PT April Boles SLP Brittany Brown assist Ruth-Morris

Laughter, Encouragement are the Best Medicine at Stillhouse

Reprinted with permission from the Paris News, Paris, Texas, published April 13, 2014
By Lauren Corbell

Visitors walking through the doors of Stillhouse Nursing and Rehabilitation immediately notice there is something different about the facility. However, it isn’t the technology that makes Stillhouse different from other similar rehabilitation centers. It’s the people.

“Our equipment isn’t different from anybody else’s, though we’re planning to purchase some innovative equipment soon,” said Deb Lookingbill, occupational therapist and director of rehabilitation. “The difference is our team and our mindset. We truly care about patients’ wellbeing. We’re in it to get them well.”

Selina Louis, assistant director of nursing, agreed.

“We have a different way of thinking here and a different approach to care,” she said.

Two physical therapists, two therapist assistants, one occupational therapist, two occupational therapist assistants and a speech therapist comprise the cheerful rehabilitation team.

PT April Boles SLP Brittany Brown assist Ruth Morris
Physical therapist April Boles, left, and speech pathologist Brittany Brown, right, assist Ruth Morris as she slides rings across a shoulder arc that improves shoulder motion.

“All together, we have 70 years of experience,” Lookingbill said. “Some of our team members have worked together for 12 years, others for six. We are a family.”

Mike Reese, operations manager, tributes part of the facility’s success to the CAPLICO mission the employees follow.

“The C stands for ‘customer second,’” Reese said. “That sounds strange to people, but it emphasizes our belief that our employees’ skills and training allow us to provide the highest level of care.”

Each of the points in the code — accountability, passion, love one another, intelligent risk-taking, celebrate and ownership — contribute to the upbeat, family-like atmosphere that, employees said, helps patients recover quickly.

And, it seems to work.

Each of the staff members interviewed told of success stories. One woman came in on a stretcher having been told she would never walk again. Two months later, she was released, and recently she walked through the front doors to visit and say hello. Another woman had broken her hip three times, and each time, she chose to go back to Stillhouse for rehabilitation.

“It’s a testament to the service here,” Reese said. “There are plenty of options in the area, but our patients decide to come back to us.”

Patient Dr. Geoffrey Grubb said he had a stroke 17 years ago followed by another small one in December. After two months at the center, he was preparing to go home.

“I’m in better shape now than I was before the stroke,” said Grubb, who had already made arrangements to teach a Sunday school class at First United Methodist Church following his release.

Another patient, Michael Dollins, told how he had come to the facility unable to stand or walk, using a feeding tube and weighing 500 pounds. He now weighs 320 pounds and is able not just to take care of himself, but he also volunteers to help around the center, making coffee, washing dishes and folding towels. Employees gave him a staff shirt, which he wears with pride.

Stillhouse Therapy Team
In his honorary staff shirt, patient Michael Dollins, front left, stands with the physical therapy team, including, front from left, Deb Lookingbill, Brittany Brown and Cara Duncan; back, Ruth Moseley, April Boles and Karina Smith.

“The patient has to put their effort into it,” Dollins said of physical therapy. “Everyone has to work together to make therapy and rehabilitation work. It takes encouragement to do your best.”

When patients are not in physical therapy sessions, the staff provides a number of activities to keep spirits high, including outings to antique car shows, restaurants and movies.

Cari Johnson, director of marketing, said one of the most popular events at the center is when the Good Ole Boys perform, which usually brings 50-60 people from the community to the facility to listen and dance.

Church services and Bible study are also available, along with a beauty shop and menu choices that include homemade dishes.

“We also emphasize communication,” Johnson said. “We give out our cell phone numbers, so there is always someone to contact 24/7.”

“We plan to continue to grow and improve,” said Reese. “We try to be the best resource for information on insurance, while providing emotional and educational support for patients and being a fun place for employees to work.”

Stillhouse Staff
Members of the Stillhouse Nursing and Rehabilitation staff are, front row, from left, Lisa Sillivan, Deb Spencer, Jennifer Thornton, Deb Lookingbill, Glenda Neisler, Connie Musick and Selina Lewis; back row, Rhonda Sisson, Danica Simmons, John Brazile, Michael Reese, Cari Fortenberry, Rocky Watley and Cari Johnson. Not pictured are LeAlandra Chandler and Charlotte Winton.

OT Awareness in Colorado

Colorado HighwayApril is Occupational Therapy Month, providing a perfect opportunity to address the question on the mind of anyone who is unfamiliar with the profession: What does an occupational therapist do? AOTA provides consumers and healthcare professionals with this explanation: “OT is a profession that helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities. OT’s holistic and customized approach to evaluations, interventions, and outcomes help a child with disabilities participate in school and in social situations, assist a person recovering from injuries to regain skills, aid an older adult to stay as independent as possible, and offer the specialized support and services to people of all ages and in all circumstances that only occupational therapy can provide” (AOTA, April).

One OT in Colorado decided that OT month was a great time to help her coworkers, patients and family understand just what an OT does and how she can help them. Hannah Stillings, OTR, has been an OT for a little over a year and with Ensign at Littleton Care and Rehab for about six months. Hannah put together a plan throughout the month to spread awareness of OT. She began by hanging posters and articles in the gym and the main entrance explaining OT’s role in skilled nursing facilities. She brought cupcakes to her coworkers with “OT” on them. She spoke with staff, describing her role in the facility and how she could support her team members. Finally, the rehab team organized a facility-wide OT potluck in the gym area where everyone could view the posters and articles. Thanks to Hannah, the team members at Littleton Care and Rehab now appreciate the unique role of OT in their setting.

