ASHA, NASL Address Concerns in Skilled Nursing Facilities New information will separate fact from fiction for clinicians, managers and administrators. News in Brief
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News in Brief  |   May 01, 2015
ASHA, NASL Address Concerns in Skilled Nursing Facilities
Author Notes
  • Janet Brown, MA, CCC-SLP, is director of ASHA health care services. jbrown@asha.org
    Janet Brown, MA, CCC-SLP, is director of ASHA health care services. jbrown@asha.org×
  • Margaret Hemm, EdD, CCC-SLP, is a member of the NASL Board of Directors.
    Margaret Hemm, EdD, CCC-SLP, is a member of the NASL Board of Directors.×
Article Information
Special Populations / Older Adults & Aging / Healthcare Settings / ASHA News & Member Stories / News in Brief
News in Brief   |   May 01, 2015
ASHA, NASL Address Concerns in Skilled Nursing Facilities
The ASHA Leader, May 2015, Vol. 20, 8. doi:10.1044/leader.NIB1.20052015.8
The ASHA Leader, May 2015, Vol. 20, 8. doi:10.1044/leader.NIB1.20052015.8
ASHA has reached out to the National Association for the Support of Long-Term Care (NASL)—which represents a cross-section of ancillary service providers in long-term and post-acute care settings, including rehab therapy providers—to address service-delivery concerns in skilled nursing facilities.
The partnership has been forged after reports from ASHA members about productivity pressures affecting patient-care decisions and clinicians’ ability to exercise their clinical judgment. In a series of meetings that began in the fall of 2014, representatives of the two organizations concluded that some of the concerns may be based on misconceptions about billing rules: Does Medicare place a time limit on evaluations, for example? No, it does not. But some clinicians report pressure from managers to consistently limit evaluation time to 15 minutes.

SLPs may be reluctant to report their concerns for fear of retribution, but in fact, facility compliance processes afford whistleblower protection that mandates an investigation be protected by confidentiality.

Speech-language pathologists also report many concerns, including having to meet productivity requirements and having their clinical judgment superseded by managers due to real and perceived pressure to maximize reimbursement.
ASHA and NASL will develop and disseminate accurate information to nursing facility employees, including clinicians, rehabilitation managers and administrators in four general categories: best practices for developing and implementing productivity standards; best practices for compliance reporting; enhancing rehab manager education and supervision; and enhancing clinical support in decision-making.
In addition to developing fact sheets to guide clinicians, administrators and managers, ASHA and NASL also want to encourage SLPs to report inappropriate practices to in-house compliance programs, so that compliance officers can investigate and address the concerns. SLPs may be reluctant to report their concerns for fear of retribution, but in fact, facility compliance processes afford whistleblower protection that mandates an investigation be protected by confidentiality.

Speech-language pathologists report many concerns, including having to meet productivity requirements and having their clinical judgment superseded by managers due to real and perceived pressure to maximize reimbursement.

In a related effort, ASHA partnered with the American Occupational Therapy Association and American Physical Therapy Association to develop a consensus statement on clinical judgment that each association distributed to its members. The consensus document emphasizes clinicians’ responsibility to understand payers’ policies and regulations, as well as their obligation to act ethically and to report inappropriate practices. It also outlines steps clinicians can take—including contacting the facility’s compliance officer—if they have concerns about inappropriate practices.
NASL also distributed the document to its member companies. “NASL rehab provider members have taken the consensus statement seriously,” said Garry Pezzano, NASL president and senior vice president of clinical operations for Genesis Rehab Services. “We have distributed it and used it as a tool and vehicle for discussions.”
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FROM THIS ISSUE
May 2015
Volume 20, Issue 5