Physician coverage in nursing homes has been cited as a key area of potential improvement for the industry — both for resident outcomes and financial health. Doctors who specialize in nursing home residents tend to be few and far between in many markets, despite the fact that timely interventions from physicians and other advanced practitioners generally lead to better outcomes and fewer penalties under various value-based models.
A new law in New York will require nursing home operators to provide information about their relationship to physicians including privileges to residents as a prerequisite for admission. Signed into law by Gov. Andrew Cuomo last month, the update to the state’s public health law means that skilled nursing facilities can’t accept residents until they receive a description of the policy regarding granting physician privileges. The issue is a matter of informed patient choice.
“Potential nursing home residents have a right to know which physicians will be available to provide care prior to signing a residency agreement,” Sanders said. “Many individuals enter nursing homes having pre-existing relationships with doctors in their community,” Sanders said. “Whether or not those physicians already have or have the opportunity to be granted privileges may play an important role in choosing a nursing facility.”
As the Patient-Driven Payment Model (PDPM) was rolled out this year, SNF-specific physician groups marketed their services as a way to increase nursing homes’ ability to serve higher-acuity residents and handle the documentation necessary to receiving proper Medicare reimbursement under the new system.