29222 Rancho Viejo Rd, Ste 127
San Juan Capistrano, CA 92675
July 2022

Click Here for a Printable Copy of the FlagPOST
Meet Ethel Praznik, our 100-year-old honorary staff member who volunteered to help stuff envelopes for the recent FlagPOST mailing.
Ethel was born on August 27, 1921, to immigrant parents (her mother from Hungary and her father from Ireland). She has lived through the Great Depression (and still saves any food not eaten as well as little tiny pieces of soap!), worked in a local hospital and factories during World War II, and has survived all that has come after that. Her husband died on their 70th wedding anniversary on July 6, 2010, at the age of 92. Ethel likes to keep busy, although she suffers from macular degeneration and severe arthritis. She still plays games on her iPad though, like Words with Friends or Gambling Casino on Facebook. She’s also an avid QVC shopper, so giving her something else constructive to do really helps the budget! 😊 

Here’s an interesting story about Ethel’s mother and her immigration from Hungary. When her mother, Mary Timko, arrived at Ellis Island in New York, she had an eye infection and they were going to send her back to Hungary. Fortunately, her relatives were able to scrape up enough money to keep her here and heal her infection. Otherwise, she would have departed for Hungary on a ship that actually sank on its way back. Just think: Ethel and her family might never have been born, and someone else might have been formatting the FlagPOST instead of Marlyn. 😊
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This month, we are also pleased to spotlight an amazing resource and friend, Lori Whitman. Lori is our accounts payable resource and provides incredible support to our therapy department. Lori just celebrated her 9th anniversary with Ensign Services in May and lives our culture to its fullest. You can see her expressions of culture and focuses during simple interactions over e-mail with a nugget typically added to her signature line, which she changes up to recognize the seasons and the holidays, as well.  

Lori is a true California native and grew up in Huntington Beach, CA. She is one of three with an older sister and younger brother. She has been living in Aliso Viejo, CA for 29 years, where she enjoys her weekends hiking with girlfriends and exploring new places, spending time with friends and family and an occasional off-roading jeep adventure with her husband! These off-roading adventures have taken them to beautiful places that they may not have seen otherwise and it has sparked an interest in buying an RV to take them to other areas throughout the United States, which they hope to do next year.  

Lori has two sons and her younger son, Austin is 27 and getting married to Kayla in October this year up in Lake Arrowhead.  Austin is pursuing his Masters of Family Therapy at Cal State Long Beach, which is Lori’s alma mater.  Her older son, Ryan, is 36 and lives in Panama City, Florida. Lori’s mom lives in an IL/AL in Huntington Beach and she also spends time helping her mom and enjoying moments together. Read On...
Left: Lori and her son and brother and Right: Lori with her sister and brother
Let’s Talk Long-Term Care Programming:
Tips and Tricks for SLPs working with Dementia
By Nicole King MA, CCC-SLP, Julia Temple Health Care Center, Englewood, CO
Use meal times to your advantage! Not only can you check in on your swallowing patients, but it is a great time to address following directions, sequencing, and attention during simple functional tasks — such as adding cream and sugar to their coffee, hand hygiene, cutting up their food, etc. It is also a great time to address communication and social interactions. The facility is their home. Tasks that might not be functional for your skilled population are functional and meaningful in LTC and memory care neighborhoods — for example, deciding which snack they want, finding their room, participating in activities, and deciding when and where they will eat.

Partner up with Activities or the Chaplain. They can provide the task, but you can provide the skilled eye, environmental modifications, and dynamic cueing that allows the residents to participate in a meaningful and engaged way. Maybe your restless patient needs to be able to come and go from the area, or certain residents shouldn’t sit near each other. It could be the resident needs parallel involvement that allows them to participate but with less environmental stimuli and/or distractions.

