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.

Programs and Group Growth at our New Texas Acquisition

By Celeste Harvey COTA/L, Director of Rehab, Lakeside Nursing & Rehabilitation, San Antonio, TX

Lakeside’s first group experience since the recent acquisition was truly an amazing experience, not only for the staff but most importantly on how the residents interacted with one another. Initially, we as a team were not sure what the outcome would be for our residents. We learned very quickly about the energy and excitement a group can create, and the ability to engage our residents was nothing shy of amazing! We had residents who had not been able to sit up in a wheelchair actually move to the beat of the music. One particular resident was beating the drum as tears ran down his eyes. When we asked why he was crying, he stated, “Happy.” We are able to show our residents that there is a “fun” functional way to do their rehab. I feel confident that I speak for everyone when I say that we as a whole are so happy for the change that has been brought to us by this contagious CAPLICO culture, not only for us as employees but most important, for our dear residents — making them feel that we have their best interests at heart.

Making Someone’s Day

By Lindsay Fry, PT, DPT, CKTP, Cert. DN, CTO, Therapy Resource, Keystone – Missions Market, TX

I sat as the DOR at Mystic Park (a new acquisition) for October. Day one I tried to do an evaluation for a resident, Arturo. I introduced myself and said I was a PT, and was going to evaluate him for services. Arturo immediately responded, “I want to dance – play Madonna…Material Girl.” I was just thinking, oh my goodness, I hope this man doesn’t fall. He proceeded to bust a move in the middle of the hallway, singing along to every word. And no…he didn’t fall!

From that day on, Arturo would ask me for a song every time I saw him and, of course, I obliged. Once November came along, I was no longer at the building every day. Arturo would ask Jasmine, the DOR, every day when I was coming back or where I was. He would ask multiple times throughout the day. I decided I would get Arturo a small present since he was so fond of me and keeps asking for me.

Today I went to Mystic Park and gave Arturo this Bluetooth microphone. He immediately asked for Michael Jackson’s Billie Jean. The microphone was already hooked up to my phone, so I put it on. He sang and danced throughout the building, showing everyone his new microphone. (Check out the video here). He hasn’t put it down all day. Every time he saw me in the hallway he had a huge smile on his face and gave me a BIG hug and thanked me over and over again. I think he’s going to want to sleep with his microphone LOL!

I can’t believe how much joy this gift brought him. Remember, it’s the little things that matter the most to our residents, and we can make a huge impact on their lives. This is my why.

Ceramic Arts at Hurricane Health

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!

Introducing the Outpatient Team at Victoria Care, Ventura, CA

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.

The Hills Got Skills 2.0

By Sadaf Roodbaei, NHA, MS CCC-SLP; Angelica Reyes, RN, DON; Paul Emerson Baloy OTD, OTR/L, DOR
The Hills Post-Acute held its second annual skills fair for our nursing staff on Thursday, Sept 15, 2022. This year’s theme was cunningly conceptualized as Circus Carnival. Our leaders Sadaf, ED and Angie, DON, with the support of all the department heads, creatively put together the circus carnival, themed Passion for Learning, as an experience for all our nursing staff to enjoy. No details were forgotten. They had everything from cotton candy machines, candy claw machine, hotdog warmers, lots of balloons, popcorn maker, circus decor, food and games, which were all set up to make the most of the clever and innovative event.

With the unwavering support from vendor and cluster partners, as well as resources, booths were assigned to discuss, educate and demonstrate specific information on skills to refresh and revitalize our nursing staff’s clinical competencies, which translates into continuing to provide of quality, top-notch care to our residents. The skills training content and competency checklist were strategically based on past survey opportunities, facility assessment and current device and equipment training. This ambitious feat was once again satisfactorily completed for the books! A testament in the pursuit of elevating post-acute care in the eyes of the world.

#OneClinical in Keystone North Texas

Submitted by Cara Koepsel M.S. CCC-SLP, Therapy Resource, CTO – Keystone North Texas

#OneClinical has been a big focus for us here in Keystone this month! We have been piloting and rolling out Ultramist, a wound care treatment tool, in several of our facilities throughout the state and have seen some amazing results. In our efforts to partner with nursing and assist with great outcomes and quality measures through our LTC programming, Ultramist has shown us the way. Our very own Dustin Rex, DPT and CTO at Park Manor Bee Cave, presented on the benefits he and his team in Apex have seen with wound healing and QMs during our company-wide therapy leadership call this month. Below is a clinical synopsis from one of our outstanding Physical Therapists at Heritage Gardens. He shares with us the success their team has seen with Ultramist during the pilot at their facility. This is such a fantastic way for us to partner with our nursing team and show our love for #OneClinical programming, while providing great care to our residents!

“The experience with Ultramist was really remarkable. We had a wound care patient (GV) referred by the Wound Care Nurse, Stephanie. The case of the patient was a diabetic wound on the left heel about 3cm (LxW). There was still significant red and pink soft tissue with callous present upon the initial trial. Stephanie extended help to take off the wound dressing and volunteered to redress the wound after the Ultramist treatment. GV was place in supine lying with the left hip internally rotated to expose the diabetic wound. The ease of the application as the patient was actually tired and asleep during the initial encounter and no pain nor discomfort was noted by GV nor the husband that was observing during the treatment session. The patient was treated 3x a week and only needed 4 total sessions to have the wound care nurse discharge the wound care treatment as it was healed successfully. I believe the Ultramist works and is beneficial for patients with diabetic ulcers.” – Francis Espinola, DPT

Large Group Therapy at Hunters Pond

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 for more detailed information on definitions, regulations, and compliance regarding group therapy.)

OT Student Shares Group Ideas at Estrella Health and Rehab

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!

Infection Control Continues in Mission Market

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