The Roots & Branches Blog

Evergreen Rehab Employee Spotlight: Todd Winston, M.S. CCC-SLP

evergreenadmin — Thu, 16 May 2013 18:13:57 +0000

Todd Winston, M.S. CCC-SLP

My name is Todd Winston and I have been a Speech-Language Pathologist since graduating from the University of Central Arkansas in 1998. I am the proud father of a 12 year old, a 6 year old, and a 6 month old. They simultaneously keep me young and turn the few hairs I have left on my head grayer each and every day

A different kind of therapy: Todd circa 2003

In the almost 15 years in which I have been a SLP, all but one of those years have been spent in geriatrics, either in skilled nursing facilities (SNF), acute care, or outpatient. The one year that I left my comfort zone was for the experience of early intervention. I became aware of an SLP's job description in high school when a close friend of my Dad's had a stroke and began outpatient therapy with PT, OT, and SLP. This eventually led to me becoming obsessed with anything neourologically related and making my decision for a major in college very simple. I have worked for Evergreen Rehabilitation since 09/09/09 (coincidentally, 9 is my lucky number) and currently work at the North Point facility in Lexington. As a huge fan/nerd of history, I genuinely look forward to conversing with and learning from each and every one of my patients on a daily basis. Through all the intermittent confusion and occasional depression, there exists a wealth of knowledge and wisdom that lives in every resident I treat that makes my job and my life that much more rewarding.

As far as success stories go, nothing beats seeing the look of satisfaction and pride on a resident's face when their diet is upgraded to a level that we all take for granted. It's always nice to see a Pt be able to return home with family and the improved ability to communicate wants/needs can never be overlooked, I take the most satisfaction in telling a resident and/or their family members that the need for pureed foods and thickened liquids do no exist anymore!

Join Evergreen Rehab in Celebrating National Nursing Home Week

evergreenadmin — Mon, 13 May 2013 19:26:35 +0000

The theme for this year's National Nursing Home Week is "Team Care - Everyone Pitches In." This year's theme is meant to recognize the many different team members whose collaborative teamwork results in optimal patient outcomes in long-term care communities around the nation.

National Nursing Home Week (May 12 - 18, 2013) is an interdisciplinary event that recognizes and celebrates not just the staff members in long-term and post-acute care communities, but also the patients they care for. The American Health Care Association (AHCA), which sponsors National Nursing Home Week, is encouraging skilled nursing centers across the country to plan and engage in team building events that involve staff, patients, and their families. For ideas and a detailed planning guide on how to celebrate NNHW 2013, visit AHCA's page. Or, if you have a great idea already, share it with the world on the NNHW Facebook page.

Aural Rehabilitation: Addressing the "Hearing" in Better Hearing and Speech Month

evergreenadmin — Sat, 11 May 2013 19:25:20 +0000

As therapists serving residents in Skilled Nursing Facilities we should have increased awareness that an individual’s auditory acuity has a direct impact on their ability to understand the spoken language of friends, family members and caregivers therefore affecting abilities to participate in meaningful interactions.

The Scope of Practice for Speech-Language Pathology includes interventions for aural rehabilitation including auditory rehabilitation, auditory processing, lip-reading and speech reading which are covered services related to perception and comprehension of sound through the auditory system.

Interventions considered Medically Necessary include:

Auditory processing evaluation and treatment such as those related to neurological impairments or the absence of natural auditory stimulation that results in impaired ability to process sound.

Note: Certain auditory processing disorders require diagnostic audiological tests in addition to speech-language pathology evaluation and treatment.

Collaboration with Audiology:

Evaluation and treatment for disorders of the auditory system may be covered and medically necessary when it has been determined by a speech-language pathologist in collaboration with an audiologist that the hearing impaired beneficiary’s current amplification options (hearing aid, other amplification device or cochlear implant) will not sufficiently meet the patient’s functional communication needs. Audiologists and speech-language pathologists both evaluate beneficiaries for disorders of the auditory system using different skills and techniques, but only speech-language pathologists may provide treatment.

Evaluation Inclusions:

Evaluation of comprehension and production of language in oral, signed or written modalities, speech and voice production, listening skills, speech reading, communications strategies, and the impact of the hearing loss on the patient/client and family.

