Celebrating Success at Beacon Harbor

By April Trammell, SLP, DOR, Beacon Harbor Health & Rehabilitation, Rowlett, TX
Jimmy arrived at Beacon Harbor on April 13, 2020. He was in a very devastated state following a spinal fusion, which was compromised, leaving him with hemiparesis from the chest down. Because he was unable to feel his legs and feet, he was having frequent falls, required a hospital bed with assist rails in order to maneuver in and out of bed, and was wheelchair-bound. “I was brought to Beacon Harbor for my last days on earth to be comfortable and to give my wife Dianne a respite.”

Plans for Jimmy were to transition here to Beacon Harbor long-term care. But Jimmy had other plans in mind. He was successfully determined to wean off of all pain medication. “Then I started doing therapy — that wore me out — but I had it in my head that I wanted to recover.” Jimmy and his team of therapists were determined to help him gain his independence. “Day after day, week after week, I started improving not just a little bit — a lot! No explanation ‘why’ except my therapy and my willingness to do what is asked of me. They have challenged me on so many things, and they are holding me up, allowing me to improve.” He progressed to being able to transfer independently in and out of bed, and to be able to complete basic self-care such as dressing, bathing and toileting independently. “I feel like I am being rebuilt. There’s something about this place that draws it out of you.”

Jimmy and his therapists continued to focus on neuro re-education, and he slowly began to regain full sensation in his body. “I am able to feel hot water and take a hot shower for the first time in over 35 years!” He did not give up; Jimmy continued to thrive in therapy and began walking with a walker for the first time in 10 years. “I started taking control of my life slow, but every day it was a very hard road to walk down — for myself, for my wife and family. I would say Beacon Harbor is just one of the best rehab centers that I’ve ever been in in this nation, and I have been in quite a few from state to state over the years. The bottom line, Beacon Harbor: You have an amazing PT, OT, ST and Nursing staff. I’m getting ready for my second phase of taking my life back. I’m going to move into assisted living, and from there, back home. Thank you for a second chance at life.”

Happy News from EPAR

By Paula Voorhis, PTA, DOR, Englewood Post Acute & Rehabilitation, Englewood, CO

In recent weeks, Englewood Post-Acute and Rehab has been handling the COVID outbreak with as much grace as possible. I just wanted to take a moment to share some photos of our celebrations of success.

This is our first group treatment since October, which is when we went into full lock-down, outbreak mode. It was organized by two of the most compassionate therapists I know, Emily White, PTA, and Wendy Garrison, OTA. The residents had a blast!

This is Ron; he was in a catastrophic car accident in 2019, which brought him to us. He received prosthetic training and was set to go home in early November, when he tested positive for COVID. Plans to DC home were postponed, but he made it, and has made it back home to Nebraska.

This is Jessica, the Clinical lead and head cheerleader for team Ron. We all cried like babies when he finally went home.

 

 

 

As a compromised patient, Glenna should not have survived, according to all our knowledge of the virus, but she did. What a happy day it was to move her off of the COVID wing back to her own room.

This was our very first survivor. She didn’t even know she was sick and was happily confused about all the fuss we were making over her. We are all truly thankful for the opportunity to celebrate with her. (photo of thankful I beat COVID)

While we all have the heartbreaking stories we carry in our hearts about those who didn’t make it, and the effects of long-term isolation and burnout as we care for our people, it remains good practice to reflect on joy and the many successes we all share to move forward. It is powerful medicine for the wounded and heart-sick amongst us.

CAPLICO Moment: Momentum Therapist Spotlight

By Paul Emerson L. Baloy OTD, OTR/L , DOR, The Hills Post Acute Care, Santa Ana, CA

Denise Del Cano, COTA, ADOR, has dedicated her career in The Hills Post Acute. An alumnus of Santa Ana College, she earned her associate’s degree in Occupational Therapy Assistant 12 years ago and has been with the facility since then. She was promoted to Assistant Director of Rehab last year and completed the DORITO program this year. Denise did her internship here at The Hills. She was supervised by Vonda Gaier, COTA, who then became her colleague. She is a Filipino American born in Los Angeles, California, the eldest of five and a loving mother to her 16-year-old daughter, Elizabeth. Interestingly, Denise was introduced to the field of therapy when her daughter received therapy for several years. Denise saw the importance and relevance of Occupational Therapy and has been an advocate ever since.

