Announcing Keystone’s Newest Chief Therapy Officers

Submitted by Jon Anderson, DPT, Therapy Resource
What a privilege I have to share and celebrate our newest CTOs (Chief Therapy Officers) in Keystone. The CTO designation is the highest designation a therapy leader in the organization can receive. It is a tall order to be in this elite club. Please join me in congratulating this elite group of Texas leaders!


Vanessa Munoz, Veranda Health & Rehab

Is Ensign in you? If there ever was someone who bled CAPLICO it would be Vanessa Munoz, TPM at Veranda Health & Rehab. She is a true embodiment of our CAPLICO culture. Vanessa began her employment at Veranda 10-plus years ago, starting as a contract PTA with Rehab Care, then eventually transitioning to an in-house therapist. She was the natural selection to lead the team when the previous CTO/DOR left to become an ED. Vanessa quickly caught on and became a driver and an integral part of the IDT team that facilitates the processes to keep the facility operating optimally; however, with that said, she is modest and attributes Veranda’s therapy team’s accomplishments to having the best people in the industry.

In fact, those that she leads commented on how well-supported they feel. She includes them in many decisions. Vanessa’s leadership has led to an extremely cohesive, well-functioning team that consistently produces high levels of efficiency and excellent patient outcomes. But how do you do all of that and do well on audits? Ask Vanessa: Veranda’s MSCA scores are solidly consistent here, too, and they have always been among the highest, culminating with the most recent one — a facility overall score of 98.95% and a remarkable Therapy score of 100%!

Covid was and has been hard for all of us, but Vanessa truly stepped up and led by example in putting in long hours and days, including nights/weekends doing triple duty as a leader, therapist and an assistant to nursing. She stepped in without being asked to help with nurse aide duties, filling in shifts to provide for the residents’ needs, demonstrating love and support by working alongside Nursing staff, and inspiring some of her staff to also help in this capacity. She celebrates her team’s accomplishments, both professional and personal — coordinating and participating in celebrations, birthdays, special accomplishments, holidays, and births. She has had team-building activities to keep her team united and with a common goal to dignify our residents’ lives. I could literally write a novel on Vanessa listing all of her accomplishments in the last 10+ years as an employee and leader at Veranda, but it can be best summated by Jason Hess, Veranda, CEO when querying about her CTO application: “She’s got my vote.” And she certainly has the vote of all who know and work with her.

Andy Cisneros, Westover Hills

Andy Cisneros, PTA, DOR joined us in 2016 via an acquisition at Legend Oaks West San Antonio as the DOR. While at Legend Oaks West San Antonio, Andy was a trailblazer in finding ways to improve length of stay while maintaining great outcomes with our managed care patients, helping to solidify their success with metrics that resulted in the facility being designated as a facility of choice. Andy was instrumental in introducing a new incontinence program, PTNM (percutaneous tibial neuromodulation), to the nursing home sector and was part of an initial pilot program to demonstrate its effective outcomes with the LTC population, which helped fuel this program being used all over the organization as a way to better treat incontinence. Beyond this facility, Andy took ownership in the cluster by ensuring no one missed a resource when capturing Medicaid CMI (case mix index), and the trainings/tools he developed resulted in a growth of >10% in the cluster of under-captured resources.

Andy is a champion in dignifying LTC in the eyes of the world, has helped initiate a number of new programs at his facility, and was one of the first in Keystone to implement the wildly popular therapeutic drumming program. In 2019, Andy left West San Antonio for a new challenge and transitioned to a new acquisition, Westover Hills. This transition allowed him to grow a new team and teach the meaning of CAPLICO to them, but the growth did not stop with just the team, because he took the challenge of growing himself as a leader. At Westover, Andy has taken ownership of assisting in the success of the building by helping in any capacity needed. He is not only the champion for the management of CMI and PDPM, but he also takes the reins in teaching others in the building on how to live CAPLICO culture. He and his therapy team have helped lead the charge in keeping the morale up for residents and staff throughout the entire COVID pandemic. “Work as though the survival of our organization depends on your continued success in your own operation. If we all do that, and help each other to succeed in spite of the challenges, we will not only survive, but we will thrive.” These are the words of Andy Ashton when he was discussing the challenges we are facing in this new COVID-19 world, and Andy Cisneros has operated the bulk of this year with those words resonating in him. He approaches the management of his metrics with that in mind, and is always looking for ways to jump the S-curve. So proud of you, buddy! Congratulations, Andy!

Jayna Owens, Legend New Braunfels

Some leaders dream about cutting edge, culture change, and progressive innovative treatments, and people like Jayna Owens, SLP, DOR, make dreams a reality. Jayna began working for Legend Oaks-New Braunfels in the fall of 2015 and began her journey with us when the building was acquired in 2016. Jayna was inspired by our core values of intelligent risk taking and passion for learning. She worked as the Speech Therapy team lead, moving up to ADOR, and later taking over as the Director of Rehab.

During this time, she took a special interest in long-term care programming and dementia design. Jayna was one of the first in our company to write multiple grants to fund her new therapy programs and vision of changing dementia care. Jayna and her team used grant funds to create and develop shadow boxes for every resident utilizing the Abilities Care Program, creating a Sensory Room with a therapeutic program across all disciplines, dining room dementia design with environmental modifications, and providing familiar landmarks in accordance with resident’s long-term memory to decrease wandering within the facility. She had the opportunity to study with some of the best dementia design specialists in the world at the University of Stirling in Scotland and apply that knowledge to her building and train other affiliates in dementia care. She has a passion for teaching and educating Keystone and the organization in long-term care programming, as she is a frequent speaker on the LTC Think Tanks.

