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Insurers pushed for weekend treatment
At Genesys Regional Medical Center in Grand Blanc, MI, all patients in the rehab center receive therapy seven days a week.
Two members of the physical therapy staff and two members of the occupational therapy staff work eight-hour shifts on Saturdays and Sundays.
"If patients are on the rehab unit for only seven to 10 days, you can’t let them be idle on the weekends," says Daniel Swank, MPA/CRRN, director of rehabilitation.
The hospital started with only a half day of therapy on Saturdays. About a year ago, half-day Sunday staffing was added. "We could accommodate all the new admits and those who really needed therapy on weekends," Swank explains.
However, as the payer mix increased to more health maintenance organization patients, insurers began requesting full therapy treatment on weekends. Insurers were pushing the acute care hospitals to release patients on Fridays, Satur days, and Sundays if they were ready, but they didn’t want patients transferred to the rehab unit if they weren’t going to be treated.
"We tell them that they will be seen and have a full complement of therapies on the weekend," Swank says.
The hospital did not add additional staff for the weekend rotation. Instead, the administration looked at the therapy staff throughout the system, including its outpatient treatment centers, and moved therapists around to provide coverage.
More group activities take place on weekends than during the week, but enough therapists work so they can provide one-on-one treatment when indicated.
"The amount of therapy depends on the patient’s individual needs and tolerance level, but it generally ranges from one to three hours of therapy per patient, on both Saturday and Sunday," says Joy Finkenbiner, PT, administrative director of physical medicine.
Therapists who work on weekends get days off during the week. All therapy staffers participate in the weekend rotation.