Don’t be afraid to “hang out” in the memory care neighborhood. Using a naturalistic approach allows you to see patterns in behavior, identify triggers of agitation, find other patients to evaluate, and get to know the staff better. I also try to do my documentation there because it provides me with more time to observe and engage. Read On...
Getting a Firsthand SNF Experience 
By Dennis Baloy, Therapy Resource, Flagstone-Momentum, CA
Congresswoman Young Kim, together with some members of AHCA, visited St. Elizabeth Healthcare in Fullerton, California, to experience firsthand how a skilled nursing facility in Orange County operates. The staff and the residents truly enjoyed some personal time speaking to her! 
We appreciate her for advocating for all of us back at the nation's capital!
Roy's Corner Legacy of Leadership
Rebekah Anekwe, New CTO 
Submitted by Aimee Bhatia, MSOTR/L, PAM, CTO, NCI Therapy Resource
I wanted to take a minute to congratulate our newest CTO in the NCI market in California: Rebekah Anekwe! Rebekah has been with our organization and at Victoria Care Center in Ventura for about seven years. In those seven years, she has completely transformed not just the Therapy team but the building with her influence. She has a deep passion for clinical programing, team development, patient outcomes, and overall doing things the right way. She has almost doubled the size of her team, initiated and expanded outpatient programming that was never tapped into, worked to improve relationships between Therapy and Nursing, and improved the culture in both the department and facility as a whole. 

Rebekah is fierce, she is dedicated, she is passionate about having the best clinical outcomes, and she knows that with good programming and the right heart, financials will follow. Rebekah treats her team like family, has developed a strong partnership with her current ED and DON in order to improve the facility and is truly humbled by this recognition. When we announced it to her team, the look of horror on her team members’ faces thinking she was leaving was priceless. They value her so much and have since announced that if she ever leaves, they will go with her — simply because she values them, helps them grow, and is a true advocate for the entire team. Thank you, Rebekah, for all that you do for Victoria Care Center. I’m excited to see how you further grow the success in your department culturally, clinically, and financially with this new title.
Be a Tow Truck, Not a Dump Truck
 Submitted by Barbara Mohrle, OTR, Therapy Resource, Keystone-N/E Texas
Keystone Northeast DORs continue to work on Building Their Legacy! As a follow-up to a recent meeting, we spent some time talking about how we can be a tow truck rather than a dump truck for our clinical partners. They came up with some great things they could “tow” off of the nurses’ plates.
Taking IDT Collaboration to Another Level By Asa Gardine, MS OTR/L, Sunstone Therapy Resource
Spearheaded by a tenacious PTA, Jake Dean, the Pinnacle Nursing & Rehab team of Price, Utah, set out to have some fun together outside of the hallways of their facility and at the same time strengthen the relationships within their team. Over the past few years, some staff in the facility found running to be a shared hobby, and they decided to train together for the Wasatch Back RAGNAR race. Their team is comprised of Julz, PTA; Jake, PTA; Haley, RD; Michelle, RN; Asa, OT; and Derek, COTA, and they call themselves “Team Pinnacle — ladas.” During the last year, they have spent countless hours training, pushing, inspiring and coaching each other to help prepare themselves for a successful race. While, of course, the training increased their teamwork and level of cohesiveness, the race day galvanized their relationships.  

