Share

Submitted by Asa Gardine, Sunstone Therapy Resource, Utah
Hurricane Health & Rehab’s therapy department is always looking for great ideas for new group treatments that are both engaging AND relevant to our patients. Thankfully, we have a passionate team member, Shannon O’Connor, who used her resources and asked her friend, Brandon Berrett, who owns The Creative Cure, a ceramic studio in St. George that provides art therapeutic services to the community, if he would be able to help with a ceramics group. Brandon also teaches ceramics at a local high school, so together Shannon, Brandon, and four of his high school students brought ceramic arts to Hurricane Health and Rehab for a massively successful group treatment.

A total of 14 patients participated, and each had their own pottery wheel and were able to receive instruction. Every patient was smiling ear to ear along with their therapists and instructors. This was a monumental effort to pull off, and the positive memories of that day are still felt by the residents who are proud of their creations of art and their expressions of themselves.

Brandon is currently providing the color for the pottery and the kiln firing and will be returning their custom pieces to them soon!

Submitted by Aimee Bhatia, MSOTR/L, PAM, CTO, NCI Therapy Resource, California
Victoria Care Center was the first building in NCI to crack into the world of outpatient by building programming at our now Pennant partners at the Lexington Assisted Living facility. The start was not easy despite being partners, but the impact that has been made and the programming that has been established is remarkable. The Lexington went through a rough patch with changes in leadership, but an administrator recently transitioned back into the role, allowing for some positive changes. Prior to this change, residents were unhappy. The facility was going through a change in leadership, and with the changes came many adjustments to the team. Therapy stepped in to make an impact on many aspects of the residents’ quality of life.

Here are just a few things that Shannon Murphy, PT; Stephanie Nowlin, COTA; and Maria Lebon, Rehab Aide took on to help the facility stabilize:

• Assisting residents in making doctors’ appointments
• Updating families regularly on therapy progress and the need for DME
• Facilitating admissions to Victoria Care Center when their residents were hospitalized
• Helping residents with banking struggles
• Assisting a resident with care for his blind and deaf dog, who has been adopted as the therapy mascot
• Adopting a resident’s cat when she had to relocate to be closer to family and providing all necessary care to improve its wellness
• Welcoming the residents into their rehab family

The amount of support, the ability to thrive, and the increased satisfaction made a significant difference in the lives of the residents. They have created an environment in the ALF where the residents often seek the therapists out just to socialize a little and many have formed friendships. . This is a true example of our organization’s culture and how invaluable it is to embrace. These three members of Victoria’s therapy team have made such an impact on a community that simply would not be the same without them. . Thank you Shannon, Stephanie, and Maria for the work you do, for the impact you make, and for constantly finding meaningful ways to impact the patients we care for every day. This is a true example of loving what you do, finding a way to make positive changes amongst hardship, and being dedicated to a valuable mission.

By Joshua Mimun, OT Student, University of St. Augustine: Austin Campus
Here at Hunter’s Pond in San Antonio, Texas, group therapy takes on a bigger form. Daily large-group therapy sessions with approximately 20 to 30 qualified residents led by 10 to 12 therapists and therapy assistants perform interventions that promote increased AROM, activity tolerance, and dynamic balance while providing opportunities for social engagement. Below, we see patients actively participating in balloon volleyball as the therapists/therapy assistants referee the skilled group intervention to ensure progression of each client toward their individualized goals. Additional interventions include bean bag hot potato, large foam beading relay race, big ball basketball, bowling/cornhole combo, and more!

The benefits of group therapy can be traced all the way back to 1905, with the successful treatment of TB patients by psychologist J.H. Pratt. Since then, group therapeutic treatment has evolved and been incorporated into many other disciplines, including occupational therapy, physical therapy, and speech language pathology. The benefits associated with group therapy include the instillation of hope, universality (I am not alone), interpersonal learning, development of confidence, social skills, social connections, and routines, all while engaging in purposeful activities that promote increased function.

Under the new CMS PDPDM model, group therapy is defined as having a qualified rehabilitation therapist or therapy assistant treating two to six patients at the same time who are performing similar activities. This new definition provides therapists with increased flexibility without compromising their ability to manage the patient’s ability to engage and benefit from group interventions. (Please refer to CMS.gov for more detailed information on definitions, regulations, and compliance regarding group therapy.)

By Jessica Foster, DPT, CLT, Therapy Resource – Bandera – AZ
Amada Gross, OT Student, came up with some cool group ideas! Some of the content on the group activities PDFs (see below) might need to be vetted for verbiage, etc., for best documentation practices, but Amanda gave these to the DOR to adapt as we needed.

Here is a picture of Amanda and the team at one of their off-site celebrations. As a new acquisition, it has been so important to Chris Rowe, the DOR at Estrella Health and Rehab, to foster team integration and bonding in and out of the building!

By Kathey Fawn, Therapy Resource, Keystone, Mission Market – TX
I know many of you are struggling with COVID outbreaks right now. It’s more important now than ever to partner closely with our Nursing counterparts to make sure infection control is at the top of everyone’s mind. If you haven’t done an in-service on PPE and hand washing lately, consider doing that at your rehab meeting this next week. Double check with your DNS on current isolation and masking protocols in your facility. I know everyone is weary, but as this new wave surges and state surveyors are becoming more critical, we have to remain diligent. Make it a game! The first person to donn and doff full PPE five times correctly gets a gift card! PPE and hand washing relay races! PPE poster contests! Do whatever it takes to make your teams be thinking about it and share your good ideas with all of us. The first person to respond with pictures of a creative infection control activity with your team gets lunch on me!

