27101 Puerta Real, Suite 450
Mission Viejo, CA 92691

July 2019

Over 250 therapy leaders gathered in Newport Beach to create a Therapy Leadership Experience powered by love! The theme of this year’s experience resonated throughout our amazing two days together spent in learning, loving and leading. Beginning with an optional yoga session in the outdoor amphitheater each morning and continuing with healthy meal and snack options combined with fresh flowers and an indoor/outdoor ambiance, the tone of the event centered on wellness.    
The WELL Project Team provided context to the idea of creating a wellness movement with the goal of not only helping ourselves, but also leading by example to positively impact all with whom we come in contact. Leaders provided written notes of gratitude, WELL Commitments and ideas for inspiring wellness among one another. Read On...

T  hanks to Alan Gibby for lots of great photos! Click here for Part 1 ... and Part 2
Got Joy?  The therapists, nurses, residents and IDT members at Mt. Ogden Nursing and Rehab do, and they are sharing these joyful moments through messages and photos. How will you inspire a WELL movement like DOR Brooke Stanley and her team did?
Therapist Profile: Roger Pavon
Roger Pavon has been part of the California Southland family for over 20 years and was one of our original pioneers who traveled via the “Southland bus” and “Southland jet” to help our affiliate operations in San Diego and Northern California. Roger was instrumental in helping implement in-house therapy with the then-named Northern Pioneers operations.    
“Roger and his wife, Grace, have three beautiful kids who grew up with us at Southland. He is a humble, loving, passionate therapist who knows how to bring out the best in every patient. My mom could not smile anymore by the time her Parkinson’s had advanced, but the moment we brought her in for outpatient services at Southland in 2017 and she saw Roger, she smiled for the first time in months with tears of joy in her eyes,” said Mary Spaeder of her appreciation of Roger.       Read On....
Highlights on Nursing and Therapy Partnership
At Glenwood Care Center in Oxnard, CA, Cherryll Santos (L) and Aimee Bhatia (R) have a unique close relationship. Cherryll’s 18 years of leadership are evident in the culture of the nursing department, as this is a happy, cohesive team with strong clinical systems in place. Aimee, DOR, has been at Glenwood as a treating OT for five years, and a DOR for almost three. The relationship between these two leaders has a big impact on how nursing and therapy work closely together.

Cherryll and Aimee collaborate on clinical decision making and utilize each other’s strengths to collaborate with physicians, build programs, nurture relationships with families, and ensure excellence in patient care. The therapy team has a Culture Committee to partner with nursing in spreading love, celebration and appreciation to the CNAs and nursing staff. It’s amazing what a little bit of recognition and gratefulness does to boost morale!    Read On....
Getting Credit for Joint Replacement
By Lori O'Hara MA, CCC-SLP, Therapy Resource - ADR/Appeals/Clinical Review
Say your patient had a hip replacement after a fall with a fracture. Coding rules say you code the fracture first, not the aftercare code. But that’s fine — as long as you check the box that says “Hip Replacement” in section J of the MDS, then the fracture code will automatically “bump” up into the Major Joint Replacement, right?

Wrong! The bump is not automatic. The fracture code that’s selected has to be eligible for re-categorization.
But how do I know? you are asking yourself.
Easy! Look at the map! Read On...
CNA to RNA Training Workshop
Flagstone – Touchstone 2.0 therapy hosted a CNA to RNA training workshop with 38 CNAs in attendance from Panorama Gardens, Camarillo Healthcare, Glenwood Care Center, Victoria Care Center and Villa Maria to participate in a certification training. The nurses were excited about how interactive and in-depth the training was and are excited to be ready to step into an RNA role in their facilities.  PDPM, here we come!  It is giving us the opportunity to expand our RNA programs to better serve our patients.
Clinical Guides Are Available for Our SLPs!
In preparation for PDPM, the SLP Case Mix Committee wanted to make sure that clinical tools and resources would be available along with training related to the SLP Case Mix. The committee got to work and created clinical guides for aphasia, cognitive impairments, dysphagia, motorspeech and trach/vent. These tools were designed to partner with the PDPM SLP Case Mix Comorbidities and also provide clinical support for the SLPs. Each clinical guide includes standardized assessment recommendations based on clinical characteristics, treatment ideas and documentation tips. All of the tools are located on our therapy portal under Clinical Programming within each topic area. 
LTC Think Tanks--A Vision to Reality By Kai Williams, Therapy Resource
We are only just beginning! We started with a vision about wanting to share the best practices that we are seeing in our facilities throughout the organization. With a centered focus on long-term care, we turned our vision into reality with the creation of the LTC Think Tanks. Click here for a brief recap about a few of our LTC Think Tanks, and we hope to continue to bring you innovative, inspiring, passion-driven ideas to help keep your long-term care residents performing at their highest level of potential with the ultimate goal to decrease their risk of further decline.

If you or members of your team would like support in program development, patient care identification strategies, and/or feedback on questions regarding long term care, please reach out to LTC_TaskForce@ensignservices.net Our mission is to provide a centralized hub to facilitate the dissemination of ideas. 

Updates: Point of Service Documentation
(Part 2 of a 2-Part Series)
By Mahta Mirhosseini, Therapy Resource
In Part 1 of our Point of Service Documentation (POS) series, we discussed how POS style documentation can have great therapeutic benefits over traditional treating first and documentation at the end of the day. If you missed the first part of this series click here . Today’s post on POS documentation will highlight our therapy EMR’s POS platform: Optima’s Point of Care or POC (pronounced “pok”). Let’s see how POC helps with efficient POS documentation.

