Trinity Community of Beavercreek - Seamless Teamwork Fuels Therapy Improvements

Trinity Community of Beavercreek is a nursing home and retirement community serving 230 residents near Dayton, Ohio. Since opening in 1974, Trinity has offered a full continuum of residential options and healthcare services. The facility offers 10 independent living cottages, 31 independent living apartments, 51 assisted living apartments and a full-service, 106-bed nursing center. As part of United Church Homes, Trinity has earned a reputation for excellence by adhering to the not-for-profit organization's mission — to provide older adults with quality services to enhance their physical, mental, and spiritual well being. Despite Trinity's hard-working staff and innovative programming, one area remained a challenge — rehabilitation.

In the past, Trinity worked with two contract therapy providers, and administration was dissatisfied with the results. That changed in 1999 when Trinity joined forces with RehabCare Group. Today, Trinity offers some of the best occupational, physical, and speech rehabilitation programs in the Miami Valley, adding high-quality rehabilitation services to its continuum of care.

Laura M. Farrell, Administrator of Trinity, recently took time to discuss her facility's partnership with RehabCare Group and how contract therapy services have enhanced the quality of rehabilitation services available to residents — and boosted Trinity's bottom line.

Q: Can you tell me how rehab services were handled at Trinity in the past? A: Two different companies provided rehab services here for a number of years. As a result, we had a very inconsistent, staggered rehab department and therapists were not part of our team. We did not have a true program manager, and there was no leadership in the rehab department. Overall, there was poor communication between our staff and theirs.

Q: When you decided to partner with RehabCare Group, what were your expectations of the relationship?
A: Our expectations were very basic. Obviously, we wanted RehabCare to provide therapy services that were going to increase our residents' quality of life. In the past, the rehab program was not able to transfer them to a higher level of functioning. Residents were not able to go back to their assisted or independent living apartments, and we were bed-locked.

We also wanted to provide a rehabilitation program that could meet the needs of patients covered by Medicare Part A and/or Medicare Part B.

Q: How has your patient mix improved? What about the quality of services?
A: We have tripled the number of patients we serve who are covered by Medicare Part A, and have more than tripled the number of patients we serve who are covered by Medicare Part B. Now, we're consistently running a census of around 9 or 10 patients covered by Medicare Part A and 12 to 15 patients covered by Medicare Part B. As a result, our revenue has dramatically increased. Plus, our rehab program is now able to discharge residents to a higher level of functioning. Today, I would say about 80% of residents who go into nursing care and receive therapy services are discharged back to their independent and assisted living apartments. We have a consistent turnover of beds in nursing care that allows us to continue to build our census of patients covered by Medicare Part A, and that is good for the facility as well as the residents.

Q: What's responsible for this dramatic difference?
A: The therapists. RehabCare's staff truly understands how to provide efficient, effective patient care in a PPS environment. And there are a lot of therapists who do not understand it.

The teamwork is also important. Their staff is part of my staff. RehabCare is involved in all the meetings and committees and is a consistent part of what we are doing everyday. Plus, the RehabCare program manager at our facility is truly a manager who can handle the caseload.

RehabCare Group's regional and management staff is also excellent. I had never met anybody except the salesperson from the other companies. My program manager's supervisor was in here for at least a week and comes back periodically — just to see how things are going.

Q: Would you say that RehabCare Group has lived up to their promises?
A: They have exceeded their promises. They told me that I would have a program manager here at least part time, but I have had a program manager here whenever I needed one.

They also have wonderful program development and have implemented a walk-to-dine program to encourage ambulation. And they are constantly screening residents who have a high risk for falls or other problems. The RehabCare staff is in the dining room monitoring residents to catch signs of swallowing problems or the need for adaptive equipment. So it is not always us bringing residents to them. They are out there seeing how they can improve our resident's quality of life.

In the past, our assisted and independent living residents had no idea who the therapists were and what they did. With RehabCare, even my residents who have not worked with the therapists know who the therapists are.

Q: What about screenings?
A: A lot of providers say that they are going to screen residents quarterly, but they don't do it. RehabCare Group backs up their promise to provide regular screenings. The therapists follow our care conference schedule and the MDS schedule, and they coordinate that very well with my MDSPlus coordinator. And they have helped us with measurements of contractures, if we have any, to make sure there is not a functional decline.

Q: How would you answer if someone from another facility asked about your experience with RehabCare Group?
A: It is my goal to have RehabCare Group here for the long term. The two companies that we had here before went out of business. But RehabCare Group is a very stable and solvent company. I feel very confident that RehabCare Group will be with us for a long time.

RehabCare Group, 7733 Forsyth Blvd., Suite 1700, St. Louis, MO 63105. Tel: 800-677-1238; Fax: 314-863-6850.