Throughout the race, each runner struggled with extreme heat and difficult terrain, but they were able to look to each other for support. Watching as this race progressed, it was amazing to observe the growth and closeness of this team get even deeper. In a RAGNAR relay race, the final stretch at the finish line is to run together as a team. As we crossed together covered in sweat and dirt, there was a new bond forged that will invariably continue into the workplace with similar levels of support and love as each of us seeks to elevate one another.  
Loving One Another 
By Patrick Teuton, DPT, DOR, Arvada Care and Rehabilitation Center, Arvada, CO
In the world of health care, there is an increased prevalence of burnout that is exacerbated by staff shortages and long days in our facilities. At Arvada Care and Rehabilitation, the acuity of our skilled hall was really high, causing extra stress for our nurses and CNAs so they were feeling really tired and needed extra support. Showing that support for one another is vital to keeping the culture positive, and that requires a full team approach. The relationship between Nursing and Therapy is so important in our facilities, and to help out our Nursing colleagues, the Therapy team saw an opportunity to show some extra love during CNA week. We went out and bought gifts to create gift bags and hand-wrote thank-you cards for the Nursing staff to pass out to them. We then communicated with them on realistic ways that Therapy would be able to assist Nursing to help the days feel easier. We received a lot of positive feedback, and the Nursing staff told us they loved the gifts and appreciated the communication. As one of our core values, loving one another is so important in our effort to make it through this difficult time in health care and to have a little fun in the process!
Love and Laughter at Catalina in Tucson, AZ 
By Shelby Donahoo, Therapy Resource, Bandera-Tucson
Rehab got in especially early on Friday, June 17, at Catalina Care Center to start cooking! Bacon, sausage, berries, and pancakes were made by the team for all the nursing staff to celebrate CNA week. The theme was “Love and Laughter” as shown by heart-shaped pancakes and funny props for photos with “Therapy+Nursing” signs.

Nursing staff really appreciated the home-cooked effort and the therapists working the serving stations for them versus buying food. Plus, the facility smelled like bacon all day. 😊Thank you, Lori Mitchell and the Catalina team for truly showing “Love One Another.”
IDDSI Diet Training Keeps on Giving 
By Angie Taylor, COTA/TPM, Shawnee Post Acute Care, Overland Park, KS
We usually get to see the beginning stages of new trainings, but it is so important to see that training carry over at the facility level. Shawnee PARC has done an outstanding job of rolling out the IDDSI program and, most importantly, fully collaborating with the Dietary department and Nursing staff to roll out the program completely with ongoing training and reinforcement to ensure accuracy. 

It started after our IDDSI diet training from the resources that sparked a full IDT discussion and from collaborating on what strategies would ensure that we roll out a successful program. This included Speech Therapy, Dietary Management, Dietary staff and Nursing staff. The best strategy we determined was establishing a consistent, reliable line of communication. The team decided the easiest and most efficient way was to establish a Tiger Text account that was set up for dietary communication only. Read On...
Pictured L to R: Kyle Hosman-ST; Karin Martindale-Assistant Dietary; Sarah Lanning-ST
Millions Are Likely Suffering from Brain Fog and Other Cognitive Impairments Post COVID-19 Infection
by Elyse Matson, MA CCC-SLP - SLP Resource
It is estimated that nearly 100 million people have contracted Covid-19. Long-lasting symptoms occur in nearly one in four people, even when they were not hospitalized. The primary complaints of those with persistent issues are brain fog and cognitive fatigue. That means millions of people are walking around with cognitive issues likely affecting their lives.  

In a recent conference from ASHA, Rebecca Boersma, SLP of George Washington University Hospital, described a new outpatient treatment protocol to address these issues. These new patients are primarily female with a mean age of mid-40s. Recovery from these subtle but debilitating deficits does not follow the normal recovery timeline and tends to be remitting and relapsing in nature. Prominent deficits including attention, working memory, word finding, cognitive fatigue and processing speed. Read On...
Give Me A K … or How About TWO?! Kim and Katie!
Submitted by Paula Reyes, PT, CTO/DOR, Medallion Post Acute Rehabilitation, Colorado Springs, CO
Introducing Medallion’s growing Speech Therapy department: Kim Taylor-Barnes and Katie Gentile! Kim originally started with Ensign in 2015 as the DOR at Healthcare Resort of Colorado, but after a short hiatus joined Medallion in June 2019. Kim has developed excellent systems in monitoring cognition and swallowing and has exceptional communication with Nursing and Dietary. 

