Functional Pathways is a therapist-owned contract therapy and management consulting provider that has exceeded expectations with our services and support for nearly 30 years. We provide staffing, ongoing support, and services to Skilled Nursing Facilities, CCRCs, Assisted and Independent Living Communities, and Hospital Rehab Departments across the United States.

Our client partnership strategy places an emphasis on relationships and aligning with those who share similar missions and values. That’s why over 70% of our clients are non-profit companies.

We aim to make a difference in the lives we touch every single day.

Our number one priority is to form long-lasting relationships with our clients, which leads to improving clinical and financial outcomes at their facilities, communities, and hospitals. Our commitment to providing next-level service and support is second-to-none, and that’s reflected in our 97% controllable client retention rate and world-class Net Promoter Score of 80.

As a values-based and relationship-focused organization, we hold philanthropy close to our hearts as well. We encourage our employees to volunteer and donate their time in support of charitable initiatives, and we’re proud sponsors and donors to the Alzheimer’s Association, American Red Cross, and other non-profit organizations. We’re also honored to partner with LeadingAge and several of their state-specific communities.

We were blessed to experience record-setting growth as an organization in 2023, adding more clients than ever into the FP Family while moving into several new states. We’re on pace in 2024 to break the growth records we set last year, and we’re excited for the opportunity to serve more patients and clients across the nation.

Why are more facilities choosing to partner with Functional Pathways? Because we provide support from all levels of our organization, ongoing MDS training and education from clinical experts, more PDPM reimbursement opportunities, 34+ therapy programs, 64+ Wellness programs, and a robust compliance department that has earned a 100% appeal win rate for 14 consecutive quarters.

If you’re interested in world-class therapy services and support, reach out today by visiting our website at fprehab.com or calling 888.449.2212 for a brief introduction.

April is Occupational Therapy (OT) Month! We hear it all the time: “I am retired! I don’t have an occupation anymore, so why would I need OT?” Our residents might be retired, but OT is still beneficial.

Our residents may not have a 9-5 pm job that takes them out of the home anymore, but there are many daily activities that feed into vocational wellness that Occupational Therapy addresses every day.

One of the goals of OT is to promote independence in functional abilities. Here are just a few of the many ways our OTs and COTAs help residents every day:

• Fine Motor Skills – Maintain dexterity and improve grip strength. Make things like sewing, cleaning, or handwriting easier.
• Visual Assistance – Perform at the top of your abilities by learning about assistance for visual challenges.
• Environmental Modifications – Are our residents’ homes as safe as possible? What about when they travel to volunteer, participate in group activities, etc.? OT can help with environmental modifications to help our residents stay safe.
• Assistive Devices and Adaptive Equipment – Did you know simple devices exist, like grab bars and reacher tools, to help make tasks easier to complete? There are also more complex resources, such as voice-activated technology, to help with making lists, medication reminders, etc.

Of course, the list above is not all-encompassing of the scope and skill sets of our fantastic OTs and COTAs. If you are a PT/PTA/ST/DOR, find your OTs and COTAs and thank them for the work that they do every day. Their hard work is a huge part of what makes our teams successful in helping our residents return to or maintain the highest quality of life!

Thank you to all of our OTs and COTAs across the country!

Pressure injuries are important health issues and often one of the greatest challenges that healthcare constantly faces. Not only can treating pressure injuries be costly, but they can have a bigger negative impact on residents’ lives than you might think.

Pressure injuries are commonly seen in high-risk populations, such as the elderly, immobile residents, and those who are extremely ill. Preventing pressure ulcers can be difficult for caregivers and the healthcare industry. Prevention is not solely the responsibility of nursing; it falls on the entire interdisciplinary team. Providing optimal care and focusing the attention to prevention can save residents from unnecessary harm, hospital admissions, and potentially death.

Pressure injuries prevention:

• Assess skin thoroughly at admission.
• Assess pressure points, temperature, and skin beneath medical devices.
• Early identification for high-risk residents with comorbidities (such as diabetes and vascular problems).
• Clean skin promptly after incontinence episodes.
• Provide adequate nutrition/hydration (if not contraindicated).
• Implement a turn and reposition schedule.
• Refer resident to the dietician.
• Provide nutritional supplements as indicated.
• Provide pressure reducing devices (mattress, wheelchair cushion, etc.).

