We reported last week on an article in The Wall Street Journal on factors that can sometimes lead to excessive provision of rehabilitation services in skilled nursing facilities (SNFs). Yesterday, The Wall Street Journal published two opinion letters on the controversy. The first—written by Sharon L. Dunn, president of the American Physical Therapy Association (APTA)—included the support of ASHA President Judith L. Page and American Occupational Therapy Association (AOTA) President Virginia C. Stoffel.
Several major news outlets recently reported stories on nationwide skilled nursing facilities (SNFs) allegedly overbilling Medicare for rehabilitation services. The Wall Street Journal featured an in-depth report on how Medicare’s reimbursement system provides incentives for SNFs to charge for services that patients might not require. The article talks about the importance of rehab, but that in some cases it’s provided at an ultrahigh level when the patient might be too fragile to endure hours of treatment each day. One case of they cited involved the severe dehydration and eventual death of a patient.
In April, Fox Business News covered the involvement of the U.S. Justice Department in a long-standing lawsuit against a major SNF—HCR ManorCare. An occupational therapist and former employee at one of the facilities filed the lawsuit in 2009. He claims the company regularly pushed physical and occupational therapy on patients whose charts recommended hospice care only.
Both articles talk about the general culture of insurance reimbursement practices being focused on prescribing the most expensive treatment in order to get reimbursed at the highest amount. As healthcare costs continue to rise, this controversy—on whether these hours of rehab get prescribed because it’s best for the patient or because they ensure financial stability for an SNF—shows no signs of slowing down.
It is worth noting that, in a related effort, ASHA partnered with the American Occupational Therapy Association and American Physical Therapy Association to aid members who may be grappling with productivity issues in SNFs. The three associations developed a consensus statement on clinical judgment that emphasizes clinicians’ responsibility to understand payers’ policies and regulations, to act ethically and to report inappropriate practices. It specifics what clinicians can do if they have concerns about inappropriate practices. ASHA and the National Association for the Support of Long-Term Care have also partnered to support reporting of inappropriate practices in SNFs.
An SLP who has a daughter with childhood apraxia of speech (CAS), Laura Baskall Smith took a big chance recently and it’s paying off in a big way. While browsing news stories on her computer one quiet morning this past May, Smith came across an article about mixed-martial-arts fighter Ronda Rousey. As she read Rolling Stone’s profile of Rousey she took particular notice of a paragraph where Rousey shared her childhood struggles with intelligible speech.
After reading the article, Smith suspected that Rousey suffered from CAS. The SLP—a CASANA-certified specialist in apraxia—immediately read other interviews and stories about Rousey to learn more. Smith decided to write Rousey and while on the UFC fighter’s website noticed a book signing happening that night less than 30 minutes from her house.
Smith rearranged her schedule, bought Rousey’s book and set off for the signing with her 5-year-old daughter in tow. That spontaneous adventure resulted in Rousey’s promotion of CAS through her Facebook page and a heart-warming blog post from Smith.
That might have been the end of it, but Rousey kept her word to use apraxia instead of speech impediment in subsequent interviews. Then a handful of mainstream media outlets such as USA Today, Huffington Post and Daily Mail wrote about the encounter. So Smith’s daring request more than met her hopes that Rousey would help spread awareness about CAS.
Oscar-winning actress and spokesperson for the National Association of the Deaf, Marlee Matlin, debuts on Broadway in September. She’ll play Frau Gabor in Deaf West’s upcoming revival of “Spring Awakening,” which actors will perform simultaneously in English and American Sign Language. Running for 18 weeks in the Brooks Atkinson Theatre, the rock musical won several Tony awards for it’s original 2006 production.
Becca Meyers, a world-record-holding and multiple medal-winning paralympic swimmer from Baltimore, recently won the ESPY Award for Best Female Athlete with a Disability. Meyers was born with Usher Syndrome, which caused her deafness and will eventually make her go blind. She’s worn cochlear implants her entire life. According to the story in the Baltimore Sun, she heard the news of her win in Glasgow, Scotland while competing at the International Paralympic Committee World Championships. Her ESPY win adds to an already stellar week–the day before the announcement she broke her own world record in the 200-meter IM by taking two seconds of her previous record time.