rates to the community, but also directly impacts nursing operations. As residents regain functional ability, their reduced care needs can significantly ease the workload on nursing staff. This improvement can help lower required staffing levels, reduce staff burnout, and ultimately mitigate turnover. In an era where nurse staffing is both critical and costly, the strategic use of robust therapy services offers a powerful tool to support clinical success and workforce sustainability.
Quality Measures – The Direct Connection
Therapy has a direct impact on key CMS metrics, such as functional improvement, reduced falls, and successful discharge to the community. Facilities that align therapy goals with care plans, accurately capture functional performance in Section GG, and integrate therapists into the QAPI process will outperform in clinical outcomes and survey readiness and maintain stronger 5-star ratings.
Elevating your Therapy Services Means Elevating Your 5-Star Rating
As CMS continues to link reimbursement and public reporting to quality performance, the strategic role of Therapy Services within the SNF has never been more vital. SNFs that prioritize high-quality, patient-focused rehabilitation programs are not only achieving strong resident outcomes but also positioning themselves for operational success in a value-driven healthcare landscape.
Elevating your Therapy Services isn’t optional – it’s essential. Strong therapy drives strong outcomes, and strong outcomes drive stars! Therapy Services are a powerful, but often under-leveraged tool in improving an SNF’s 5-star rating.
UNLOCK YOUR THERAPY SERVICES’ FULL POTENTIAL!
Contact Polaris Group for a Comprehensive Assessment of your Therapy Program and to learn about partnering with our experts to ensure that your Therapy Services are Delivering Stars