Katie started her student internship at Medallion in January 2022. Kim and Katie developed a great peer relationship and together developed excellent treatment plans, improved staff education regarding diet consistencies and dementia, and implemented fun and exciting group therapy sessions. They quickly realized that this partnership needed to continue. Katie joined our team as a full-time SLP under her CFY in May 2022. Together, this dynamic duo has doubled the SLP caseload with the expansion of our outpatient SLP program and has significantly improved Medallion’s SLP casemix. They have developed excellent collaboration with PT and OT for optimal therapy outcomes and discharge planning. The sky is the limit for these two! We are thankful to have Kim and Katie at Medallion!
Flag Celebration: Meadowview Nursing and Rehabilitation
Submitted by Dominic DeLaquil, PT CEEAA, Therapy Resource, Idaho & Nevada
Meadowview Nursing and Rehabilitation in Nampa, Idaho recently celebrated winning the facility’s first Flag!  

Prior to acquisition in May 2017, Meadowview (formerly Midland Care Center) was struggling. The reputation in the community was poor, culture in the facility was lacking, and Therapy was contract and had a strong “us versus them” mentality. Since then, Meadowview has undergone a complete transformation. The building has been remodeled, and an 18-bed skilled unit was added with a new and improved therapy gym. Therapy moved in-house, the culture throughout the building is one of the best throughout the organization, and Meadowview is now a facility of choice in the community...It was a touching celebration and even included the ED Melissa trying her hand at ice-sculpting under the tutelage of another ED in the market that is an accomplished ice-sculptor! Congratulations, Meadowview!  Read On...
Moments of Truth
Submitted by Angie Taylor, COTA/TPM, Shawnee Post Acute Overland Park, KS
Moments of truth come in all shapes and sizes. Sometimes it can be a moment of truth that shines through in our normal day-to-day job duties and roles that we have. As therapists, we are constantly advocating for our residents, but sometimes this advocacy goes above and beyond others. Our PTA Buddy Eblen did that for one of our residents. Kacie came to us initially with a fracture, then developed COVID pneumonia and had a long road to recovery to return back home with her Mom and daughter. Due to all these conditions, Kacie had a slow recovery where, at times, we were not sure if she would rehab home. Buddy was the voice and champion who kept fighting for Kacie and encouraging her not to give up. He was able to consistently work with her to make the functional progress with stairs and ambulation that she needed to achieve to return home. Read On...
Success from Collaboration
Submitted by Camrin Netty, MS, CCC-SLP, DOR, The Healthcare Resort of Leawood, KS
I am often inspired, challenged, and humbled by our staff here at The Healthcare Resort of Leawood, but recently I was especially moved at the display of teamwork implemented by four individuals from three different departments. Dangelo, one of our dietary aids, consistently goes above and beyond to care for our guests. One day, he noticed that one of our long-term care residents, Norma, was having difficulty with eating breakfast. He immediately communicated with Catherine, one of our COTAs, his concerns for Norma. Catherine, in collaboration with fellow COTA Erin, alerted our LPN Rilee, who promptly assessed her and documented a change of condition related to Norma’s range of motion that was impacting her ability to feed herself. Rilee then communicated this change of condition with our Therapy department to make sure that Norma was placed on OT schedule for evaluation. The communication and diligence implemented by Dangelo, Riley, Catherine, and Erin reminds me of the quote by Hellen Keller: “Alone we can do so little. Together we can do so much.” It took the collaborative effort of these individuals to impact a positive movement in the life of Norma.
Recruitment and Development Initiative: "BE A PART OF THE CURRICULUM"
Submitted by Mira Waszak, Therapy Resource, Pennant-Washington
Joe Pergamo, DPT, DOR at Rainier Rehab in Washington, will be providing clinical inservices and mock interviews to COTA students at Pima Medical Institute every seven months. Today's topic centered on therapy and dignifying long-term care! Thank you, Joe!
DORiTO Steps in to Help Cluster in Need 
Submitted by Mira Waszak, Therapy Resource, Pennant-Washington
Josh Clarke, DPT, is a Physical Therapist at Rainier Rehab and is currently in the DORiTO program. When he heard we were in need of a PT and DOR at Bainbridge Island Health and Rehab, he was up for the challenge. He travels two to three nights per week away from home and is a ray of positivity and professionalism. He is humble and seeks out every opportunity to learn and develop his leadership. The residents and his coworkers wish he could move there permanently, but we are grateful for his commitment to helping. Thank you, Josh!
Therapy Dream Team Partnership at La Canada Care Center
Leading with Humility and Ambition 
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. Read On...
Therapist Profile
Jeffrey Montesclaros, DOR Cloverdale Healthcare
The Red Bike: A Short Story of Redemption from Depression
...My story is not about depression but more about resilience. Through our life experience, my wife and I became very resilient and we developed a problem-solver mindset.