Customer Second: Residents approach her knowing that she will listen and immediately respond to their requests. She will ask any of our facility staff how well each one is doing and how she can assist them to make their day better.

Accountability: She assists her supervisor in creating daily schedules and follows up on department needs and requests.

Passion for Learning: She is seeking ways of learning new things, being receptive to new information and understanding, and embracing the Hills Post-Acute way of doing things.

Love One Another: She genuinely cares for the staff. She will hand you a cookie or any treat to perk up your day.
Intelligent Risk Taking She will listen and learn our new way of doing things. Willing to unlearn past habits, think outside the box and develop better and efficient new systems.

Celebration: She will bring in breakfast or lunch to celebrate the day’s hard work, keeping each one’s morale in check and in good shape. She will celebrate birthdays or becoming a new member of the team.

Ownership: She demonstrates ownership by making everything personal because she believes in her heart that this is her second home and that her co-workers are her family.

Therapy Update from VPAC

By Dawn Thompson, DOR, Victoria Post Acute Care, El Cajon, CA
Hope everyone has been staying safe and healthy. Here is an update from the Hidden Gem of East County, Victoria Post Acute Care [Yes, that was really once a slogan of VPAC).

VPAC has continued to accept COVID + patients, and as of August 16, there had been approximately 140 COVID admissions and 95 discharges to the community (25 skilled currently). Our entire VPAC team has continued to embrace the adversity of COVID as a challenge to overcome and catalyst for learning and growth. We’ve been honored to discharge so many residents home with family members and to prior living situations. The joy on residents’ and staff’s faces when escorted out the front doors on a red carpet to waiting family members is priceless. We’re looking forward to crossing the triple digit threshold for community discharges.

Over the last few months, there have been many non-COVID-related changes within our department. Lead PT, Melissa, had a baby and has been out on maternity leave, and our wonderful SLP transitioned to a building in Texas. We’ve welcomed two new team members and are excited for their added contribution to the team. We continue to complete the LEAF form weekly for COVID-related time within the facility to have a true picture of department productivity.

Another major change within our department is the inclusion of the RNA team. The therapy team has absorbed the RNAs fully as rehab team members. The RNAs moved into the therapy gym, contribute in team meetings and participate in team building lunches/potlucks. This has allowed for greater relationship building and communication between therapists and RNAs. The increased conversation, coupled with our LTC screening process and new QM weekly meeting, have resulted in more referrals for LTC evaluations. We hope to continue developing LTC programming to better serve our VPAC residents [and increase PNSD].

We consistently find reasons to celebrate — this summer, we have had wedding celebrations, baby showers, birthday parties, goodbye and welcome parties. It’s become part of our weekly routine to have lunch together on Tuesdays. [See attached photos of celebrations].

Last month, I was invited to lead the culture portion of the resource call. We explored the Enneagram and team dynamics. I also had the opportunity to be a part of a COVID-19 Rehab Panel for the San Diego District CPTA (thank you, Sam). I was asked to share my experience and what I’ve learned from an outbreak with the facility and accepting positive patients from the community along with staying safe in the SNF setting, IDT treatment approach and mental health of COVID and SNF residents. It was a great experience exchanging information and experiences with peers.

As we persevere through the pandemic, I am often reminded how fortunate I am to have such wonderful teammates. I continue to be the proudest team leader.

Keep staying safe, wash your hands and wear a mask.

Evacuating from the Fires in Northern CA

Patients lined up to get in the transportation vehicle

By JB Chua, DOR, Summerfield Healthcare, Santa Rosa, CA
October 9, 2017, and September 28, 2020 two dates that are significant to Summerfield Healthcare Center. These are the days that we, the Summerfield family, had to evacuate our patients out of our facility and send them temporarily to another place that is not their home. Their limited choices were either in a relative’s home, another skilled nursing facility and worst, evacuation centers. These were definitely one of the most stressful events that Summerfield had experienced. Staff worried about their homes, patients worried about their safety and patients’ families worried about their loved ones. The sky seemed to empathize with the situation with its gloomy hue and the air felt like a snake coiling around your body making it so hard to breath and the smoky air threatens to cut off your oxygen. Definitely not something anyone wants to experience during their lifetime.

