Working around the Holidays
Now that we're into the holiday season, how are your working hours affected? Most of us have to work weekends or longer hours to make up for a holiday that falls in the middle of the week, right?
This was not the case prior to PPS, as Medicare recognized most major holidays. This was a big issue that was debated when the bill was being drafted. However, in order to minimize the length of stay in a SNF, it was decided to require the same number minutes in an assessment period regardless of the holiday. And shorter stays means fewer Medicare dollars spent. That means we may get the actual holiday off, but will have to work a Saturday or Sunday to capture a person's minutes in order to keep them in their established RUG category.
We all know about the RUG groups. Minutes of therapy delivered determine the level of reimbursement. As much as I've seen some contractors decrease minutes around holidays, it's not a good idea. Not only is the facility unhappy as it means a loss of revenue, but Medicare tends to view it as manipulating minutes for the convenience of the therapists. Bouncing a person between RUG groups in a short period of time may send up a red flag, and you might be paid a visit from the auditors.
I guess the important thing to remember here is the patient. If you were in a SNF recovering from an injury or illness, would it be fair to have your rehabilitation put on hold just because your therapist didn't feel like working? My thought as a patient here would be "I want to get home as soon as possible". Remaining in the SNF for extra days due to staff wanting time off would not make me happy. I also tend to think of customer relations here too. Just like any business, when a customer is happy they tend to relate that to a few other people. When a customer is unhappy, they tend to tell many more people about their bad experience. If there are too many bad experiences related about your facility, it can keep people away. When business decreases, that means fewer hours available to work.
So, try to keep your perspective from the patient's point of view. They are our customers, and without them we would be unemployed.
Until next time, hope all your thoughts are good,
Tim