27101 Puerta Real, Suite 450
Mission Viejo, CA 92691

June 2019

Welcome to Our New Monthly FlagPOST!
Our hope is to connect you with leaders and ideas across the organization to stimulate enthusiasm for growth and development by learning from one another. We will have ongoing “columns” on PDPM, Financial Health, Business Development, Best Practice Highlights, and Best in Nursing and Therapy Partnerships. Enjoy! 

Leading with Love
We are eagerly anticipating a very special Annual Therapy Leadership Experience set to kick off on the evening of June 10 at the Hyatt Newport Beach in this, our 20 th year of operation as an organization. This year’s theme: JOY in Leadership: The unexpected power of leading with love , sets the stage for a beautiful line-up of leadership, learning and true fun! The evening of June 10 is expected to be an evening filled with JOY as our leaders arrive and begin catching up with one another and our business partners from around the country in a fun, casual atmosphere.  A central focus throughout the meeting will be on topics of The WELL Project with focus on suggestions for strengthening mind, body, spirit and heart for optimal well-being. With 16 different Think Tank Sessions to choose from and time with leaders including our own Clay Christensen, Beverly Wittekind, Tyler Douglas, Barry Port, Debbie Miller, Spencer Burton, as well as CMS Leader John Kane, our DORs will have an opportunity for growth like none other. Our central focus of the think tanks will offer DORs a deeper look into PDPM along with opportunities for strengthening therapy presence through program development, marketing for census development and expanding roles and responsibilities in response to payment changes on the horizon.  
Highlights on Nursing and Therapy Partnership
Pair to Care!
By Jon Anderson, Senior Therapy Resource
The Keystone Directors of Rehab and Directors of Nursing came together in League City, TX for a two and a half day retreat with a focus on Resilience and growing together in partnership.  The agenda included topics such as Heart Rate Variability and Heart Centered Breathing as practical solutions to help you lower your stress, revitalize energy and resilience and restore your mental, emotional and physical balance, as well as a day of learning about various programs, the highly anticipated Medicare payment system change called PDPM and financial review. Through a silent auction, the nurse and therapy leaders raised nearly $6,000 for the Emergency Fund. And the awards ceremony showed YTD best ever clinical survey results, decreasing turnover and significant strength in clinical and therapy programming as evidenced by other amazing results such as quality metrics and program growth. 
T he Dynamic Duo at Legend Oaks New Braunfels: The Strong Partnership Between Nursing and Rehab
By Stephanie Winkler, M.A. CCC/SLP, Central Texas Therapy Resource
(L) Roy Buckley, DON, and (R) Kyle Martin, DOR, L egend Oaks New Braunfels, TX, truly exemplify excellence in nursing and therapy partnership. Together they have helped Legend Oaks New Braunfels become one of the leaders in programming in our industry and the facility of choice in their area. These two amazing leaders have embraced the Abilities Care Approach and have made it their goal to keep their residents with Dementia happy and to live life with a purpose.  Kyle and Roy worked together to begin the life story boards and to train their CNAs and Nursing staff to better communicate and help our Dementia residents to remain at their highest functional level.  

Roy was right on board with supporting his CNAs with the Abilities Care classes and helping to bring awareness and dignity to his Long Term population. The CNAs loved the class and so far, each CNA that has graduated from the course continues to be employed at Legend Oaks New Braunfels.  

Roy and Kyle have worked with the staff and have added a “Bus Stop to No Where,” and have written and been approved for two state grants to include shadow boxes (for memory cues) and a brand new sensory room. This outstanding partnership has made great programming possible. The results are showing in family and resident satisfaction, improved quality measures, and an overall decrease in declining conditions. The facility has seen that with great care through rehab and nursing, wonderful things happen.  
Deciding the Principle Medical Diagnosis
By Lori O'Hara , MA, CCC-SLP, Therapy Resource - ADR/Appeals/Clinical Review
Although the PDM only affects therapy buckets, determining the most appropriate diagnosis to put in the first position is an IDT Decision. It is meant to reflect the condition that most strongly explains the reason the patient needs to be skilled in the SNF, and sometimes that is not necessarily the condition for which they need rehabilitation (although it will be often!) The DOR and the therapy team should discuss the reasons the patient needs any therapies they’re receiving, and then the DOR discusses that with the IDT to reach a decision. Here are few decision making examples:  Read On...
Financial Health
By Ciara Cox, Therapy Financial Resource
  • Did you know that 5 minutes (in an 8-hour day) is 1% productivity?
  • Did you know that for every 12 minutes of clinically appropriate concurrent-treatment you do in a day, your productivity would increase 1%?
  • Did you know that a 1% increase in productivity decreases our Cost-Per-Minute by 1.4 cents?
  • Did you know if we had done 1% more clinically appropriate concurrent treatment in April we would have saved Ensign Affiliated SNFs $189,000?

