Facility-Wide Celebration at Mission Hills

By Maybelle Hui, OTR/L, PAM, DOR, Mission Hills Post Acute Care, San Diego, CA
I wanted to send some pictures over to show everyone how Mission Hills Post Acute Care has been celebrating! In the last year, we’ve had five “best months ever” for taking care of our long-term residents with our clinical programs.. For our last “best month ever” in October, we decided to share our celebrations with our whole facility. It actually started with one of my therapists suggesting we do some kind of celebration with the CNA staff, as they all work so hard. I wanted to share this celebration with the Nursing staff as well, since we are down to only three Nursing managers holding down the fort at Mission Hills and they are all working well beyond their job duties. One of my other therapists also wanted to include Maintenance and Housekeeping since they also are so integral in keeping our building running. So, with all this, we decided to ask our administrator if we could just make this a facility-wide celebration so everyone could celebrate with us and feel included. And of course, he said yes! 😊

We are so lucky to have this culture of recognition and celebration — one that we’re aware not all departments have — and we wanted to share our successes with our colleagues since they all play a role in the care of our long-term patients. We decided to have a “Boodle Fight,” a practice that originated in the Philippines military, where a big pile of food is served in the middle of a really long table in a mess hall; every hungry soldier eats with their hands, symbolizing camaraderie, brotherhood, and equality in the military. The “fight” in the name refers to the act of grabbing and eating as much as the soldier can before others grab them, otherwise you won’t have any. In retrospect, it is symbolic of what our Rehab department was trying to do with this celebration in the first place!

All That Jazz Brings Back Memories and Camaraderie

Submitted by Sarah Scott MS, CCC-SLP, Pointe Meadows Health and Rehabilitation, Lehi, UT
Micki Allred is a new addition to the ranks of Ensign Affiliate SLPs! She was a graduate student clinician at Pointe Meadows Health and Rehabilitation with a considerable aptitude for AAC and working with dementia patients. She accepted a position with Pointe Meadows and Provo Rehab and quickly became full time at Provo. Within her first month of full-time employment, Micki has been changing lives.

Pointe Meadows has a long-term resident, Jim, who has dementia and a history of CVA. Additionally, he has late-life loss of vision and became totally blind four years ago. Jim is a complex and dynamic personality with a lifetime of experiences. He raised five children as a single dad, ran his own business, played professionally as a jazz musician (drummer), and earned a black belt in martial arts.

Jim lived at an assisted living facility and declined in functional ability prior to admission to Pointe Meadows. At the time of admission, the patient spent the majority of his time in bed, resisted wheelchair and other activities, and stated, “I have no purpose.” He had a significantly reduced tolerance of ambient noise with hearing loss and demonstrated agitation in complex environments like the dining room.

Enter Micki. Micki earned a master’s degree in music prior to earning her master’s in communication disorders. She discovered through interview and personal history questions that JMicki’s husband, John (who is also a musician), and Jim have common connections. John’s friend Lars, who is a well-known bass player, played in a band with Jim in the 1960s. Micki went to work to create a meaningful group experience for Jim and many other residents and patients on speech therapy. John and Lars performed jazz music, demonstrating concepts Micki taught, including music dynamics (pianissimo, mezzo-forte, fortissimo), improvisation, melody, etc.

Notably, 30 residents and patients attended the group with rapt attention. Several “wanderers” engaged in the lesson/performance without loss of attention. The SLP team and graduate students circulated to facilitate participation and accuracy. Jim sat front and center for the 50-minute-long group, stayed to visit with other residents for an hour, and then ate lunch in the dining room. After lunch, he had plenty of energy and willingness to participate in OT.

Thank you, Micki, for bringing Jim and the Pointe Meadows crew “All That Jazz.”

Group Refinishing Project Brings Sense of Purpose

By Tess Hurley, DPT, Meadow View Nursing & Rehabilitation, Nampa, ID
In autumn 2022, the Meadow View Therapy Department teamed up with maintenance staff and residents to refinish the weathered, wooden outdoor furniture. This project consisted of refurbishing 12 tables and over 20 chairs.

Throughout the crisp and sunny weather, Therapy, maintenance staff, and residents worked together to sand, stain, and seal the wood. The much-used and appreciated outdoor furniture was given new life!