Are you interested in promoting and celebrating OT Month next year? The AOTA has lots of ideas for you! Click below for 10 simple ways to spread awareness at your facility and in your community:

Ten Things You Can Do To Celebrate Occupational Therapy Month

Tools for Tracking and Reporting Therapy Outcomes

As more and more emphasis is placed on therapy outcomes, two programs have made it to the top of the list for implementation.

1. National Outcomes Measurement System (NOMS) for Speech-Language Pathologists

ASHA’s National Outcomes Measurement System (NOMS) is a voluntary data collection system developed to illustrate the value of speech-language pathology services provided to adults and children with communication and swallowing disorders.

The key to NOMS is the use of ASHA’s Functional Communication Measures (FCMs). FCMs are a series of disorder-specific, seven-point rating scales designed to describe the change in an individual’s functional communication and/or swallowing ability over time. Based on an individual’s treatment plan/IEP, FCMs are chosen and scored by a certified speech-language pathologist on admission and again at discharge from SLP services to depict the amount of change in communication and/or swallowing abilities after speech and language intervention and submitted to ASHA’s national registry. In addition to scoring the FCMs, SLPs also provide basic information on patient/client demographics and intervention characteristics (e.g., SLP diagnosis, frequency/intensity of treatment).

The NOMS FCMs can be used to assist with Medicare’s claims-based reporting. The CMS measures, known as “G-codes” with accompanying severity/complexity modifiers, can easily crosswalk to the NOMS 7-point scales. It is important to note that the FCMs are only one component of NOMS. To receive access to all of the components of NOMS — the national database of treatment outcomes and customized data reports — your organization must subscribe to NOMS and become a registered NOMS site. To find out more about how NOMS and its FCMs relate to Medicare’s claims-based outcome reporting using G-codes, view frequently asked questions related to NOMS and claims-based outcomes reporting.

More information can be found at www.asha.org/NOMs.

Anyone interested in NOMS participation can contact their Therapy Resource or our internal NOMS liaison with ASHA: Tamala Sammons at tsammons@ensigngroup.net.

2. Continuity Assessment Record and Evaluation Item Set (CARE) for Physical and Occupational Therapists

As a part of the Medicare Post-Acute Care Payment Reform Demonstration (PAC-PRD), a standardized patient assessment tool was developed for use at acute hospital discharge and at post-acute care admission and discharge. This tool was named the Continuity Assessment Record and Evaluation (CARE) Item Set. Data collected using the CARE Item Set served as a major source of information in the demonstration. The CARE Item Set measures the health and functional status of Medicare beneficiaries at acute discharge and measures changes in severity and other outcomes for Medicare post-acute care patients.

The CARE Item Set is designed to standardize assessment of patients’ medical, functional, cognitive and social support status across acute and post-acute settings, including long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs) and home health agencies (HHAs). The goal was to standardize the items used in each of the existing assessment tools while posing minimal administrative burden to providers. The CARE Item Set builds on prior research and incorporates lessons learned from clinicians treating the continuum of patients seen in all settings. The CARE Item Set targets a range of measures that document variations in a patient’s level of care needs, including factors related to treatment and staffing patterns such as predictors of physician, nursing and therapy intensity.

Physical Therapy data collection and reporting will relate to mobility. Occupational Therapy data collection and reporting will relate to self-care.

Learn more at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Post-Acute-Care-Quality-Initiatives/CARE-Item-Set-and-B-CARE.html.

Rehab Optima is already approved as a data collector for CARE, so our clinicians will be able to simply enter data directly into the electronic record. Rehab Optima is also working on a partnership with ASHA to be able to do the same for NOMS in the future.

To access a lunch and learn recording from Rehab Optima on this topic, click the following link and enter your email: https://www1.gotomeeting.com/register/861998488.

Wound Care Treatment Approach for Physical Therapists

The PulseCare Medical Closed Pulse Irrigation™ system was founded by Dr. Patrick Marasco, an American Board Certified physician specializing in wound cleaning and care and reconstructive plastic surgery. The result is a unique Closed Pulse Lavage/Closed Pulse Irrigation™ system that allows patients to receive wound care by physical therapists at bedside. The system includes products that enable wounds to be safely sealed and isolated while they are irrigated by trained clinicians. PulseCare has been proven to reduce bacteria (biofilm) from the surface of wounds by 86.9 percent. PulseCare products eliminate the possibility of contamination through aerosolization and splash back, and they enable all byproducts of wound irrigation to be safely collected and disposed.

Advantages of using PulseCare as part of the wound care program:

  • Removes necrotic tissue and slough
  • Reduces biofilm by 86.9 percent with each treatment
    • No other wound treatment can selectively debride, cleanse and remove bacterial biofilm with the same level of efficiency and safety.
    • Biofilm can regenerate within 48 hours. This procedure is an essential selective debridement for removal of biofilm that sharp debridement cannot combat.
  • Portable — can be used in skilled nursing facilities without risk of contamination
  • Safe — eliminates aerosolization and splash back
  • Cost-effective — eliminates cost and time of operating room debridement, because PulseCare can be safely administered at bedside
  • Uses physical methods to eliminate biofilms (MRSA, PS, MDR-AC) without harming normal tissues
  • Can be used to eliminate biofilm in conjunction with Negative Pressure Dressings (Wound VacTM and Blue SkyTM), Hyperbaric Oxygen Treatments
  • Well-tolerated with minimal discomfort during treatment
  • Daily treatments by a physical therapist for enhanced wound bed preparation

A variety of patients can benefit from this wound intervention, including but not limited to patients with acute or chronic (non-healing) open wounds (surgical, vascular and pressure); patients with contaminated or infected wounds, including: MRSA (Methacillin Resistant Staph Aureus) and MDRB (Multi-Drug Resistant Bacteria).

Find demonstration videos and product information at http://www.pulsecaremedical.com/.