Speech-Language Pathologists (SLPs) maintain an important role in identifying patients who could benefit from skilled intervention. The input from SLPs and justification within the speech documentation is critical for quality improvement and helping to avoid payment adjustments within the value-based purchasing program (VBP), the quality reporting program (QRP), while improving outcomes for Nursing Home Compare. The scope of the SLP includes evaluation and treatment in the areas of communication, swallowing, and cognition.
PDPM recognizes the impact of swallowing and cognitive disorders on the patients in SNFs. For swallowing, all aspects of swallowing are considered, from diet alteration and also including feeding behaviors and pain. For cognition, SLPs address attention, memory, problem solving, and executive functioning.
Collaboration between the MDS Coordinator and the SLP, either directly or in consultation, improves accuracy of the data, helps identify patients who need services, and enhances interdisciplinary communication. Effective collaboration between nursing, therapy, and administration upon the patient’s initial evaluation ensures the patient is assigned to the correct clinical and payment categories. As we know, under PDPM, information from therapy documentation can have a significant impact in supporting several sections of the MDS, including Section K, swallowing and nutrition status; B and C, cognition; and I and O, clinical category via multiple diagnoses.
SLPs have the opportunity and ability to advocate for improvements in skilled nursing facilities by ensuring patients get the speech-language services they need. The SLPs should be encouraged to assist with enhancing PDPM reimbursement and delivering the appropriate level of care to our patients. Doing so will enhance accuracy of the clinical categories and ensure quality care is being provided.