POC is designed with the treating and documenting therapist in mind. That is why it does not have administrative and reporting features to slow down the system. Read On...
Group Therapy
Orem’s Trip to the Zoo!
By Kelly Alvord, Therapy Resource
After piling into Orem’s van and renting another large van and hauling wheelchairs with another rented trailer, 20 residents made their way to Hogle Zoo! Staff members and their families volunteered to make this day possible. To quote DOR Mark Walker, “What an experience! A lot of work, but the smiles on these 20 residents were priceless.” Thanks, Mark, and everyone at Orem for making these memories and elevating the lives of everyone involved!    
Group & Concurrent – The Data and the Delivery by Chad Long, Therapy Resource
As we close out June, we find ourselves only three months away from PDPM! So how are we doing? Overall as of May, we are providing 5% clinically appropriate Group & Concurrent to all Payers and 17% to our Non-PPS Payers.
How does each affiliated company stack up? Here are a few stats through May. Read On...
Therapy Updates
Congratulations to DORs, Kristen Weaver (left) and Angela Anderson (right) who were newly named a CTO (Chief Therapy Officer)! Additional announcements have been made and will be featured in next month's FlagPOST.
Host an Entry-Level OTD Capstone Student: A Great Way to Extend the Reach of Your Department By Ciara Cox, Therapy Resou rce
As many of you know, entry-level occupational therapy degrees are available at the master and doctoral level. Excitingly, part of the included requirements for an entry-level OTD is a 14-week Capstone experience .

The students will have finished their internships and will be looking for 14 weeks in-depth exposure to one or more of the following areas:  Read On...
How to Pull the BIMS from PCC
 By Gary McGiven, Therapy Resou rce
This is very good information for our SLPs to justify if there is a need to further evaluate the cognitive function of our residents. DOR Eileen Baker did this at Draper, and Jamie, her SLP, added two to her caseload with no sweat. This is in a building with one of the smaller long-term caseloads. Hopefully we have provided our SLPs with necessary resources for them to further evaluate the cognitive function. If we haven’t, this can be a good tool to show your ED. Picking up one patient will more than pay for most of these tests our SLPs want.
PCC report to access BIMS score:
Go to clinical>reports>assessment scoring> choose date range wanted> click scoring magnifying glass> choose BIMS> run report
CEU Course Offering Aug 24-25 Innovative Interventions for Preventing Falls
By Nelson Layos, Therapy Resou rce
If your team didn’t get a chance to attend last April’s CEU class at Southland Care Center in Norwalk, CA, we scheduled the same class this Aug. 24 and 25, “Innovative Interventions for Preventing Falls,"  limited to 50 participants (prioritize full-time staff ). Please provide names of therapists/assistants who want to attend (PT, OT, PTA and COTA) to Nelson Layos, nlayos@ensignservices.net , as quickly as possible.

This year, the contract is for $170 per participant. Please discuss approval for attending this CEU course with your ED because each facility will be paying per number of attendees. Location will be in Southland Care Center (auditorium), 11701 Studebaker Road, Norwalk, CA.
These DORITOS Aren't for Munching !
We currently have 28 therapists as part of our Director of Rehab in Training Opportunity (DORITO) program, with seven markets represented across the organization. We spoke a lot at the Therapy Leadership meeting in June about developing your successor. Who are you training to be the next leader in your building, your cluster or your market? The DORITO training program is a unique opportunity for therapists to learn from other therapy leaders and Service Center leaders. Built to Last (Jim Collins) speaks to “homegrown management” as one of the principles practiced by the most successful companies that they studied. Consider the DORITO program to grow your people, develop leaders and prepare for growth!  
Heart Beats - Using HeartMath Spontaneously
 by Casey Murphy, Therapy Resource
I was at our Legend Greenville facility to assist with Mock survey, and I ended up (organically and unplanned) doing an impromptu in-service with the therapy team on HeartMath. I demoed the Bluetooth device on one of the therapists who told me she was “stressed,” and we saw amazing results just with a three- to five-minute session (in front of a bunch of therapists!). She felt more relaxed afterward and was smiling a lot more for the duration of the day.
The team was so impressed, they wanted to try it on one of their patients. I sat with a speech therapy student with a patient who had dementia (and a pacemaker). I was able to sit and talk to her, taking her through the breathing exercises and talking about her family for a total of 6.5 minutes. She was only in high coherence for 12% of the time, but was in medium coherence for a whopping 41% of the time. We ended things with her smiling and thanking me for taking the time to talk to her about her family. The supervising SLP told me that she normally is not able to hold her attention; in fact, they had a goal for holding attention span for five minutes. She also told me she is usually very anxious.   Read more....
Moment of Truth
Submitted by C. Scott Hollander, DOR, Pointe Meadows, Lehi, Utah
In the middle of June (no special occasion), one of our residents and therapy patients, J.C., and our physical therapist, Mitch Gibson, DPT, planned to dress up like clowns together just for the fun of it to celebrate life. Mitch even rode in on his 6-foot-tall unicycle! These two frequently plan together the day before to match in their dress; this time, they went all out! Thanks to Mitch for living our core value of Love One Another. And thank you to Mitch and J.C. for bringing smiles to all the resident and staff faces!