Benefits of preventing pressure injuries:

• Improve quality of life for residents.
• Decrease the risk of hospital admission.
• Prevents pain and infections.
• Improve Quality Measures.

Prevention of a pressure injury is a critical part of caring for a resident. For residents at risk, appropriate interventions need to be in place and communicated to the healthcare team and the caregiver. Treating a resident with a pressure injury requires a team approach to provide treatment that will maintain health and quality of life. No pressure, No injury.

Did you know that outsourcing your rehab services can improve your clinical outcomes, reimbursement opportunities, and appeal win rate?

In a study led by Melissa Brown, COO of Gravity Healthcare Consulting, in-house therapy models “typically have lower patient outcomes and reimbursement, higher compliance risk, conflict of interest issues, a lack of accountability, inefficiencies and treatment inconsistencies and inflated wages.

So how can a Skilled Nursing Facility combat these issues? By outsourcing their rehab services to a true therapy partner.

According to a recent study by Black Book Market Research, 80% of SNFs that outsourced their rehab therapy reported service levels that “exceeded expectations.” Outsourcing allows SNFs to focus on their core functions while a therapy provider handles all the challenges of operating a rehab department. Partnering with the right therapy provider can lead to higher patient satisfaction rates, more quality outcomes, lower turnover rates, and higher appeal win rates.

Improved Quality of Care and Expertise

A true outsourced therapy partner does more than just staff your facility with qualified rehabilitative therapists. Outsourcing with the right partner can also provide clinical, reimbursement, and compliance support specialists with expert industry knowledge on the rapidly-changing rehab industry along with ongoing education and training to support your skilled nursing facility every step of the way.

A team of rehab-focused experts can help guide facilities through regular CMS regulation changes, MDS changes, and compliance demands. A fully invested partnership includes setting clinical and financial goals together and putting specific goals and benchmarks in place regularly to attain those goals, so there are no gaps in knowledge and no missing operational support.

Not only that, but outsourcing your therapy services can actually lead to improved patient outcomes and quality of care.

It’s a popular misconception that in-house rehab management allows for better control of services delivered, thus leading to better outcomes. But in the same Gravity-led study, facilities that switched to a contract therapy provider saw “resident outcomes and satisfaction had soared.”

Cost Savings and Increased Efficiency

Partnering with a contract therapy provider can actually lead to a reduction in expenses versus keeping therapy services in-house or management-only models.

In-house and management agreements have numerous hidden costs, especially when it comes to staffing and training. In the Gravity study, revenue for SNFs declined by 29.7% for management agreements and decreased by 44% for in-house models when compared to revenue with a contract rehab partner.

Additionally, SNF provider margins are often much greater with an outsourced therapy partner. The same study revealed SNF margins were the largest with contract therapy providers, with providers using management-only models seeing 60% less SNF margins and in-house models seeing a 71% decrease in SNF margins.

Choosing the Right Contract Therapy Provider

In short, partnering with a rehab provider allows SNFs to feel supported in a way that’s lacking when servicing rehab in-house.

Functional Pathways is all about exceeding expectations and providing world-class customer service as a nationwide contract therapy provider. We help our partner facilities achieve clinical and financial outcomes above and beyond industry averages. Our clinical and compliance teams provide regular training and education on MDS changes, QRP management, Casper reporting, audit risks, and more.

“The team Functional Pathways has developed at our organization has been simply outstanding,” said Scott A., Administrator at one of our partner facilities. “The team is second to none. The residents at our assisted living facility rave about the services they receive from the FP team.”

Our compliance and clinical teams have helped our partner facilities achieve a 100% appeal win rate for 14 consecutive quarters, dating back to 2020. Our partner facilities on average have increased their PDPM reimbursement opportunities by $24 PPD after outsourcing their therapy management to Functional Pathways, and 83% of our facilities are rated as 4- or 5-stars for Quality Measures.