Intervention Inclusions:

Examples of rehabilitation include but are not limited to treatment that focuses on comprehension, and production of language in oral, signed or written modalities; speech and voice production, auditory training, speech reading, multimodal (e.g., visual, auditory-visual, and tactile) training, communication strategies, education and counseling. In determining the necessity for treatment, the beneficiary’s performance in both clinical and natural environment should be considered.

(Medicare Benefit Policy Manual Chapter 15: Section 230.3 Practice of Speech-Language Pathology)

Evergreen Rehab Employee Spotlight: Hannah Rosemeyer, M.S. CCC-SLP

evergreenadmin — Thu, 09 May 2013 16:57:59 +0000

Hannah Rosemeyer, M.S. CCC-SLP

Personal Info

My name is Hannah Rosemeyer and I received my Master’s Degree in Speech-Language Pathology from the University of Memphis in 2010. I currently reside in Memphis with Sean, my husband of one year, and three lively dogs.

Why I Decided to Pursue a Career in Speech-Language Pathology

When asked why I decided to pursue a career in Speech Pathology, I thought to myself how I would try to shorten my answer, since the path leading up to this pursuit has been a long one. My upbringing was different than most, as my parents have been missionaries to South America for 35 years and counting. My sister and I were raised in Brazil until our late teenage years, speaking both Portuguese and English. Being raised in a foreign country, my love for language and culture naturally developed.

From a very young age I watched my parents’ love and dedication towards helping those in need and it sparked the same desire in me. While growing up, I always knew I wanted to help those in need.

My younger sister was a late talker and later diagnosed with Language-Based Learning Disabilities, which was only compounded by being raised bilingually. Everyday reading and writing tasks became a nightmare for her, while homework was a family effort. With the help of a reading specialist (as she was called in the early 90s) my family learned the tools to help my sister make it through not only high school but through college as well. Thanks to my sister, I have been breaking down tasks, reducing background stimuli and providing cues for a long time!

As a teenager, I was first introduced to the medical side of speech therapy when my grandfather suffered a stroke affecting both his speech and swallowing skills. I was able to experience first-hand the progress he made, with the help of a speech pathologist and my wonderful grandmother. With many hours of hard work, he was eventually able to regain his speech and swallowing function.

Because of these life experiences, becoming a speech pathologist was only natural to me. Having a job that combines all of the elements that helped shape who I am almost seems too good to be true!

My Evergreen Story

During graduate school I was introduced to the wide scope of Speech-Language Pathology, from early intervention programs to acute care settings. However, I graduated without having experience in a Skilled Nursing Facility. As I was applying for my Clinical Fellowship (CFY), I decided I wanted to take the opportunity to learn about a setting that was unfamiliar to me. In October of 2010, Evergreen Rehab gave me the chance to do so at Pine Meadows in Bolivar, Tennessee. I have been hooked ever since!

Lessons Learned

I have learned so much from patients, fellow therapists and coworkers in the short time I have been practicing. One of the first things I learned working in a SNF was that I needed to adjust my expectations for progress. I realized that progress is a lot slower than it had been with patients in other settings. That in itself was a learning experience for me. I quickly learned to celebrate small successes, such as when a patient remembers to look at a calendar to recall the date, or to press the call-light when in need, or to take small bites during lunch.

I have also learned the importance of interdisciplinary communication. I make an effort to frequently communicate with not only the CNAs and nurses, but also with the dietary staff, activities coordinator, social workers, and restorative staff.

Carry-over is nearly impossible without having the entire team on board. While ensuring their privacy, I discuss patient’s limitations and expectations in order to ensure carryover during all aspects of their care, such as daily living and social activities.

I attempt to reinforce this carryover by introducing myself first; getting to know staff members by name and eventually showing caregivers what the patient is capable of. I have learned that caregivers are often surprised by a patient’s abilities, such as feeding themselves or singing a song when given the proper cues and opportunities to do so.

As important as interdisciplinary communication is, I have also learned the importance of acknowledging and thanking staff members when they take the time to utilize safe swallow or communication strategies. I try to remember to thank those who properly position a patient for a meal or use a communication board when a patient is unable to verbally communicate. Appreciation goes a long way. Furthermore, establishing a relationship with all staff members of the facility not only helps the patients’ overall quality of life, but also opens the door for future communication.

