Midwest_Physicians in Nursing Homes

The Need for Physicians in Nursing Homes

The need for physicians in nursing homes remains essential, and their role continues to evolve and progress as the years go by. Physicians have always performed crucial roles in nursing homes. However, they often work alongside nurses and are primarily responsible for caring for patients. But as long-term care transitions toward environments for higher acuity patients and nursing home liability is under increased scrutiny, physician roles are expected to undergo even more significant changes.

Nursing home settings may be more feasible for prospective doctors, given their relative freedom from bureaucracy. Dr. Justin DiRezze, CEO of Theoria Medical, shared this opinion. 

Dr. DiRezze said physicians working in nursing homes do not often feel the burden of the red tape and bureaucracy inherent in most medical communities. It is especially true among those working in SNFs or skilled nursing facilities. 

For Dr. DiRezze, freedom from the constraints of corporate medicine allows SNF physicians to affect their patients’ lives more directly. This opportunity is mainly unheard of in other sectors of the medical care profession. 

What are “SNFists”? 

“SNFist” is used for physicians working in acute care settings. Over 90% of their billing claims involve nursing home duties. The term has been in use for only a few years. However, it is becoming more commonplace in the medical industry, given the increased role of physicians in long-term care settings. 

Nursing homes don’t necessarily employ SNFists. Some maintain private practices, while medical management firms use others. 

In any case, there were over 6,000 SNFists providing care services in nursing home settings in 2017. Efforts are underway to define these medical practitioners’ roles based on data gathered from 2019 to the present day. 

Challenges for SNFists 

As expected, there are significant challenges ahead for SNFists. According to Dr. DiRezze, most revolve around misconceptions about medical management in long-term care settings. 

Many in the industry feel that there has been a noticeable absence of physician advocates and noteworthy medical directors. For Dr. DiRezze, there is still work to do on this front, and they have barely scratched the surface. She also said that SNFists face an uphill battle trying to implement changes in an industry that has long been resistant to change. 

SNFists’ roles in Nursing Homes 

There was a 48% increase in SNFists from 2014 to 2017. But despite this significant growth, these physicians continue to perform roles that have yet to be assigned a standard definition. Developing this definition has traditionally been the responsibility of the Center for Medicare & Medicaid Services (CMS).

Interestingly, even CMS literature utilizes the “SNFist” term. Nevertheless, there remains a need to assign reimbursement codes for the added responsibilities of these physicians. It is crucial for associating SNFist care with patient outcomes and is even more urgent given the shift to higher acuity patients in post-acute care environments.

According to Dr. DiRezze, “a ton” of services provided by nursing home physicians aren’t subject to reimbursement in the current milieu. Many of these are associated with SNFists. 

One of the main obstacles is insufficient funds to compensate for the administrative work provided by SNFists. Although physicians get payment for discharge paperwork and regulatory visits, many do not get reimbursed for patient chart reviews, among other services. 

Unfortunately, it may be a while before anyone addresses the current shortcomings. SNFists’ roles are only now gaining recognition, so it may take several months or even years before the CMS creates reimbursement tags for SNFists. 

As new COVID-19 variants still threaten to erupt in parts of the country, the roles of SNFists remain just as vital. Besides merely providing medical care, physicians are also often placed in decision-making roles. Many are integral to formulating isolation and testing procedures, visitation policies, and controlling infections. 

It also has to be said that SNFists generally provide higher quality care than other doctors.  

About Midwest Insurance Group

Midwest Insurance Group is a risk retention group developed by Caitlin Morgan Insurance Services in response to the unique needs of the healthcare industry, particularly that of senior living facilities. With rising premium costs and difficulties in obtaining coverage from the traditional professional and general liability insurance market, Midwest Insurance Group represents a viable, long-term insurance alternative for the senior living sector, giving members complete control over costs and claims management. Midwest Insurance Group is reinsured with Lloyd’s of London, and A rated by Demotech.

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