One of our patients stated, “I am so excited that I can hardly sleep!” This project gave residents the opportunity to feel a sense of purpose, achievement, and pride in their work. The group activity doubled as a therapeutic activity, as the residents were able to work on improving their strength and cardiovascular endurance.

The residents also enjoyed getting out of their rooms and having time to socialize with others while working. Each day for over a week, our Therapy staff assisted each patient for an hour. The patients would listen to their favorite tunes, provide valuable sequential advice in regard to the proper steps, and actively participate in the physical task of woodworking — all with smiles on their faces. Our residents enjoyed refinishing the tables, as it gave them an opportunity to contribute to their homes and community by improving an outdoor socializing space. Also, the residents are of a generation in which disposal of useful items is unheard of. Thus, the fact that they helped refurbish existing, functional wood furniture was not only beneficial for their psyches, but it saved Meadow View an estimated $3,500 to replace those items.

Now when our therapists take residents outside to ambulate and exercise, they can use the tables as a way to motivate the residents and remind them of their hard work. The patients responded very positively and stated that it helped them feel more excited about going outside and that they felt more at home. One patient stated, “It felt good to contribute to my home, and it reminded me of my good ol’ days.”

Therapy Recruiting with Our Leaders

By Scott Hollander, Therapy Recruiting Resource
The therapy recruiting resource team wants to express how much we appreciate each of you who contributed and participated in therapy recruiting in 2022. This past year, we had the privilege of getting back in-person with students and veteran therapists in career fair and convention settings and professional healthcare networking mixers. Leaders being present at these events has been the best part of this return to in-person events. Many of you have had a career fair suitcase mailed to you and have been the sole representative in these efforts. Thank you!

Significant impact was made at ASHA and AOTA. At ASHA, we had three of our SLP master clinicians present, and it was great to see the therapy recruiting resources step back and watch Sarah Scott, Melissa Alexander, and Hannah Allen take the spotlight and share who we are as an organization and the impact that we are having on long-term care and post-acute rehab in the eyes of the world. At AOTA, it was great to have so many of our OTs and COTAs come to our booth and share with others how special it is to be a part of our organization. Stephanie Cole, Patty Fantauzzo, Joe Pergamo, Mira Waszak, TJ Petty, Sarah Boone, Martin Monarrez, Denny Davis, Jenny Farley and Lito Ortiz’s team have all helped with guest lectures at universities across the country. We have held healthcare professional networking events in Rhode Island, New York, Tennessee, Texas (Stephanie Winkler is the highlight of all of these in Texas), California, Washington, Utah, Arizona, and Nebraska and appreciate everyone who has contributed to these events.

We are privileged to work with so many great leaders and with such a unique and strong organization. We love and appreciate every one of you. We wish you Happy Holidays and a Happy New Year!

Change of Condition Strategy Pays Off

By Todd Burgener PT, DPT, CBIS, DOR, Mount Ogden Health and Rehabilitation, Ogden, UT
Mount Ogden has traditionally been very proud of their low readmission rates, high employee retention rates, and 0% agency utilization. As Mount Ogden has emerged from the COVID-19 era within the last year, the situation has changed. As with the rest of the industry, Mount Ogden found itself dealing with a staffing crisis, including with CNAs and nurses. While experiencing ever-increasing turnover rates in all departments and increased agency usage, the resulting readmission rates began to soar. It became very apparent that certain systems such as change of condition reporting needed an overhaul. The Mount Ogden Therapy department recognized that we had an opportunity to support our nursing partners and play a more active role in this effort.

After several strategy sessions, operation “Change of Condition” was born. The Therapy department made a few critical strategic changes, which included moving therapists’ weekly schedules to four 10-hour shifts to allow them to attend morning and afternoon nursing huddles. During those huddles, high-risk change of condition patients were identified. These patients would be a focus during therapy sessions, where detailed vitals would be taken and reported back to Nursing. Therapists would have more supervision and monitoring of these individuals to be able to prevent any changes of condition or at least be able to intervene more quickly if a change of condition occurred.

Since these changes have gone into effect, we have seen significant changes in our readmission rates, from 28% in July of 2022 to 8.3% in October. Our staffing has stabilized, as we have been able to focus on recruiting and retaining nurses and CNAs.