Paramedics in action

As we received the orders to evacuate, text messages and phone calls started to flood my phone. Messages that even I, who holds my team to a very high standard, was surprised to receive… “I’m on my way and Schuyler (my OT’s boyfriend) also wants to know if he can help.”… “Michael (my PT’s fiancée) and I will be there in a little bit.” and many more similar messages, there were some of my staff who were evacuated, on vacation and have younger children who came in to help. Literally, all hands on deck. As the evacuation progressed, each and every patient was assisted in getting dressed and back up on their wheelchairs, we served them breakfast and helped some residents eat, some helped them back to their room to use the bathroom, the therapy room was converted into a calming room where we played soothing music on our phones (power was down so we were not able to use our therapy music player) and some staff were trying to re-assure our residents that everything is going to be fine, even though there were some doubts if it really was going to be. When the transport arrived, we started to roll our patients out towards a safer place. Even with worried hearts and uncertainty, the staff continued to re-assure our patients, waved them good bye and told them that they were going to see them again when everything was all over.

October 19, 2017 and October 4, 2020 two more dates that will be remembered as well, not because of any tragic event, but because of what these dates unconsciously signify to each and every individual at Summerfield Healthcare Center. It signified opportunity, growth and most importantly hope. Opportunity for each one of us to hit the reset button and start anew. The building was deep cleaned by the staff members, from therapists, nursing, administration, you name it, and you got it. Each and every single one looked for opportunity rather than focusing on the misfortunes and tragic events. Growth was experienced from overcoming challenges such as having to go to another facility to help out with our residents, finding new ways so that we can still provide for our residents and staff even when our resources were not as readily available during normal times and finding a new homes for those who had lost theirs. Lastly, hope; hope that everything we had gone through this year was fully addressed so that we will be better prepared both physically and mentally should these type of events happen again.

As I write this article, there are multiple times that I have had to hold back my tears, not because of sadness but because of how I was humbled with what I had seen and lived through. It reminded me of a saying about how a person’s character will really show up during tough times. On behalf of the therapy team I observed my therapists showing great devotion to our patients and to our facility. They were there from evacuation, helping other facilities, cleaning up the facility and welcoming our patients back. During these difficult times I was mostly impressed with the support they gave each other. I have read a lot of success and inspiring stories that gave me chills as I read them. Having to experience one, is quite overwhelming and humbling. Every now and then, even before this experience, I would send a message to my therapists that I am proud to be a part of our team. As I sent another message to them, after we received the announcement that we can get our patients back in our facility, those same words felt insufficient to really express how I felt. I know deep in my heart, that if the same thing happens in the future, Summerfield Healthcare Center will rise to the occasion once again, because that’s who we are.

Defining Moments in Times of Evacuation

By Milena Milenkovic, OT/DOR, Park View Post Acute, Santa Rosa, CA
I was at home, in my pajamas, when I got the text message from our DON on Sunday 9/27 at 11pm, “We need all hands on deck to prepare packets for the potential evacuation.” I slowly jumped out of my bed and headed straight for the espresso machine while my partner read Twitter and Nixel alerts aloud regarding the location of the fires, direction of the winds, and latest evacuations orders.

When I arrived to Park View around 12:30am, the power was off, the building was running on a generator, several members of our leadership team were already busily doing various prep work while the rest of the building was quiet, patients and residents sleeping, nurses and CNAs attending to their tasks. While making copies of patient’s charts in our long-term section, I heard various residents snore, some waking up from sleep, asking for help, and hearing CNAs quickly attending to the resident, comforting them from a bad dream, helping them fall back asleep.

Soon enough, it was nearly 4am and I found myself taking a quick nap in the middle of the therapy gym, listening to the NOC shift sounds of med carts, occasional call lights, and staff’s footsteps. I anxiously napped, waiting for 5am so that I can send a text to my therapists. I worried about what to say to them, worried about those that had to evacuate, worried that many may not show up, that this is just too much, and that we may not have enough support in the morning if we had to evacuate. As 7am rolled-around, the shift-change happened, all my therapists showed up (some much earlier than usual), more staff rolled-in, and our building came to life. As our sister facility, Summerfield, started evacuating, it was our turn to continue “cold-calling” all SNFs within the Bay Area to ask them to accept our patients in the case of evacuation. Ash was falling from the sky as we secured beds for all of our patients. We were ready.

