Print Only a few months after CMS massively changed how skilled nursing facilities are reimbursed for therapy services, the pandemic hit and threw long-term care operations into a tailspin. That makes it difficult to determine exactly how the change affected therapy services and therapists in nursing homes, researchers say. A report published in Health Affairs on Monday shows that therapist staffing levels were cut in anticipation of and after the change to the patient-driven payment model in October 2019. The new model replaced the long-standing Resource Utilization Group payment system, known as RUG, with general support from the post-acute care industry. But, after the fourth quarter of 2019, there isn't reliable data to further track the changes, the authors said.