Presenting the First CMO Award for Endura

By Maryanne Bowles, Endura Therapy Resource, Colorado
Back in January 2021, I presented on the resource call about thinking outside of the box on what therapy could do to help Clinical and opportunities we could take. I presented on an MDS coordinator position being held by a therapist. The position works closely with the nursing team and completed MDS are reviewed and signed by a nurse. In this situation our therapist MDS coordinator has her work signed off by her MDS coordinator Apollonia Williams, RN, MDS Coordinator

This week, we presented Carolyn Pluta, OTR/L, CMC, MDS coordinator at South Valley Post-Acute, with the first CMO award for Endura. As the MDS Resource Appy Williams, RN wrote: “Carolyn, thank you for all of your hard work and dedication. You’ve helped pave the way in MDS for Endura, and we are so grateful for all you have done.”

Carolyn began her career as an OT at Julia Temple Specialized Care in 2015 as a staff OT and clinical lead. Carolyn wanted to grow as a leader in therapy. Carolyn then became the DOR at Arvada Care Center in 2017 through 2021 and was a therapy Summit attendee in 2019. Carolyn wanted to grow within the company she loved and with the population she adored, so she expressed interest in the MDS coordinator position with her supervisors and colleagues. “People can’t support you or let you know of opportunities if they don’t know what you are striving for,” she notes. She applied at our Acquisition building South Valley Post Acute and grew to become the first cluster lead MDS coordinator and a mentor for new MDS coordinators. She truly has helped to hold the facility accountable to reach its goals each quarter. We are proud of Carolyn and where she has gone with her desire to achieve this honor in her role. Congratulations — what a great success!

My CAPLICO Journey

By Jasmine M Bala, OTR/L, DOR, Mystic Park Nursing & Rehabilitation, San Antonio, TX
Customer second! That was the reason I joined the movement. My grandmother instilled this principle in me early in life — that you can’t give what you don’t have. So, you need to love yourself first before you can love other people.

It was February 2019 when I joined the Sonterra Family; Lindsay Fry hired me. I loved my peers and I loved the freedom to be the therapist I wanted to be. However, I think I was too comfortable for a while. Lindsay keeps pushing me to start leading. I remembered telling her I’m allergic to stress … “I can never be a DOR,” I thought.

Then DORiTO came in early 2022. Being a DORiTO opened my eyes. My trip to the Service Center made me see the heart of servant leadership up close and personal. I grasped CAPLICO. I saw the great example of people breathing and living CAPLICO in every way. I saw how ownership works and how beautiful love one another is, and I went home with one goal: to Live CAPLICO.

Great things don’t come easy; it takes time and resilience. Mystic Park was my answered prayer. On October 1, 2022, I transitioned to my new home, Mystic Park. CAPLICO was alive and strong! I was in awe of how everyone worked together and supported each other. People from the Service Center, resources from everywhere, and the cluster family came over to help out. DORs from other facilities came and were treating, evaluating patients, and helping out. When the state came for a full book on our second week, I was never shaken. The support was overwhelming. CAPLICO was there on day one. Lindsay, my constant guide and friend, stood with me and is still standing.

The goal was to build a strong team (we only had two therapists when we started: one COTA and one SLP). We sought to bring in the right people and lay the foundation: CAPLICO. During our first month, we were able to build such a beautiful team. The residents were ecstatic, families were overjoyed, and staff was amazed at how we were able to turn the building around. We saw success story after story after story! Family, staff, and residents continued stopping by to give appreciation for what Rehab was doing. And to top it off, in our first month, we hit our target! Having an ED who has your back is everything! Osiris is awesome! Attached are pictures of our first team building/celebration for a job well-done!

Now I can say I love being a DOR, and I can’t wait to start training, supporting my staff, and growing with them as they find their inner geniuses. After all, we are in the business of building leaders. To Dignify Long Term Care in the Eyes of the World is my WHY. CAPLICO is my HOW.