Jayna’s 120-bed facility might not seem like it could support 25 full-time therapists, but due to the nudges and pushes with LTC program development that she has established, her team is equally as inspired and encouraged by the changes happening in dementia care and take pride in Legend Oaks-NB being a progressive leader in innovative long-term care. Way to go, Jayna! Congratulations!

Marci Williams, Wisteria Place

When Marci put her mind to becoming a Physical Therapist, it was no easy task. Already a mother to her precious son Braiden, born with special needs, she was set to leave Abilene and head to Dallas for her last clinical rotation. When Marci learned that Braiden would need to have major surgery and she would be needed at home, she changed her last clinical rotation from Dallas to Abilene and started her rotation at Wisteria in October of 2013. Wisteria became part of the Keystone family in January 2014, and Marci accepted a full-time PT position with Wisteria in Feb 2014. With less than two years of clinical experience, Marci was promoted to DOR at Wisteria, and she has been building and growing the department there ever since.

The shift from student to employee to director would have been a challenge for many, but Marci was up to the task, learning while she taught others. Marci has worked over the years to grow programs and build a team that she loves. Marci had to work hard to grow her team into what they are today; over the years, she has added staff to accommodate program growth, nearly doubling the size of the therapy team. She has seen multiple administration changes at Wisteria and has stepped up every time to assist the incoming leaders as they build rapport, establish systems, and seamlessly transition through grace and knowledge. She is humble yet extremely strong, not only functioning as the DOR of a thriving facility, but serving as a hybrid therapy resource as well for the past two years, providing guidance and support to all of our affiliates in West Texas.

In addition, Marci has specialty knowledge of Kinesio taping, wound care, and PTNM, presenting on the LTC think tank call for incontinence care and training others in her area. She continues to show results across multiple areas, from exceptional MSCA scores to market metrics. However, Marci is not afraid to show vulnerability when necessary for growth. In preparation for PDPM, as facilities across the nation were re-claiming the use of group treatments, Marci humbly admitted that this was an area she lacked knowledge in and reached out for help. The power of asking. Time and time again, Marci has humbly led with no claim to success other than results. Marci continues to grow and evolve, joining committees and asking for education to better serve her team and her cluster, and we are so proud to honor Marci and recognize her as Chief Therapy Officer!

Roohi Kapoor, Mason Creek

Please allow me to introduce you to Roohi Kapoor. She is a Physical Therapist by trade and supports our Mason Creek facility as the Director of Rehab. Roohi began as a staff PT at Misty Willow in 2017 before transitioning to become the DOR at Mason Creek in 2019. Before I can share the details of her achievements in her role as DOR, you must get a grasp of who she is beyond the role. Roohi is in the process of completing her transitional Doctorate in Physical Therapy. You would have no idea that she is balancing this level of academic growth on top of her many responsibilities. At the start of Roohi’s transition to DOR, she was challenged to grow long-term care programming and build cultural unity within the facility. To say she has accomplished that goal, and so many others, is an understatement. Yes, her metrics rank amongst the highest in the organization from PNSD, CPM, and Productivity, but the true measure of her success is the actionable execution of clinical programs. She empowers her OT and SLP to grow dementia care with purposeful intent, and she partners with her fellow PT to deliver PTNM (incontinence program).

Roohi’s rehab team was quite tenured before she joined, and they have welcomed her with open arms. Her reach is not limited to just therapy services; she has built a bridge between Therapy, Nursing and the entire IDT. Roohi will extend her support to her cluster and market partners without hesitation. She is able to create buy-in and excitement behind each of her ideas. Education and training is of her utmost importance, as she always wants her team to be ready for anything. Her near-perfect MSCA results are further evidence that she moves with precision and is very thoughtful in how she prepares her team. She is constantly searching to understand what/how she can enhance her skills, both clinically and operationally. It is with great joy that I can share that she will be continuing her professional growth by becoming an AIT. We are beyond proud that she has earned the coveted title of Chief Therapy Officer. Congratulations, Roohi!

Charlie Costa, Legend Garland

Charlie Costa, PT, is the DOR at Legend Oaks Garland. Upon acquisition, this facility was struggling, and unfortunately continued to do so for a while. But through all the struggles, the shining light was always Charlie and his Therapy team. While all other metrics were trending in the wrong direction, Therapy was steadily growing stronger and better. Charlie was able to truly balance the financial responsibilities of the facility and the clinical needs of the patients, and he has been instrumental to Garland’s rise to the top of the market. Charlie has a passion for marketing, and he can often be found working with nearby facilities, home health companies and doctor’s offices to help in census development. Charlie is always up for a challenge; he is the first to introduce a new initiative. When we re-introduced group and concurrent modalities of treatment, Charlie was one of the first in Keystone to train his team and really show us all what a difference this mode of efficiency can make. He was one of our first DORs to embrace the value of DOR treatment in building morale with his team, and he loves to train and mentor students; you never walk into the department without seeing someone learning something new.

Charlie loves to roll out new clinical programs for his residents, as evidenced by his Part B PNSD being consistently in the top 5, and by the smiles on the residents’ faces! If one were to look at therapy metrics, Garland is always in the top third of every metric, not only Part B PNSD, but also productivity, cost per minute, and margin percentage, all while being able to balance his ownership in the data with his love for his team and facility. Charlie’s culture in the facility can only be described as contagious, and in the words of his ED, Will Sherman, “Charlie brings a great energy to our team where there is accountability, but in a loving and fun approach, which is a bright spot in our facility … you really can hear Charlie’s laugh down the hall, and it just makes you smile, because he not only enjoys what he does, but he has the right passion in making sure our residents are cared for properly and manages things as if it were his own.” Amazing job, Charlie, and congratulations!