A new dawn, a new era has emerged for patients who find themselves within a skilled nursing environment…and that’s a good thing! In the past, the services provided by speech-language pathologists (SLPs) were often overlooked in the skilled nursing setting.

In my experience, although newly admitted patients would have orders for physical therapy and occupational therapy, SLP services were sometimes neglected. Typically, this results from a lack of understanding or awareness in nursing about the areas within the SLP scope of practice, which covers all areas of communication and swallowing.

With the recent transition to the Patient-Driven Payment Model (PDPM), a greater emphasis has been placed on the importance and value of promptly and accurately identifying patients in need of rehabilitative services offered by SLPs and its impact not only on the clinical outcomes but also reimbursement for these patients.

Ensuring that we identify patients who require the services of an SLP can have a significant impact on health outcomes and quality of life. For example:

• Effective management of dysphagia (swallowing difficulty) can help to significantly reduce the risk of aspiration pneumonia and re-hospitalizations.
• Providing patients having cognitive or communicative deficits with tools to express pain or communicate their needs can improve their quality of life and help them participate better in their ADL tasks as well as with other therapies.
• Individuals with dementia often exhibit challenging behaviors, such as aggression, yelling, or repetitive actions. These behaviors are a means of communication, and a speech-language pathologist can assist with identifying the underlying message and providing a more effective way to communicate that message, thus reducing behavioral issues.
• Assessment and treatment of individuals with cognitive impairments can help reduce fall risk and improve safety.

To ensure that patients who require the skilled services of an SLP receive the care that they need, consider an SLP referral for the following situations:

• Coughing during meals
• Difficulty swallowing medications
• Weight Loss
• Poor safety awareness
• Difficulty communicating wants and needs effectively
• Memory deficits

Learn More About Speech Therapy

An SLP has the important role of ensuring that each patient can communicate better and eat safely. Get together with your facility’s SLP to develop awareness about appropriate referrals through in-services or screening tools. Better identification of patients that would benefit from the rehabilitative skills offered by an SLP will ultimately result in better health outcomes and quality of life for patients.

The Future of Speech Therapy

As the field of speech-language pathology continues to grow and a greater emphasis is being placed on SLP services, more and more specialized training and certifications are being offered. For example, several universities now offer a clinical doctorate or SLP-D in speech-language pathology in addition to traditional master’s programs. SLPs can also further their careers in an area by obtaining a specialty clinical certification.

ASHA currently recognizes four specialty clinical certifications for speech-language pathologists who have demonstrated “advanced knowledge, skill, and experience in a specific area of clinical practice.” The four specialty clinical certifications currently include:

1. American Audiology Board of Intraoperative Monitoring
2. American Board of Child Language and Language Disorders
3. American Board of Fluency and Fluency Disorders
4. American Board of Swallowing and Swallowing Disorder

Advances in research have also resulted in the development of specialized training programs such as the McNeill Dysphagia Therapy Program, Lee Silverman Voice Treatment, and Modified Barium Swallow Impairment Program Profile. It is important for speech-language pathologists to keep up as the field continues to grow and gains more recognition by staying current with assessment and treatment approaches so that we can provide our patients with quality services grounded in evidence-based practice. So not only have we begun a new era for speech patients, we’ve begun a new era for SLPs as well…and that’s a good thing!

If you or a loved one are considering speech therapy or have any questions, please contact one of our clinic locations at your convenience.