LTC Programming at Kirkwood Manor

By Heidi Gulley, PTA/DOR, Kirkwood Manor, New Braunfels, TX
At Kirkwood Manor, we have diverse and robust LTC programming. We believe in individualizing treatment to fit patient-specific needs to improve quality of life. We also tap into the many talents and tools that come with a large rehab staff. We focus on LTC programming to improve the quality of life of our LTC residents, and during our rehab meetings, we discuss new ideas and areas that therapists are passionate about and ways to implement those ideas.

One of our programs is a lymphedema program that is headed up by one of our PTs, Francisco Yap. He has had great success in this area and has greatly improved the quality of life of our residents who benefit from this program. (photo)

Another LTC program that we are also having great success in is revamping our Abilities Care program, updating and ensuring all residents in the facility have an updated life storyboard. This helps greatly with our dementia patients and patients who are more behaviorally challenging. It allows us to reach the patients who never get out of bed and build rapport with them, and then we all celebrate our success stories when we make breakthroughs.

It is a really cool thing to know that we get to be a huge part of this — that the resident who yells and never gets out of bed is now going to activities and having meaningful interactions with others, and that the resident who was unable to use their arms or legs effectively due to edema is now able to function more effectively.

Workout to Win

By Mark Walker, PT, CEEE/DOR, Orem Rehabilitation & Skilled Nursing, Orem, UT
Each week, our residents are asked if they want to participate in a home exercise program prescribed by the Therapy department. These are in-room exercises with handouts provided by one of our physical, occupational, or speech therapists. If a resident chooses to participate in the program, they are given a punch card that helps them and us track if they completed their daily exercises. When the full punch card is completed, it is then entered into a bimonthly drawing for one of our prizes (massage pillow, water bottle, cup holder, coloring pencils, coloring book, Orem Rehab swag, etc.)

Each raffle drawing is done in the gym every other week, and we are seeing the buzz getting around. Last week, we had 17 participants from our residents here at Orem. This isn’t a program run by the therapist, so there is no impact on productivity or efficiency. Our therapy aides run this, and it gives them a program to take ownership over. We are seeing some huge success as residents look forward to their daily workouts. The staff is helping the residents complete their workouts and are letting us know when they have done so. Each resident who enters a completed punch card into the raffle is given either a chip, a Gatorade, or a treat, so everyone is a winner bimonthly. The cost is minimal, and we are even starting to see staff/families donate prizes for the raffle. It’s a fun way to get our residents engaged in exercise and improve their quality of life.

Congratulations to Our Newest SPARC Winner!

Kelly Janak, PT Student, University of Texas Medical Branch, Galveston, TX
Graduation Date: August 2023

Read her winning Essay below:

Although health is typically viewed in a more physical sense, I have come to recognize and appreciate the more cognitive-emotional aspects as well. Many times, patients who have suffered an injury or are coping with life-changing diagnoses might experience a loss of control. One of the things that drew me to physical therapy is that it is a profession with the goal of empowering patients. Unlike other professions that beg patient cooperation while treatments are passively applied to the patient during the healing process, physical therapy teaches patients to heal themselves through a more active role. However, I have learned that without patient investment, physical therapy treatment is not as effective. Time engaged in therapy during the treatment session alone is not enough to provide a substantial impact. The patient must spend time training outside of the treatment sessions, otherwise the positive effect of physical therapy may grow stagnant. Without patient buy in and commitment, even the most ideal treatment plans will lack effectiveness. The patient must be motivated to take an active role in their health and to continue to train outside of appointments. Truly a large part of therapy involves establishing a therapeutic alliance with the patient and inspiring their engagement in the healing process. Although it’s undeniable that my education and training have expanded my knowledge and understanding of how to identify and treat patients with different diagnoses, it has also expanded my ability to motivate my patients, my understanding of how to relate to my patients, and willingness to seek the most effective treatments for each individual.

