​Having worked in long term care in a variety of roles, this professional has seen firsthand the challenges that arise when an organization decides to change its therapy provider.

My experience includes delivering direct care for both contract and in-house therapy services as an occupational therapist, then serving as a single site therapy manager, to an executive rehab leader overseeing multiple therapy programs through acquisitions, divestitures, and provider transitions, and now as a compliance manager guiding organizations in strengthening their compliance programs.

This range of experiences has allowed me to see the successes and pitfalls that can occur, from deciding that a new therapy provider is necessary to ensuring a relationship stays strong, and everything in between.

Whether transitioning from a contract therapy provider to in-house services, selecting a new contract partner, or navigating operational and regulatory complexities, organizations must carefully balance continuity of care, financial stability, and compliance. Rushed transitions can lead to gaps in service delivery, contract disputes, and reimbursement challenges.

The good news? A well-planned transition can ensure that the new provider is not only a replacement, but a true partner aligned with the organization’s culture, values, and clinical standards. The following steps offer a roadmap to navigate this process thoughtfully, minimizing disruption, and maximizing success.

Step 1: Assessing the Need for a New Provider

Organizations typically consider changing their therapy provider for several key reasons. Performance concerns like inconsistent service delivery or compliance issues may prompt leadership to explore alternative options. Additionally, financial considerations often play a role as organizations seek opportunities for cost efficiencies without compromising quality. In some cases, the motivation stems from a desire for enhanced service offerings or a more aligned partnership that supports the organization's long-term strategic goals.

When evaluating a potential transition, it is essential for leadership to conduct a thorough assessment of the existing provider's strengths and weaknesses. Identifying gaps enables leadership to make informed decisions and positions the organization to choose a new therapy provider that aligns with its specific goals.

Step 2: Collaborating with a Selection Committee

Once the decision is made to transition to a new therapy provider, it is essential to establish a multidisciplinary committee to guide and oversee the entire selection process. This committee should comprise key stakeholders from various departments within the organization to ensure that all perspectives are considered. At a minimum, the committee should include the compliance officer, nursing home administrator, director of nursing, head of clinical operations, chief financial officer, and a representative from information technology. Consider including a resident representative to ensure that the voices of those directly impacted by therapy services are heard.

The transition committee will work together to establish objective criteria that define the ideal therapy provider for the organization. This criterion should be used to create a scorecard against which an organization can weigh each provider. With these standards in place, the next step is to issue a request for proposal (RFP). The RFP should clearly outline the organization’s expectations, goals, and timeline, providing potential providers with a clear understanding of what is required for consideration.

Step 3: Performing Due Diligence

The committee should use the ratings gathered in the RFP to create a short list of the top providers they want to investigate further. Final candidates should be invited onsite for interviews and/or presentations. This interview is an opportunity to ask detailed questions about the providers' services, culture and how they plan to meet the organization's specific needs.

An organization must conduct reference checks, appropriate credentialing, and background checks as required by state, federal regulation, or the Office of Inspector General (OIG).  For example, sanction screenings such as OIG's List of Excluded Individuals and Entities, the federal System for Award Management and the State Medicaid Provider Exclusion and Suspension List should be conducted. Review the providers’ compliance policy, ask for evidence of regulatory and compliance training and inquire about their claims denial rate. Even if a provider looks good on paper, it is critical to see if their practices reflect their values before making a final decision.

Step 4: Facilitating Contract Negotiations

Once the top therapy provider is selected, both parties are ready to formalize their business relationship. A contract policy provides a structure for those tasked with negotiation. To start, this should include fundamental provisions like indemnification, liability, compensation, and billing among other items. Additionally, the organization should ensure that the contract includes a clause requiring the provider to adhere to the organization’s code of conduct and compliance program.

A definition of deliverables involving key performance indicators, adequate and competent staffing, and resident satisfaction goals should also be included.

Consider bundling value-added services, such as participation in key meetings and periodic training for staff and residents, alongside the main target. These services may not be billable but enhance the quality of the care delivered. Lastly, the organization should ensure that legal counsel reviews the contract before execution.

Step 5: Developing a Transition Plan

Once an organization is ready to bring in a new therapy provider, it’s essential to create a timeline that pinpoints clear milestones for each transition phase.

A communication campaign should be developed to ensure consistency of messages and promote transparency to residents, families, and staff, fostering confidence that continuity of care will be maintained.

Another key part of the timeline is staff training and integration to make sure that a new provider’s team is familiar with the organization’s culture and operational workflows.

Technology integration also contributes to the transition plan, ensuring interoperability, data security and adequate equipment and infrastructure.  A compliance checklist should also be created to ensure the organization remains survey- and audit-ready.

Step 6: Implementing and Monitoring

Once contracts are signed and a transition plan is in motion, the transition committee must stay engaged. For the transition to be truly effective, the existing staff and the new therapy team can collaborate for a seamless changeover.

Another key step in implementation is reviewing the policies of both the organization and the therapy provider to ensure alignment with the organization's values and standards.
On the monitoring side, organizations should ensure they are audit-ready, schedule mock surveys to verify compliance with federal and state regulations, track providers' performance against agreed-upon terms, and create a channel for residents and families to provide feedback as the team continues to shift.

Step 7: Overseeing the Post-Transition

Finally, over the course of three to six months, the transition team should stay involved to ensure that the new therapy provider meets expectations.

The team’s role in this stage is substantial and will require a similar representation of individuals within the organization who can tackle areas including:

• Regulatory compliance.
• Monitoring performance.
• Reviewing key performance indicators.
• Collecting and analyzing resident and family feedback.

Keeping a Strong Partnership

Transitioning therapy providers is a large undertaking that can significantly impact the residents and staff of an organization. To respect the investment of time from the search committee and honor the mission of providing top quality care to residents, the organization should take care to maintain the partnership with a therapy provider and find ways to strengthen it proactively.

Strengthening these relationships can take multiple forms but should include open communication that allows challenges to be addressed and practices to be improved upon. The partnership between the organization and therapy provider should be built on a shared commitment to delivering exceptional care while upholding the organization’s mission and values.

Angele Tran, OTR/L, CHC, CAPS, is a compliance manager at Friends Services Alliance in Blue Bell, Penn. She is a licensed occupational therapist in Pennsylvania.