By 2:30pm on Monday 9/28 (32+ hours of being awake), after a near fall from exhaustion and pizza for breakfast, I knew it was time to go home and sleep. The sight of so many alert, awake, kind, calm, and composed Park View staff showing up in the morning brought the comfort, sense of security, and sense of overwhelming connection that we would OK, no matter what. Everyone became a leader by supporting one another, one hour at a time.

During these times, it has been so difficult for many of us who are unable to see our families and close friends. Some of our families and friends live in places that we cannot travel to, some are part of the vulnerable population, and some are no longer with us on this Earth. While napping in the middle of the gym, listening for evacuation alerts, hearing the flow of the NOC shift, I felt a sense of gratitude and acceptance that this, Park View and its staff and what we do as a team, is my family and this is where I am meant to be. That moment of exhaustion combined with team unity, trust in others, and the sight of our staff leading with patience and love is what I always look back on when I need a reason to continue fighting through the challenges that continue coming our way. Together, one day at time.

 

Fire Evacuation on 9/28/20

Submitted by Shoba Neupane-Gautam, DOR, Valley of the Moon, Sonoma, CA
It was Sept. 28, 2020. I was excited to attend my very first annual Therapy Leadership Virtual meeting. As I was working from my home office that morning, I heard from our therapy resource and DOR team that the Santa Rosa area had a bad fire and residents were being evacuated from our sister facility, Summerfield.

I called Summerfield DOR, JB Chua, to offer some help. I realized JB was remaining calm but was disappointed that with the evacuation he may not be able to attend our annual meeting that day. As soon as I heard many residents were being transferred from the Summerfield facility to Broadway Villa Post-Acute, JB and I coordinated with Ensign IT to grant me Summerfield Optima and PCC access.

JB helped evacuate his facility and still arrived at my place around 1:30 pm to attend our virtual meeting together. We both were able to attend the meeting peacefully. As soon as the meeting was over, we coordinated with the nursing/ admission team to identify the residents who were being transferred to Broadway Villa Post-Acute. Then I reached out to my team and requested that they visit those residents, provide them comfort and reassure their safety. After we identified 18 residents who were transferring from Summerfield (SF) to Broadway Villa (BW), we reviewed each and every resident’s needs and coordinated staffing between our two facilities.

Both SF and BW rehab staff were highly cooperative, cohesive and willing to assist residents. As a result, all 18 residents were able to receive skilled rehab services in a timely manner.

Thanks to both home teams’ cooperation, this situation was managed calmly. I was still able to attend all three days of the therapy virtual meeting. I am beyond thankful to my team at Broadway Villa, our therapy resource Jennifer Raymond, the Summerfield Rehab Team and JB’s leadership.

 

Reuniting Families and Friends

By Joyce Koyama, OTR/L, The Orchard Post Acute Care, Whittier, CA

On March 13, 2020, President Trump declared a national emergency, citing an outbreak of COVID-19. On that same day, CMS strictly restricted in-person visitation to only compassionate care situations in skilled nursing homes in order to prevent the introduction of COVID-19 to our most vulnerable population: the elderly with pre-existing medical conditions.

Like many seniors, our residents at The Orchard thrive on the opportunity to spend time with their loved ones. They look forward to having lunch with their spouse, to catching up with friends, to seeing their grandchildren grow. For many months, they were deprived of these meaningful visitations, or at least reduced to visits virtually or done outside their window. While many families tried to make the most of the situation by attempting to talk through glass, decorating their windows with signs and balloons, or even bringing singers to sing for their loved ones to bring cheer, it just was not the same.

As we gained a better understanding of COVID-19 and infection numbers locally were declining, our facility came up with a plan to build a visitation area as a way to help reunite our residents with their families and friends. Plexiglass was added to three sides of our existing gazebo against a side entrance. Just weeks later, the Activities Department was able to bring residents out into the sanitized area at a designated time where family and friends would await them on the other side of the glass.

At last, a clear view of each other from head to toe. Sounds of cheer, laughter and tears of joy can be heard and seen from the visitor area. Hands held up to glass, face-to-face conversations, and a heart-warming feeling with a hello and good-bye. Our resident Sandie described seeing her family for her birthday as “uplifting,” as she has felt lonely after not being able to see them for months. Resident Rosita said she felt happy seeing how tall her granddaughter had grown. It was unanimous that our residents felt overwhelmingly happy and loved after seeing their family and friends again.