As I have learned more about the multitude of benefits that physical therapy can provide, I have gained a variety of reasons to support engagement in physical therapy. If a patient can understand the vast benefits of physical therapy, such as the improvements in health, functionality, longevity, and emotional well-being that exercise can provide, then they are much more likely to not only be driven to be engaged and compliant in their therapy experience, but also enjoy it and continue to exercise after discharge from physical therapy. It is also important to keep therapy exercises salient to the patient. Not everyone enjoys doing squats, bicep curls and abdominal crunches. For individuals who don’t enjoy these exercises, exercise can seem tedious and unappealing. But using creativity to create “non-conventional” exercises that appeals more to the patient’s personal interests can be more exciting. If the patient is doing treatment that directly relates to their hobbies, interests, and personal goals, they are much more likely to enjoy their experiences in physical therapy, which will make them more likely to do the work involved in order to accomplish the goals of their physical therapy program. For example, if the patient really enjoys gardening, they can be prescribed exercises pertaining to gardening so that the patient can be engaged in exercises that are meaningful to them and directly observe the correlation of their dedication to their treatments and their increased ability to engage in their activities that are important to them at a higher capability. I hope to provide a positive benefit to my patients in the form of helping them to see that their hard work can pay off in ways that are meaningful to their individual lives so that they can view exercise as something that is empowering rather than menial. I hope to not only improve their therapy experience but drive them to continue to lead a healthy lifestyle even after discharge as they strive for continued improvement in functional ability through motivation derived from things they love to do.

Patients will not be motivated by health care professionals that they do not trust. As part of the nature of the career, physical therapists spend much more time with patients than their counterparts from other health professions. This provides a substantial opportunity to either build a great therapeutic alliance, or tear it down. In pursuit of the first, I have learned that often the best way to establish patient trust is through understanding and openness. According to evidence, patients trust healthcare providers who they believe truly have the patient’s best interests at heart. However, in the hustle and bustle and time restraints of daily work life as a physical therapist, it can sometimes be difficult to take the time to establish an actual relationship with patients. In a career that specializes in people, it can become an unfortunate consequence to lose recognition of the sense of humanity that patients possess. But I think that if I continue to value each individual and recognize their inherent worth, I can maintain a recognition of the dignity that each human being possesses without losing sight of that in burnout. I will strive to always show compassion and patience and respect to each of my patients. Beyond that, I hope to continue to try to understand my patients on a deep level by trying to make a meaningful connection and by listening. My work with diverse populations has further affirmed the fact that every individual is unique and I can only know and understand each person and their needs by actively learning to understand them. I will also strive to maintain a personal sense of openness, honesty, and humility to further foster a healthy relationship. I hope that establishing authentic relationships with my patients will not only help them become more engaged in physical therapy and make the experience more enjoyable for them, but also encourage them to make more meaningful relationships with other individuals.

Lastly, and more obviously, it is important to seek out applicable current evidence-based practice and be in constant pursuit of personal growth within my role. Even with the best intentions, if I am not effective at my job, I will not be a very good physical therapist. Also, being an adept physical therapist can help with encourage patient investment in physical therapy. Patients will have a greater acceptance of physical therapy if they can witness the benefits that are provided from the treatments firsthand. Seeing as physical therapy is a relatively new profession which is constantly evolving, it is imperative to keep up with evidence-based practice by researching new treatment strategies that will be effective to implement in my patient population every day and to encourage co-workers to do the same. In order to best serve my patients, I recognize that it is my duty to be well-informed on effective treatment strategies that will benefit my patients and adjust my practices to develop alongside current research in order to ascertain that my treatments are effective for my patients. Along with this, I aspire to always be improving my clinical skills and knowledge. I will pursue increased proficiency in the realm of physical therapy so that I can develop into a professional who can provide the greatest benefit to my patients. I understand that they are trusting me to guide them towards better health and capability and I want to honor that by continuously improving my ability to deliver great service to my patients. I hope to become shrewder in identifying potential diagnoses and practices that might not be healthy for my patients and become more proficient on educating them on methods to improve their health. I hope to be successful in empowering them to lead a healthier life, even after they have finished with physical therapy so that they can be more free from the constraints and complications of poor health. By improving my knowledge and skills, I hope to effectively help them not only to return to their baseline health, but inspire them to continue to rise to a higher state of health so that they can enjoy their lives to a higher degree.
Through my devotion to patient motivation, relationship, and evidence-based practice and personal development, I hope to spark my patients to be empowered to take control of their own health, rather than maintain a passive role. I wish for them to be driven to lead a more healthy and full life in whatever capacity is available to them, so that they can enjoy the benefits in functionality, energy, emotion, and well-being. I hope to encourage them to see healthy living and improved function not as an unattainable goal or as undesirable work, but as a natural and enjoyable part of their everyday life.