I have thoroughly enjoyed the few years I have been practicing Speech-Language Pathology and I have so much more to learn. I am excited for the future of this field. I love what I do and I hope that my passion continues to show through my work with every patient that I treat.

Celebrating National Nurses Week 2013

evergreenadmin — Tue, 07 May 2013 18:35:54 +0000

The American Nurses Association (ANA) has posted the following in celebration of this week being National Nurses Week. Please see below:

"National Nurses Week 2013
Delivering Quality and Innovation in Patient Care

Often described as an art and a science, nursing is a profession that embraces dedicated people with varied interests, strengths and passions because of the many opportunities the profession offers. As nurses, we work in emergency rooms, school based clinics, and homeless shelters, to name a few. We have many roles – from staff nurse to educator to nurse practitioner and nurse researcher – and serve all of them with passion for the profession and with a strong commitment to patient safety.

Background
National Nurses Week is celebrated annually from May 6, also known as National Nurses Day, through May 12, the birthday of Florence Nightingale, the founder of modern nursing. Visit the NNW History page, part of the NNW Media Kit."

In addition, today (May 7) is Nurse Assessment Coordinator day. Find out more about the role of Nurse Assessment Coordinators at the AANAC's website here. On behalf of our skilled therapists (PTs, OTs, SLPs), assistants, and the patients we all serve, Evergreen Rehab would like to say thank you to the nurses across the nation. You are an integral part of any healthcare team. Thank you for all that you do!

Source: http://nursingworld.org/nnw

Evergreen Rehab Employee Spotlight: Katie Ford, M.S. CCC-SLP

evergreenadmin — Fri, 03 May 2013 16:27:51 +0000

Katie Ford, M.S. CCC-SLP

My name is Katie Ford and I am the speech-language pathologist and rehab director at Metcalfe Healthcare Center, a 114 bed facility, in Edmonton, KY. I currently live in Bowling Green, KY with my three year old little boy, Layne. I have worked with Evergreen Rehab here at Metcalfe Health Care Center for four years.

Working in long term care in a rural area such as Edmonton has many challenges, but Evergreen has provided our team with support, compassion and guidance throughout. When I first started with Evergreen in February 2009, our team consisted of only one full-time certified occupational therapy assistant (COTA), one physical therapist assistant (PTA) and a PRN occupational therapist (OT) and physical therapist (PT). Through hard work and our dedication to quality patient care we have grown to a full time staff of one PT, one PTA, two OT's, one COTA, and a therapy tech, along with a great group of PRN staff members. One of the things we are very fortunate to have at our facility is great team dynamics and strong communication between all therapists. Consistent with the small town family feel you find in this community, we incorporate that not only into our patient care, but our treatment of each other. Another factor that has helped our success here is our open line of communication with nursing.

Maintaining an open and supportive relationship between therapy and nursing, to me, is one of the largest factors in providing successful and quality patient care. I depend on CNAs for a large number of my speech therapy referrals, along with referrals for other disciplines. The CNAs are often the ones that care for our patients on a daily basis and are the ones that will be able to notice a change in a patient's status quicker than any other staff members. Having that strong relationship with the CNAs is something I value greatly. I want them to feel comfortable enough with me to be able to come to me with questions or concerns. Unfortunately, I have seen situations where the CNAss have been “talked down to” by therapists. Being respectful to all staff members - from housekeeping all the way through administration - is something I strive for as a therapist and request from all of my therapists as a rehab director. After all, we are all on the same team with the same goal of providing a positive and successful experience for all patients at our facility.

For me, long term care is where I know I belong. The daily intrinsic rewards of it make it not only a job for me, but a calling. Success to me depends on being able to feel as if I am making a difference and believing that the simplest acts of kindness and compassion can have the strongest impacts on others. I'm very grateful that I'm able to work at a facility, with a group of therapists, and for a company that value these same beliefs.

May is Better Hearing and Speech Month

evergreenadmin — Wed, 01 May 2013 17:46:25 +0000

May is Better Hearing and Speech Month! We hope to improve understanding and knowledge regarding the ST Scope of Practice throughout the month of May.

Please see here (or click on the image below) for more information regarding Speech Language Pathologists and the services that they can provide.

