New Research Links Reduced Therapy Minutes to Declines in Resident Function Following PDPM Implementation
Analysis of 3.5 million SNF stays highlights therapy’s role in functional outcomes and value-based performance
[Cumberland, MD] — Gravity Consulting is highlighting new research that underscores the critical role of therapy services in driving resident outcomes in skilled nursing facilities, particularly as reimbursement models continue to evolve.
A 2025 study published in the Journal of the American Medical Directors Association examined more than 3.5 million skilled nursing facility stays to evaluate the relationship between therapy intensity and resident functional outcomes following the implementation of the Patient-Driven Payment Model (PDPM).
The study found that reductions in therapy minutes were associated with measurable declines in activities-of-daily-living (ADL) performance. Researchers estimated that decreased therapy utilization accounted for nearly 48% of the worsening in functional outcomes observed after PDPM implementation.
“These findings reinforce what many providers are experiencing in real time,” said Melissa Brown, Chief Operating Officer of Gravity Consulting. “When therapy intensity decreases, functional outcomes follow. And as those outcomes become more closely tied to reimbursement, the operational decisions around therapy carry greater financial impact.”
The analysis highlights the growing importance of therapy as a driver of resident mobility, independence, and self-care—key measures increasingly reflected in quality reporting programs and value-based purchasing models.
As the industry continues to shift away from volume-based reimbursement, providers are facing new pressure to align clinical operations with measurable outcomes. Therapy services, once viewed primarily through the lens of minutes delivered, are now being evaluated based on their ability to influence functional improvement and prevent decline.
“This is not just a clinical discussion—it’s an operational one,” Brown added. “Facilities that take a more intentional approach to therapy utilization and integration will be better positioned to succeed as value-based models continue to evolve.”
About Gravity Consulting
Gravity Consulting is a healthcare consulting firm focused on solving the operational and clinical challenges facing skilled nursing, senior living, and home health providers. The firm specializes in therapy management, reimbursement optimization, compliance, and performance improvement strategies that drive measurable results in a value-based care environment.