Our story started in 2005 as newlyweds. My wife, Raissa, had this idea of migrating to the United States to pursue her adventure of traveling. Prior to that, I already had a stable job working as a team supervisor for a call center, and my wife was already enrolled by her parents to be a doctor. Our parents were not very hopeful that we would make it in Uncle Sam's land. But my wife and I are stubborn. Needless to say, we won that battle, as we ended up in a very small town in Guymon, Oklahoma, with a population of less than 10,000. I worked multiple jobs, from a meat packing factory QA supervisor, to Walmart department manager, to liquor store attendant, to mowing lawns and doing carpentry work on weekends while my wife worked at a small hospital as a lab medical technologist. Still in our 20s, we bought our first house in 2009 in a bigger city, Tulsa, Oklahoma.

Everything was set and planned, from having a stable job to getting reliable cars and having our first home. Now we were ready to grow our family. And yes, we did. After two miscarriages, we finally had a child named Justin, and he was our bundle of joy in 2012. Sad to say “had” because the only thing that was not according to plan was having a child with a rare genetic disorder who only lived to be 18 months old. Justin was born with peroxisomal biogenesis disorder, which affects multiple systems in the body. Our little Justin suffered from frequent seizures, hypotonia, liver and kidney issues, blindness and many other health issues. He was fed through a G tube and later had a tracheostomy tube to help him breathe. Read On...
The Last Facility with Contract Therapy Goes In-House
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: Read On...
Irondale’s Home-Grown Recycling Program 
By Steve Hudak, MPT, DOR, Irondale Post Acute Care, Commerce City, CO
When Alex moved into Irondale in April 2021, he noticed there was no recycling taking place. He teamed up with Steve Hudak, MPT/DOR, to do something about it. Steve purchased a can crusher to attach to an outside fence, and Alex took to the halls persuading other residents at Irondale to save their cans. Daily, Alex separates the tabs from the cans to donate to the Ronald McDonald House, and Steve takes the cans home to throw into his recycling bin. So far over 100 pounds of cans have been kept from going into our waste system! It is great to see the teamwork of the facility do a little something to make our planet better.
Welcoming New Staff with Personalized T-Shirts 
By Jessica Foster, Therapy Resource, Bandera-AZ
Therapists Kirsten Gilbert, OT, and David Boyd, COTA, from Rio Vista Post Acute in Peoria, Arizona, surprised their rehab team with individually made shirts for each of their disciplines! They have been working hard over the last couple of months to welcome new staff and wanted to have shirts that were fun that they can wear out on group outings. They have been planning a group outing each month to wear their shirts, most recently to bowling and a pool party! 
Pecan Valley BBQ Success 
By Kathey Fawn, Therapy Resource - Keystone
Kathey Fawn, Therapy Resource for Keystone, teamed up with Sandra Robles, MDS Resource and the Alamo Cluster MDS, DON, ED team and all the resources that support the Missions Market to host an employee appreciation BBQ for Pecan Valley in San Antonio, Texas.  
What Market or Facility Can Have the Most Fun with Their Patients and Staff Today?
By Jon Anderson, DPT, Senior Therapy Resource
Think, for a moment, about playing like a kid. We need to get back to that! I challenge you today to create a special memory with your patients and staff: Play like a kid, and most importantly, HAVE FUN! I know we have some FUN people out there on our teams, and many of you receiving this newsletter are already little FUN factories. Amp up the fun factor, and share your Special skilled play and fun with our patients via group therapy today!