Employee Spotlight: Beth Davis, PTA & Kim Horn, MDS Coordinator

evergreenadmin — Thu, 25 Apr 2013 16:46:33 +0000

Our employee spotlight feature this month is featuring Beth Davis, Physical Therapist Assistant & Kim Horn, MDS Coordinator at Sandalwood Nursing Center. We sat down with Beth and Kim to get their thoughts on the collaboration between MDS and Rehab. Here are their shared responses:

What are the benefits of keeping open lines of communication between MDS and Rehab?

The relationship between MDS and Rehab is a marriage of sorts. As in any successful marriage there needs to be clear and open communication in order to ensure that the family (residents) get the highest possible benefit they are entitled to. In addition to communication there needs to be a daily commitment to understanding, flexibility, and compromise.

Can you tell us some general reports/information that you all pull in order to track functional declines in residents?

Here at Sandalwood we track our residents' functional declines on many levels to ensure that no one "falls through the cracks". We have a daily review of all admits, falls, incidents, and med changes, then wts. are reviewed weekly, next we have monthly QI, and lastly quarterly/annual screens.

Beth, how do you as an RD communicate information obtained from Kim to your therapy team?

Communication between MDS and the therapy team is another multilevel effort. On a daily basis information is shared on a communication sheet following the morning stand up meeting. Referalls for therapy are communicated on a screening form
and each month the care plan schedule is posted.

Beth, how do you organize obtaining Quarterly and Annual screens and how do you as a therapist determine the need for screening and/or further evaluation?

The therapy team completes our quarterly and annual screens based on the care plan schedule however therapy completes ours a month ahead of MDS to ensure that any matters that may arise are already being addressed or resolved by the time the actual care plan is completed. In the interim of scheduled screens all falls and declines noted by restorative, nursing, or any one else on the Sandalwood team receive screens.

Referrals come from all sources, i.e. families, nursing, social services, housekeeping, other residents etc. All members of the Sandalwood family are welcome and encouraged to make referrals. These referals can be as formal as filling out the screen form to as casual as a post-it note or verbal concern. While you might be sceptical at non-skilled team members like housekeeping, patients, or families making referrals we can attest to on more than one occasion having one of these folks come to us and say "Mr/Mrs. Happy seems to be sliding our of the wheelchair a lot" or "never comes out of the room anymore." While this is very informal it is a valid observation and warrents further investigation, i.e. a screen to determine if an evaluation is in order.

Kim, how do your dual roles of MDS Coordinator and Restorative Nurse allow you to effectively refer residents to Beth that could potentially benefit from therapy services?

As MDS and Restorative Nurse, my role is to always be looking for significant changes whether they be improvements or declines. It is important to keep an eye out for the improvements as they are the things that sometimes get missed when we are ordinarily so focused on decline.

Because Beth and I each have 25+ years experience in geriatrics, are both strong multitaskers, good listeners, enjoy our roles here at Sandalwood and understand that it takes both of us to successfully navigate the MDS and PPS processes combined we are able to ensure our "family" gets the most of the benefits they are entitled to.

Dixie Boyles Tuition Assistance Fund

evergreenadmin — Wed, 17 Apr 2013 19:07:23 +0000

In memory of Jane “Dixie” Boyles, beloved co-worker, friend, and loyal member of the Evergreen family, we are dedicating a tuition assistance fund to aid full-time and part-time Evergreen employees who are pursuing degree or certification programs in the field of therapy. Dixie was an accomplished Physical Therapist who worked with pediatrics and geriatrics alike; she worked in Long-Term Care as well as the school system, and also owned and operated her own independent rehab company. A woman of many talents, Dixie played a multitude of instruments including guitar, bass, piano, banjo, and harp. She enjoyed playing music with others, most especially her father. Though Dixie passed away tragically in November 2010, she will never be forgotten. Dixie holds a special place in the lives of those she touched, always providing a smiling face, sound advice, or words of encouragement whenever they were needed. The difference she made in the lives of those around her cannot be overstated. We wish to honor Dixie’s memory by providing a way to help others realize their professional aspirations and to continue to serve as Dixie served.

For more information on the Dixie Boyles Tuition Assistance Fund, including guidelines for application, please consult the attached form here.

