• JulieAF

PDPM Survey Results

Updated: Nov 6, 2019

The results are in, and the results are not pretty.


Methodology to make this semi official:


Chris created a survey in SurveyMonkey. We posted this survey in multiple facebook groups composed of PTs, PTAs, OTs, COTAs, and SLPs. I am an SLP and Chris is an OT, so we posted in more of those professions' groups. We advertised almost exclusively on facebook through groups and sharing of individual posts. We reached out to our friends in all three disciplines and asked many of them to share the survey with their friends who may not be active on FB as well.


Over the course of 24 days, we had 3251 responses to the survey. Out of the 3251 therapists who’ve responded, 2162 have been affected by the implementation of PDPM.

That’s 66.4% of therapists.


We acknowledge that people may have been more likely to fill out the survey if they were affected, but that’s still a ton of therapists who’ve had a change since the change in reimbursement.


Let’s break down some numbers and give more information:

905 SLPS

882 PTs

1421 OTs

43 therapists skipped this question.


We had thought PTs/OTs would be equally affected, so the 550+ difference between PTs/OTs was surprising. Maybe more OTs were affected, or maybe it was because the two people behind the survey were an OT and an SLP, so our survey outreach was greater to these professions.


Out of 3251:


427 therapists were laid off: 13.17%

237 therapists received a pay cut: 7.31%

1212 therapists had reduced hours or benefits: 37.4%

276 therapists were other, which tended to be reduced hours AND pay, etc: 8.52%

1089 therapists didn’t have a change at all, which was 33.6%


We asked the therapists which companies they worked for, but we are leery of publishing the results due to fear of litigation or retaliation. There were three big companies that made up a majority of the numbers, and there are reports of up to 8700 therapists who’ve been laid off in 2019 from these three companies. One company made up 19% of the layoffs in our survey.


The most common written-in answer for elaborating on what happened at your company was: “groups/concurrent,” indicating that companies have changed practices due to PDPM. Many of the responses indicate a push towards group treatment and concurrent treatment, with some companies essentially advocating only for group and concurrent treatment and state to not provide individual treatment at all.


Another common response was higher productivity levels of 95-120% are now required in SNFs, which proves that therapists have to complete groups in order to hit these high numbers. Other companies notified employees their pay rate would be reflective of their productivity levels and less productive therapists would be given a pay cut, reduced hours, or first to be laid off.


Of interest:


OTs were most likely to email the reporters.

SLPs were the least likely to email the reporters.

We have no implications from that. I just thought it was interesting. Different personalities are drawn to different professions? We don’t know.


What does this all mean?


If things have changed at your SNF, you are not alone! You are in the majority. You are not making things up! Many things have changed.


So what can we do now?


Contact your representatives.


If you text the word “resist” to 50409, the resistbot will email your members of congress with your concerns about the change with PDPM.


Here’s a pre-written message you can send them:


Subject: Ten thousand therapists laid off


CMS implemented a change in payment model to skilled nursing facilities, and companies used this opportunity to lay off to up to 28% of their workforce. Estimated numbers are at least 8700 therapists laid off all over the country.


Now many of our seniors are being forced to participate in groups of 2-6 for treatment instead of the individual treatment they’ve been receiving for 20 years since the last payment model (PPS) was implemented.


Here are some links with info:

https://www.modernhealthcare.com/payment/therapists-decry-layoffs-amid-snf-reimbursement-overhaul

https://www.modernhealthcare.com/operations/therapists-look-cms-aid-snfs-restructure

https://blog.asha.org/2019/10/07/slps-in-snfs-share-stories-of-pdpm-related-layoffs-treatment-and-pay-cuts/

Thank you for reading.



Our professional organizations AOTA, ASHA, and APTA are aware of such changes and are also collecting information and stories as well. If you have stories, you can reach out to them as well. (healthservices@asha.org, quality@aota.org, okay I can't easily find APTA's)


You can also connect with your local politicians to bring awareness to this issue.


Remember, advocacy is a complex but vital process in which we need EVERYONE to assist with. We cannot wait for someone else to take the initiative. It is integral that everyone is proactive in making their voices heard. The resistbot takes 1 minute to send out and the AOTA e-mail link takes only minutes to complete as well.


The main issue is that the public is not aware of the PDPM changes and we as therapists need to be advocates for the professions. Now is not the time to be complacent. Call your senators, call your local politicians, call CMS. Call and bring awareness to the issue at hand.

While it is true the national organizations are collecting data to share with CMS, it can be noted that significantly more people responded to us rather than to the national and state organizations. A group of 6 therapists including myself launched this survey with the intent of seeing the damage done by the companies' implementation of PDPM and we have over 3500 responses, which exceeds the responses ASHA, APTA, and AOTA have received about the same topic. If the 6 of us can do this on our own free time and get this many results, imagine how much more we can achieve with thousands of other therapists working in coordination?


And lastly, if you would like to discuss the effects PDPM has had on you or other practices you’ve seen in skilled nursing, please email akacik@modernhealthcare.com. He is the one who broke the news of the layoffs and is continuing to look into what’s occurred in nursing facilities. You can remain anonymous if you like.


A big thanks to all 3000 of you who participated in this survey. We wouldn’t have gotten this data without your courage to make what’s happening public.

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