Updates: Point of Service Documentation (First of a 2-Part Series)
By Mahta Mirhosseini, Therapy Resource
Traditionally, therapists have approached treatments and documentation in a compartmentalized fashion; a hands-on treatment session was provided, then documentation was done after the session was over, often times at the end of the day. With increasing use of technology and EMR software in healthcare, you may be hearing more talk about Point of Service documentation in our therapy settings. Some therapists wonder whether POS documentation can be done effectively, or if it may take quality treatment time away from patient care. Here, we discuss how POS charting can be an effective adjunct to the therapeutic process when it is done correctly.  Read On...
Group Therapy
Benefits of Group Mode of Treatment
By Chad Long, Therapy Resource
As we move closer to October 1 st changes with PDPM, many therapy programs have made concerted efforts to implement Group and Concurrent modes of treatment and have noted how their patients are enjoying them.  Since January of 2 019 we can see a significant shift to adding multi-patient treatment programming across several affiliated companies.   What is the impact of group treatment to our organizations?  Let’s briefly look at how these modes of treatment have an effect on Financial, Clinical and Cultural outcomes.
Successful Implementation of Group Interventions for SLP Treatment Plans
By Tamala Sammons, Senior Therapy Resource
There has been a lot of energy around implementation of group therapy. It’s a great way focus therapeutic interventions on retraining previously learned skills, reinforcing strengths, teaching compensatory strategies, developing functional skills, and increasing self-awareness to facilitate successful adaptation or adjustment. A big part of speech-language pathology intervention focuses on effective communication and compensatory strategies. Clinically appropriate group intervention is a great treatment approach to assess the effectiveness of skills trained and carry-over of compensatory strategies. Patients enjoy these activities that take them away from their daily normal treatments. Additionally, there is a lot of literature that points to the importance of opportunities for social engagement as part of rehabilitation. Speech-Language Pathologists have many fun ways to integrate group based on various clinical conditions being treated.  Read More Here....
Inaugural Natalie Blascienski Award
This new special award, in essence, emulates the spirit and incredible human being that Natalie was.  Read her story here....
When Natalie passed, we knew there was really only one person who could help the Euless team make such a difficult transition. Kim Graybeal has eased the burden with grace and dignity. She carries Natalie’s memory in high esteem and continues to hold their team together in ways that few others could. In spite of the huge void left by our beloved Natalie, we award Kim with the first annual Natalie Blascienski Award to recognize how she has stepped up in the face of adversity, shown leadership in times of turmoil, and displayed unconditional love to her team, her facility, and to Natalie and her family—many traits that Natalie possessed. Please join me in congratulating Kim Graybeal, DOR of Legend Euless, as we honor her with this prestigious award.
(L to R): Natalie, with Hillary Golec and Kim Graybeal
Therapist Profile: Jacob Barnes
Did you know….
Jacob Barnes is the Therapy Program Manager at Park Avenue Health & Rehabilitation Center in Tucson, Arizona. Inspired by his Occupational Therapist mom, he began volunteering at Northwest Hospital in Tucson when he was 14 – only to be offered a paying job when he turned 16. After becoming bored with work in hospital transportation, Jacob trained to become a Patient Care Technician and ultimately, the hospital paid for him to complete the Physical Therapy Assistant program at Pima Community College. 

This proven Ensign leader has an obvious talent for creating outstanding Animoji’s, but his hidden talent is crossing his eyes – while keeping one eye straight. He hasn’t revealed this talent to his 5 and 2 year old sons yet – but it will be interesting to see if they have inherited this strange but amazing ability! A Pittsburgh Steelers fan, Jacob spends his down time hanging out with his family, studying Jujitsu with his son, and when he gets the chance, scuba diving with his wife in places that include Jamaica, Mexico, Hawaii and California.  Read More Here....
Brindy Klym!
B rindy Klym, a May 2019 OT graduate from Florida Gulf Coast University, is our 2 nd quarter SPARC winner! 
Daily, I do my best to live by Mahatma Gandhi’s words, “Be the change you wish to see in the world.” I envision a world of greater creativity, compassion, and empathy, and strive to embody these traits in order to help others live happier, healthier lives...

Welcome to our New Partners!
Alta Mesa Health & Rehabilitation, Mesa, AZ
Downey Post Acute Care, Downey, CA
Mainplace Post Acute Care, Orange, CA

Phoenix Mountain, Phoenix, AZ
Rio Vista Post Acute Care, Peoria, AZ
St. Elizabeth Healthcare & Rehab, Fullerton, CA
The Hills Post Acute Care, Santa Ana, CA
Villa Maria Post Acute Care, Santa Maria, CA