OT Month Employee Spotlight Q&A: Bob Luffy, OTR/L

evergreenadmin — Tue, 16 Apr 2013 18:06:26 +0000

What drew you to the OT profession?

Upon entering college I always knew I wanted to go into the medical profession to help people. So, I sat down with a professional counselor and as soon as I heard about what occupational therapy had to offer I was hooked. As I got further on in my professional studies, the thought of being able to change people’s lives was exciting. Even now as a clinician I’m constantly reassured that this is where I belong. Being able to help people overcome a difficult time in their life and regain function, either by changing how it is done or regaining the ability to complete their task, is thrilling.

What are the benefits of collaborating with nursing and other staff to implement the best possible therapeutic intervention?

No matter how holistic we as OTs try to be (or think we are), we are not the sole arbiter of services for our patients. Therefore it is our obligation to communicate with nursing, MD, PT, SLP and even CNAs to provide the best care possible. CNAs are helpful because they can offer you information on how a patient performs when you’re not with them such as in the evening at bedtime. Similarly, it’s our duty to reciprocate and inform the CNAs on how the patient is performing with us. This will help with carryover and can potentially make the CNA’s job easier and the patient safer.

Do you have any pointers on targeting IADLs and BADLs in treatment?*

*(IADLs are Instrumental Activities of Daily Living, i.e. common, daily activities (housework, managing money, etc.) that, while not necessary for fundamental functioning, allow the patient to live in a community on their own. On the other hand, BADLs, or Basic Activities of Daily Living, are essential self-care tasks such as eating, bathing, dressing, etc.)

It is simplest to incorporate BADLs into your session if you are obviously working with a patient on their morning routine. But, IADLs may be a little more difficult especially if there is no kitchen or mock apartment set up for the patients to trial activities in. Many of our patients like practicing the act of going over to the nearby store (which happens to be right across the street) so we incorporate that into our sessions on occasions. It’s a great way to practice safe functional mobility ambulating or in a wheelchair crossing the street. Also, while in the store, patients have the opportunity to practice simple money management.

Any tips on treating low level patients?

I’m sure we would all love to have those easy patients who just had a hip or knee replacement; those patients that are fairly high functioning and only need a little therapy for strength, ROM, balance deficits and some AE education and training. But, as we came into this profession hoping to help everyone we can, that includes those patients that are more challenging. One way to approach this is by finding out what time of day works best for your patient. For example, I treated one particular patient who no matter how hard you would try to work with them in the morning or evening they were nearly impossible to work with. But, this same patient right after lunch was always really pleasant and would come down to therapy and happily work on anything. Who knows, maybe we just serve great lunches. Then there are those patients who sadly are very low with respect to physical functioning. For the patients that require our services for ROM contracture management, splinting, and positioning, try enhancing their experience by having the radio on playing music. Give the patient your full attention during their session by talking with them if they can speak, or to them if they cannot. Even if the patient can’t communicate to you, take cues from their environment. Maybe a family picture on their bedside table will lead you to talk about them having a beautiful family, and how you enjoy spending time with yours. Discuss the weather and maybe how it’s a beautiful day outside, and if it’s possible take them out for their session. Simply by being compassionate and showing you care you are making a difference to your patient and enhancing their quality of life.

The Roots & Branches Blog

Evergreen Rehab Employee Spotlight: Todd Winston, M.S. CCC-SLP

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Join Evergreen Rehab in Celebrating National Nursing Home Week

Aural Rehabilitation: Addressing the "Hearing" in Better Hearing and Speech Month

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Evergreen Rehab Employee Spotlight: Hannah Rosemeyer, M.S. CCC-SLP

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Celebrating National Nurses Week 2013

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Evergreen Rehab Employee Spotlight: Katie Ford, M.S. CCC-SLP

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May is Better Hearing and Speech Month

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Employee Spotlight: Beth Davis, PTA & Kim Horn, MDS Coordinator

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Dixie Boyles Tuition Assistance Fund

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OT Month Employee Spotlight Q&A: Bob Luffy, OTR/L

What drew you to the OT profession?

What are the benefits of collaborating with nursing and other staff to implement the best possible therapeutic intervention?

Do you have any pointers on targeting IADLs and BADLs in treatment?*

Any tips on treating low level patients?

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