Reviving Group Culture: Utilizing Evidence-Based Practice to Boost Group Percentage

By Calley Johnson MS CCC-SLP, DOR, The Healthcare Resort of Kansas City, KS

At The Healthcare Resort of Kansas City group therapy was not a well utilized therapeutic approach in 2024. There were several misconceptions regarding the efficacy of group therapy and billing for skilled group approaches. Groups were often met with resistance and inability to attempt groups. The DOR and therapy resource brainstormed and action-planned education to provide to the therapy team to provide support for understanding

Our focus for education included the basics of how to group based on insurance stipulations and what to include in documentation to provide skilled information when utilizing groups. The biggest impact to revive our group culture at The Healthcare Resort of Kansas City was to provide meaningful evidence-based research that demonstrates the efficacy of group approaches.

• Study included approx. 900,000 patients - Low (below the median of 5%), Medium (median to <25%), and High (25% or more) to reflect the 25% multiparticipant therapy limit required by PDPM.

• Patients receiving low levels of multiparticipant therapy had 14% higher odds of improving in function and 10% higher odds of community discharge.

• Patients receiving medium levels of multiparticipant therapy had 18% higher odds of functional improvement and 44% higher odds of community discharge.

• Patient’s receiving high levels of multiparticipant therapy did not reflect higher improvements in function.

From the article Some But Not Too Much: Multiparticipant Therapy and Positive Patient Outcomes in Skilled Nursing Facilities. Prusynski et. al. : J Geriatr Phys Ther. 2022 Sep 14;46(4):185–195. 

Following this inservice, increased buy-in was evident immediately. In December 2024 our skilled group percentage was 5%. After our inservice, the skilled group percentage increased to 11.14% for March and 18% for the first week of April. The therapy team is creating fun and engaging groups that not only speak to individual goals and plan of care but also provide peer socialization opportunities for our residents!

Photos: (R) Speech group addressing safety awareness and real-life problem solving in the kitchen, (L)

Physical Therapy group addressing obstacle navigation, (Center) Occupational Therapy utilizing Fall Prevention Jeopardy for safety within the facility and home

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