Jewish Center For Aged - Beyond The PPS: Successfully Utilizing Contract Therapy
JCA is a not-for-profit organization founded in 1906, with the mission of respecting Jewish values and traditions, and caring for the aged without regard to individual resources, within a framework of fiscal responsibility. JCA is an affiliate of the Jewish Federation. Other long term care facilities in the area average 85% occupancy, compared to JCA's average 96% (JCA's long term care beds are generally 100% occupied).
Randall Delkus is Administrator and COO at the Center. Rehabilitation services were outsourced prior to his coming to JCA two years ago. JCA was looking for stability in a provider, and also sought a company that treats its staff fairly. Especially important, JCA wanted to make sure residents and their families would always be dealing with the same staff.
Mr. Delkus and a committee composed of board members undertook an intensive interviewing process involving five local and national rehabilitation services firms. "We looked at everything - outcome studies of other facilities the companies were in; what kind of success rates they ran; what network they had with the doctors and community; how many people they were transitioning into the community. And, of course, we talked to our friends in the business. Long term care in St. Louis has a very close network. It can be a good source of valuable information."
JCA chose to go with RehabCare Group. "And we've been happy ever since," says Mr. Delkus.
In the year that RehabCare has been responsible for the Center's rehab services, there has been very little turnover of staff. RehabCare Group is providing training that other providers haven't provided since the changeover to PPS. JCA now has a firm grasp of PPS and, as a result, is better utilizing their Medicare skilled beds.
Some of the services RehabCare Group provides for JCA are unique to the industry or are no longer provided by competitors. An example is a restorative program that sees people periodically after discharge from the skilled therapy unit. Missouri state law mandates that nursing homes help maintain the optimal level of function for their residents. To help meet this requirement, RehabCare Group periodically evaluates residents to identify those who have lost functionality. If anyone shows a decline in their ADL (Activities for Daily Living), the restorative program notes the impairment, and forwards that information to the resident's physician. Based on the physician's order, the skilled therapy program provides the appropriate restorative therapy.
Mr. Delkus says some of the services RehabCare Group provides surprised him. "Naturally, they provide skilled physical, occupational and speech therapy, and safety training, too. They also assist us in preparing for our Joint Commission Accreditation, and help us stay compliant with HCFA and state regulations. But their director in our facility is a creative writer talented enough to work on programming and grant writing ideas. This capability was an unexpected surprise that wasn't part of the contract.
"Clinical programming is another area of creativity. We have the breakfast club program, the dining program, the walking program - and they're currently at work on an exercise program. This kind of creative programming is clearly beyond the realm of skilled therapy.
"RehabCare Group put a nice group of people in here for us to work with," says Mr. Delkus. "They've integrated well with our staff, not only from a professional standpoint but a social level, as well. They have really become part of the JCA family."
And what of the results that have been achieved since RehabCare Group and JCA started working together?
"They (RehabCare Group) have been very, very good with their outcome studies. The average stay in the subacute beds is 21 days. We're getting people better, quicker - we're getting them back to the most independent environment possible. In regard to the PPS, RehabCare brought in some very knowledgeable, trained people who in-serviced our people and helped us get up and running and efficient with the system.
"One of our goals from the beginning was to maintain a consistent staff working with our patients. We've achieved that goal. One of the best things about working with RehabCare Group is that they are team players. They develop their programs according to what the facility wants. Whether we want something in the area of value-added service in an outreach program, or a grant-writing opportunity, they're willing to step in and do it for us. That kind of service is hard to beat."
Provided by: RehabCare Group