Impact of PDPM on Workforce

October 3, 2019

ASHA is disappointed and deeply saddened to hear reports of decisions to terminate and/or change the employment contracts of ASHA members and other therapy professionals employed in skilled nursing facilities (SNFs) without allowing the Patient-Driven Payment Model (PDPM) to be implemented as intended by the Centers for Medicare & Medicaid Services (CMS). ASHA remains deeply committed to working on implementation of the new Medicare payment system to minimize impact on members and residents in SNFs. 

PDPM was implemented in a budget neutral manner. Reimbursement from Medicare is unchanged under PDPM relative to the previous payment system. SNFs and rehabilitation providers have a clear obligation to deliver the same level of care that was justified to be medically necessary under the previous payment system. Workforce reductions are not warranted since there are no significant reductions in reimbursement for delivering medically necessary care.

ASHA is continuing to directly engage with the rehabilitation providers, SNFs, and industry leaders such as the National Association of Rehabilitation Providers and Agencies (NARA), National Association for the Support of Long Term Care (NASL), and American Health Care Association (AHCA) to resolve issues related to PDPM implementation that adversely affect ASHA members. ASHA is collaborating with our colleagues at the American Occupational Therapy Association and American Physical Therapy Association to strengthen our voice and ensure that medically necessary patient care is being delivered and monitored effectively by CMS. CMS is tracking the delivery of therapy minutes and precipitous changes in care patterns are cause for audit and review.


ASHA members are encouraged to utilize the PDPM resources available on the website to effectively advocate for the value of their services in their SNFs. ASHA is working to respond to member needs, consistent with our role as the professional association, through ongoing advocacy and other forms of member support. We know each of your circumstances is unique but if there is anything we can do to help you navigate these changes effectively in your own SNFs, we are here to help. Feel free to contact Monica Sampson, ASHA’s director of health care services, at, for additional information and resources.


ASHA Corporate Partners