Woo-hoo! We stopped what we were doing down in the therapy gym at Parklane to go over hand washing. We used Glo Germ Gel to review just how thorough we have to be to get squeaky clean hands! Lots of laughter, with a side of learning! …Jennifer Henderson, OTR, DOR, Parklane West Rehabilitation Center, San Antonio, TX

Let’s keep in mind the strategies we can use when these situations arise. Do we have residents in the facility who are not skilled and still need our services during an outbreak scenario? If our therapists are out with COVID, are they able and willing to do Telehealth? Are they able to use some of this time they are at home to complete annual Ensign U? Let’s ensure we know what patients are coming off of skilled services to our LTC units and assessing their needs. Many of them have declines and experience isolation during this transition time, so they will definitely need us to be involved

By Jacquelyn Eaton, TPM, The Healthcare Resort of Topeka, KS
The Healthcare Resort of Topeka implemented a system so that our CNAs and Nurses know what the transfer, ADL and mobility levels are upon the day of evaluations by therapy. Our therapist will complete the evaluations, fill out a quick form and submit the form to me so that I can update the care plan and tasks in PCC in real time. The patients care plan and tasks are updated based on the level of assist on the day of the therapy evaluation, then as needed when the patient progresses to the next level of assist. Therapists here at the facility will also update the CNAs and nursing staff working the current shift to allow them to pass on information at shift change.

We started this process so that staff know more about the patient and weightbearing status. It has become standard practice and a fall prevention program as the nurses know more about the patient and how they move in bed, to chair, with a walker, assist levels with showering, dressing and hygiene. As the patient progresses, the task and care plan will change, but usually by week 1 or 2 the CNAs are very familiar with the patient and a simple update in PCC is all I have to do. We use a Red, Yellow and Green “stop light” tag system to identify when the patient is ready to move on their own:

Green means: “Go, they can walk independently and do their own self-care” May ambulate at will, no assistance in room/dining room or activities

Yellow means: “Slow down, they need hands on help with ambulation and self-care” Help assist to dining room and with self-care

Red means: “Stop, they should not be up on their own and need direct contact at all times with ambulation and self-care” Requires hand assistance with ambulation and self- care

PT, OT and ST collaborate on whether or not they can move their tag up to the next status. We love this process, and it helps us keep patients happy and healthy as well as on their way back to their prior level of function.

Submitted by Cory Robertson, Therapy Resource, Pennant-Idaho
Discovery Rehab and Living in rural Salmon, Idaho, is a smaller facility in a mountainous rural setting that has been using contract therapy for years. Staffing is a large challenge and was seemingly a revolving door of therapy clinicians. Early last year, the contract company brought on a new leader. This leader demonstrated excellent drive and CAPLICO culture but without the same support from the contract therapy company that Ensign-affiliated facilities appreciate. Largely because of this leader, the facility ED Steve Lish, with cluster, market and resource assistance, decided to once again bring therapy in-house. Jolene Hugo, COTA/L, TPM, leads the Therapy team at Discovery Rehab and Living and exemplifies CAPLICO while managing the difficulties of a small rural therapy department like an all-star. Here are some of her reflections on the transition:

“May of this year marked our one-year anniversary for transitioning from contract therapy to in-house therapy at Discovery. When discussing the risks versus rewards of transitioning to in-house a year ago, I was intimidated. I felt nervous because I wanted to be able to prove that our therapy department could perform well. However, during and after the transition, I felt the weight of it all lifted by all of the support that being a part of Ensign Services has to offer our Therapy team and building. Being in-house really helped our Therapy department be part of a team and not just Therapy versus Them. I have a great resource and cluster partners that are readily available to work through difficult moments and the daily challenges. I have amazing opportunities to attend meetings that have helped me grow personally and professionally as a leader. Before being part of Discovery Care Center and our Ensign affiliates, , the challenges of the role really felt heavy, but now I have the resources to confront the challenges confidently.”

Submitted by Shelby Donahoo, Therapy Resource, Bandera-Tucson
Meet Annie Combs, TPM, and Jesus Salazar, assistant TPM at La Canada Care Center. Annie and Jesus were hired into their respective roles at the same time in November 2021. Wanting to strengthen La Canada leadership for the facility and for Rehab, ED Mike Bostwick made the decision to bring on both of them to support each other as first-time department managers.

They were a team from day one: no ego, just respect for each other, sharing new ideas for the department and responsibilities. While Annie had completed the DORiTO program, Jesus had not, and he started in February 2022. Annie made sure Jesus was applying and doing the DORiTO lessons in real-time at the facility as they occurred. Jesus said this made a world of difference in his learning experience.

The facility was having some issues with Nursing and Rehab communication, impacting group and LTC treatment sessions. Missed visits, low group, productivity, and tension affecting morale were issues. Brainstorming with Annie for his Capstone project, Jesus created a structure for scheduling and communicating individual and group sessions. He involved Nursing in patient goals and group participation. From February to May, productivity, group and concurrent, and most importantly GG outcomes improved tremendously.

Recently, Annie and Jesus took it upon themselves to go out to their Alma Mater, Pima Community College, and market for every single building in Tucson, not just their own. And they had a blast doing it! While learning herself, Annie supported her partner in his success, thereby multiplying leadership growth. By being a humble leader, she showed what true leadership qualities look like.