While there is nothing that can really replace the warmth and value of a real hug or a held hand, for now, this is a wonderful and sweet way to reunite our residents with their loved ones. For families on the other side of the visitation area, they feel relief to see their loved ones doing well. And for our residents, they are given hope and joy — a goal we have accomplished here at The Orchard Post-Acute Care.

Let’s Keep Doing the Important Work

By Cara Koepsel, M.S., CCC-SLP, DOR, Golden Acres Health and Rehabilitation, Dallas, TX

Here at Golden Acres in Dallas, Texas, we love our long-term care residents. They are the heart and soul of our facility, and we wouldn’t have it any other way. One of our residents passed away recently, and it never gets easier. The family reached out to myself, the DOR, and the social worker in hopes of getting a copy of her grandmother’s life storyboard that was created during therapy with one of our amazing speech therapists. Her granddaughter wanted to utilize this resident’s life storyboard to aid in writing her obituary. To think that the Abilities Care Approach Program could, in such a trying and upsetting time, bring joy and meaning to a grieving family is truly amazing.

What an important program this is, and what a reminder that what we are doing in therapy every day matters maybe more than it ever has before. The Abilities Care Approach Program is a program widely utilized across our Ensign facilities that is evidenced-based, and essentially allows the therapists to work with family members and residents to develop a life storyboard that paints a picture of our residents’ likes, dislikes, family history, and abilities they have within their communication and self-care activities through their changing stages of dementia.

For our family members to be involved in their loved one’s care through the stages of dementia is so important, especially right now as they cannot see their loved ones as they are used to. Our therapists, through this program, can work with our families to give them peace of mind that during a pandemic, their loved ones are being loved and cared for so well. Our long-term care programming continues to be so important right now! Let’s remind ourselves that we continue to make a huge difference in our residents’ lives!

A Home Run to a Strong Partnership Created with Utilization of Grand Rounds and Stop & Watch Tool

By Jon Anderson, PT, Senior Therapy Resource

The pandemic has changed so many things in our daily rituals, and at Legend New Braunfels the facility quickly found itself with less referrals, resulting in decreased skilled and overall census. The facility is known in this quaint community for its fast-paced rehabilitation program and more recently unique treatment approaches surrounding memory care. In an effort to collaborate and ensure patients in the facility avoid the hospital, the facility implemented the Stop and Watch tool along with Grand IDT Rounds.

The Stop and Watch tool allows any employee to document a change in a patient, providing a direct line of communication to the nursing team for further assessment. Bob Said, RN, DNS reports that initially this was looked at as perhaps creating more work for the nursing team, and there were questions surrounding whether a non-nurse would be able to utilize the tool effectively and appropriately. However, it has been quite the opposite. The nursing team provided training to all clinical staff, including the therapy department, on how this tool can be used to effectively capture an early change in condition.

Over time, the recidivism rate was impacted, which created less work for the nursing team. Bob was quick to point out to the team of nurses he supports how much time was saved by having to do fewer orders and assessments as part of the discharge/readmission process, while keeping the patient happy, healthy and out of the hospital by identifying these subtle changes. Jayna Owens, SLP, DOR for New Braunfels, agrees that this strong collaborative clinical approach has led to breaking down silos: “By leading in a way that it’s OK to step on each other’s toes, and even encouraging to do so, we are able to partner early and address clinical issues rather quickly.”

Both Jayna and Bob, along with Amber Thompson, PTA, LNHA, have also shared the importance of doing daily grand clinical rounds on every patient in the facility. Bob reports, “At first it’s a huge undertaking and can quickly eat up your day. Our first grand round took three hours to complete, and you question if this is efficient. But like anything new, you create a process, and over time it becomes faster. We now have it down to about 1.5 hours.”

Jayna and Bob both agreed that the time spent upfront at the start of the day has paid off, we now actually have more time later in the day because we already addressed the majority of the clinical issues in the morning. “You have a better understanding of all the patients,” says Bob. “You know the care plans are being followed because you look at it daily, and whether we knew it or not, we were elevated in the eyes of the front line staff because they see you on the floor daily in every resident’s room. No one’s left behind.” Amber, Jayna and Bob all agreed that these two new things are here to stay, even after the pandemic. ”We have really been pushed as leaders, and this has allowed us to better support the ladies and gentleman, along with creating more open lines of communication with the staff.”