How do skilled nursing rehabilitation managers track efficiency and costs?

Financial and efficiency indicators have not been used extensively by skilled nursing (SNF) rehabilitation managers, but may prove useful in the prospective payment system (PPS)-dominated long-term care (LTC) environment. The purpose of this pilot study was to demonstrate a method for measuring the extent of SNF rehabilitation managers' use of volume, revenue, cost, and manpower indicators; and whether usages differ among occupational, physical, and speech therapy managers. The subjects were 74 occupational, 75 physical, and 72 speech therapy managers employed by a multinational health care corporation. A total of 221 Likert scale surveys were mailed to SNF rehabilitation managers to obtain data on use of 32 efficiency and financial indicators. The 32 indicators were in four categories: visit volume, revenue, costs, and manpower utilization. Twelve indicators were used regularly by at least 60% and three were used regularly by 85-100% of respondents. The response rate was 17.89%. Chi-square analyses were performed for therapy discipline and response frequency. None was significant at 0.05. Three of the payermix indicators demonstrated post-hoc significance in "regular" or "sometimes" use by the physical therapy managers. The results show discipline-specific differences among LTC rehabilitation managers in the extents of efficiency and financial indicator usage for decision making. Suggestions for future use of the survey instrument are provided. The method proved useful for demonstrating differences in the combinations and degrees of use of the 32 indicators. The results point to a need to educate SNF rehabilitation managers in cost-monitoring techniques. Recommendations for cost monitoring are provided.