Home Health & Hospice Week

Tip: Perform a cost benefit analysis when deciding whether to hire directly or contract out.

Staffing your therapy team is an ongoing job, and contract therapy companies are plentiful in some areas. This route may or may not be the right staffing method for you. Get the facts here so you can make the best decision when you need therapists.

The following are positive aspects of using contract therapists, as observed by Lynn Steffes, PT, DPT, president of Steffes & Associates in New Berlin, Wis.:

• Contract therapists come in with a variety of experience and often with an ability to jump into a new situation quickly;
• They can offer you flexible hours when your caseload is unsure;
• They can fill a gap when you are waiting for a student to become licensed, a new hire to transfer, or an employee to return from a medical or educational leave; and
• Contract therapists do not create long-term expenses in terms of salary and benefits.

 Downsides of using contract therapists, according to Steffes, include:

• They may be less committed to the overall success of your agency;
• You might inherit their bad habits from prior experience;
• They may be more difficult to supervise because of their independent nature, "so be cautious in setting and agreeing on expectations prior to contracting," Steffes suggests.

In home care, they also may lack the experience or motivation to fulfill home care-specific duties such as OASIS, experts point out.

Explore Different Contracting Options

Just as there are several types of directly employed therapists (full time, part time, and PRN), there are different types of contract therapists, notes Steve Passmore, PT, DPT, CEO of Healthy Re-cruiting Tools in Murray, Ky. (Travel therapists, short-term help, maternity leave coverage, long-term coverage, etc.)

Nyman Associates in Fort Washington, Pa., prides itself in filling multiple types of staffing needs, but particularly in handling therapy-specific administrative burdens that another type of provider might not specialize in.

"We can consolidate a lot of the necessary evils that hospitals and agencies can’t do — for example, therapy-specific continuing education and credentialing," says Robert W. Serianni, MS, CCC-SLP, VP of clinical services for Nyman Associates. "The HR department at the hospital may only know how to credential doctors and nurses."

Some staffing agencies may also serve as a support network, which could boost morale and retention rates. For example, a provider may have only one full-time SLP "who has no other peers to regularly connect to," Serianni notes. "If, however, the SLP works for an agency with 25-30 other SLPs on staff, he has a network, mentorship, sounding board, and people to share materials with, etc."

Another way: You may prefer to bypass an agency and deal directly with an independent therapist. "I have had the most experience with individual therapist contractors and have found a majority of them to be highly professional," Steffes says. However, "an agency might be a good choice for filling a position where there is a staffing gap that cannot be left open — an agency could fill it even if one contractor backs out."

Cost-benefit analysis: Assess your needs, operations, and business goals when determining how you will hire or contract. "In general, contract therapists come at a higher price tag as compared to an internal hire," notes Brian Weidner, founder of Career Tree Network in Milwaukee, Wis.

On the other hand: You could be looking at long-term cost savings. "Over the years, you will save money if the agency is responsible for intangibles, such as hiring, recruiting costs, continuing education, mentorship, etc.," Serianni says.

Another thought: "Going with employed therapists may be seen as cost-effective but it also requires more control of training and support systems geared toward therapists," Passmore says.

Finally, ask yourself why you need to hire. "Contract therapists are often a band-aid to fix a larger staffing problem," Weidner observes. "All employers, regardless of the … setting, should be increasing their proactive recruitment strategies so they can have an active talent community for their long- and short-term hiring needs."

Note: For more information on therapy, subscribe to Physical Medicine & Rehab Coding Alert at www.aapc.com/codes/coding-newsletters/my-physical-medicine-rehab-coding-alert.