If you want to improve your facility’s financial and clinical outcomes and want help making your facility a 5-star center of excellence, contact Functional Pathways today about outsourcing your rehab services.

Sources:

https://acrobat.adobe.com/link/review?uri=urn:aaid:scds:US:f9bee7dc-c892-37d7-9fa2-470b3ff25bd4https://acrobat.adobe.com/link/review?uri=urn:aaid:scds:US:ff353d5a-a19b-31ad-8fa8-43c254600c9c

Millions of people in the US are diagnosed with diabetes every year. Diabetes is a chronic health condition that affects how your body turns food into energy. The body breaks down most of our food into glucose (sugar) and releases it into the bloodstream. When your blood sugar increases, it alerts your pancreas to release insulin. Diabetes is a result of either not being able to produce enough insulin or not as well as it should.

Signs and Symptoms of Diabetes:

• Urinating often at night
• Losing weight without trying
• Presence of ketones in the urine
• Blurry vision
• Slow-healing sores
• Excessive thirst and hunger

Diabetes can lead to serious complications, such as heart disease, stroke, problems with feet (check them every day), chronic kidney disease, nerve damage, and diabetes-related ketoacidosis (life-threatening). Diabetes is the number one cause of lower limb amputation, kidney failure, and adult blindness.

Type 1 diabetes was once most commonly seen in children, teens, and young adults, but now it’s seen at any age. Once was considered insulin-dependent or juvenile diabetes, this form of diabetes is caused by autoimmune disease, in which your immune system attacks the body instead of protecting it.

Risk factors:

• Family history of type 1
• Age

Type 2 diabetes is often seen in people over age 45, but more children, teens, and young adults are diagnosed with it as time goes on. This type of diabetes doesn’t make insulin and can’t keep blood sugars at normal levels.

Risk Factors:

• Prediabetes
• Family history
• Physically inactive less than 3 times a week
• Race – African American, Hispanic, or Latino, American Indian, or Alaska Native.

Other forms of diabetes are gestational and prediabetes. Gestational is seen during pregnancy and is usually resolved after the baby is born. Prediabetes is high blood sugar, but not high enough to have type 2 diabetes. Without intervention, it will likely develop into type 2 diabetes.

Diabetes is determined by a simple blood test:                                                                                                

• A1C measures blood sugar level from the last 2-3 months.                                                              
• A fasting blood sugar test measures your blood sugar after not eating anything overnight.
• Glucose tolerance test measures blood sugar after drinking a liquid that contains glucose.                               
• Random blood sugar test measures your blood sugar at the time you are tested.

Managing your diabetes:

• Insulin (type 1)
• Monitoring your blood sugar (glucose) level
• Exercising
• Healthy eating
• Healthy weight

Although diabetes is manageable, it is a life-threatening disease. Therefore, it is important to monitor blood sugar levels, develop healthy eating habits, attend regular doctor visits, and adhere to your medication regimen.

Remember: Too much sugar can have you in a Not So Sweet situation.

Falls can be especially dangerous for older adults, often causing fractures, hospitalization, and disability. The risk of falling increases with age, leaving senior populations vulnerable and posing a serious threat to health, longevity, and independence for older adults.

The senior population at greatest risk for loss of function or loss of life after a fall are residents age 85 and older. The average age of assisted living residents is 84. Though most facilities allow patients as young as 65, 52% of residents are over 85, and 30% are between 75 and 84. This also presents a risk to assisted living and independent living communities where older adults reside, as falls are a major contributor to hospitalizations among seniors. Reducing hospitalizations is a primary goal in most communities. The good news is that many falls are avoidable.

More than one in four people age 65 years or older fall each year, and half of those will end up falling again within six months. That’s over 3 million falls per year, with half of all those being fatal and over 87% requiring emergency room treatment. Of those hospitalizations, 50% require surgery to repair hip fractures.

It’s fair to say that having a holistic, resident-centered fall assessment and senior fall prevention program in place is critical to both residents and community operators.

Studies show that fall risks are multifactorial and that effective fall prevention programs are lacking in most communities. Most organizations don’t offer specialized, clinical therapies aimed specifically at reducing the risk of falls among senior living populations. Higher-risk populations, such as frail, injured, and post-surgical individuals, require specialized clinical programming not widely found in today’s communities, and home health programs often don’t address these individuals from a clinical standpoint. As a result, the lack of a universal fall screening and prevention program within senior living communities is the root cause of falls.

According to The Joint Commission, the frequency and severity of senior falls can be attributed to six leading contributors:

• Inadequate fall assessment
• Lack of adherence to safety practices
• Inadequate care management/not having proper access to skilled therapy
• Deficiencies in the physical environment (surroundings presenting a risk)
• Lack of action by leadership

To be successful, community leaders must make fall prevention screening and clinical programs accessible to residents on demand, and in the convenience of their homes.  Falls are preventable with the right programs, including regular resident risk assessments and clinical outcome-based programs. Functional Pathways offers a multitude of fall prevention and Core4 specialty therapy programs like Be Steady and Aqua therapy, along with balance assessments and fit tests to assess risk factors and recommend therapy and wellness programs to residents who are at risk.

Our next blog in this two-part Fall Prevention series discusses proven ways for senior community leaders to reduce falls. For more information on fall prevention programs for your CCRC or AL/IL community, click here.

When alternative interventions are not effective, restraints are devices used to limit the client’s movement to prevent harm to themselves and others in a health care setting.

There are typically three forms of restraints used in a long-term care setting – physical, chemical, and environmental.

Physical restraints are equipment or material attached to the client to restrict voluntary body movement (i.e., arm/leg restraints, hand mitts, lap belts, bed rails, arm trays, wedge cushions, etc.).

Chemical restraints are psychopharmacologic agents used mainly to reduce agitation and violent behavior in clients (i.e., haloperidol and lorazepam).

Environmental restraints restrict the client’s access to all parts of their surroundings to reinforce boundaries, whether it is to items or certain activities.

Risks of Using Restraints

Although restraints are mostly seen as devices used to prevent self-harm and to those around the client, they have the potential to have the opposite effect.

In a long-term care setting, there are many clients diagnosed with neurological disorders, such as dementia, that inhibit proper thought process. Clients with dementia tend to wander and forget limitations. This can increase risk for falls, making fall prevention one of the main reasons for physical restraint use in facilities. Yes, physical restraints have prevented accidents, but they also can be contraindicative according to researchers. Delirium, muscle atrophy, pressure injuries, increased agitation and anxiety, and decreased mobility are a few significant risks of physical restraints. Unfortunately, there have been instances where accidental strangulation and other serious injury has occurred while the client attempted to get out of this form of restraint.

Due to the sedative effect of chemical restraints, clients can become withdrawn, depressed, agitated, hypotensive, and experience dysrhythmias. When given in excess, client’s respirations and heart rate can decelerate drastically resulting in death.

Out of the three forms of restraints commonly used in LTC facilities, environmental restraints can be considered the least risky.  Instead of restricting the client’s ability to move their body, the environment is altered to keep the client safe. For example, locking away items that can be harmful. This doesn’t stop the client from moving about if able but keeps the objects or situations that cause harm away. Although it is the least restrictive, there are still risks associated with environmental restraints. The client could feel a loss in autonomy and dignity, resulting in emotional trauma.  

Alternatives

Here is a list of some alternatives to the restraints discussed above:

• Build trusting relationships with clients.
• Give tools to staff to deescalate incidents where clients are agitated or combative.
• Provide dementia management strategies for all staff.
• Ensure you are staging clients with dementia to establish appropriate interventions and communication approaches.
• Staff units properly to enable timely responses to clients’ needs and supervision.
• Ensure client’s surroundings are free from hazards – clear clutter and clean up spills.
• Work with interdisciplinary team to evaluate and treat mental health concerns appropriately.
• Provide safe area (and equipment if needed) to walk/roll around.
• Consult your therapy team to evaluate client status and changes

Remember: There may be instances where restraint use is inevitable after all other alternatives have failed. However, it should never be used for staff convenience.