Perspective: The nursing home industry is very competitive in today’s healthcare environment. Facility Administrators are try to improve existing skilled care programs while at the same time looking for ways to provide additional income streams to their facility. Rehabilitation Directors are continually challenging their staff to push their patients to improve and extend care.  With the substantial growth in the number of people who will need quality care both in skilled rehabilitation and general wellness over the next ten years, the questions are:

• How do nursing homes stay competitive, marketable and innovative?
• How do nursing homes continue to provide quality care with the goal of setting themselves apart in their community’s market place?
• How do facilities improve in the transition of patients from rehabilitation to a normal home life?

Predictable Future: The largest and most unhealthy age group today is the “baby boomer,” market. Nursing homes are going to have to find more ways to help the aging and particularly seniors in order to keep up with the demand. Common and business sense tells us skilled care combined with preventative wellness is a MUST, if we have any chance of getting a handle on this problem.

Skilled care alone is not going to cut it; wellness programs should be implemented to increase cash flow and competitiveness. The most important element is getting the rehabilitation part of a facility to work with the fitness and wellness entity. The other challenge is, administratively calculating and quantifying the benefits of the services long term. Most benefits will be tangible, yet immeasurable. In the end administrators and rehabilitation directors must understand wellness programs at the very least have PR benefits not only to the facility and the families associated, but promotes every aspect of the care within their facilities doors.

Is this a new way of thinking for nursing homes, yes? Is it going to be challenging to implement, absolutely? Are wellness programs a good way to be competitive/marketable and innovative, with out a doubt?

Proposed Wellness Program: Reso-Care is a service oriented entity of a larger fitness facility called RESOLUTIONS LLC.; located in St. Matthews area of Louisville. Reso-Care’s primary service is the development and implementation of fitness and conditioning services for senior citizens and those with post rehab disorders. In addition to on site programs we provide an off site facility in the St. Matthews area where seniors and their families can participate in fitness, nutrition and wellness programs.

Objective: To add a healthy life style service to each nursing home. To aid, assist and encourage those over fifty to continue exercising and eating better after any form of skilled care rehabilitation. To work closely with the physical or occupational therapist in helping the patient return to a some what normal physical health.

Reso- Care post rehabilitation services do not purport to provide any aspect of medical treatment for a client’s condition; yet may provide the following services:

Fitness Assessments
Strength Training
Flexibility Training
Cardiovascular Training
Functional Conditioning
Weight Reduction

These six activities or services make up the post rehab “scope of practice”. The goal of Reso –Care is to take over where your doctor or therapists left the patients treatment. We will work closely with the medical practitioners establishing the appropriate protocol and keeping them well informed during your entire post rehab sessions. Some of Reso-Care works conditions we work with are:

-Total Knee Replacement
- Diabetes
- Lumbar Disc Strain
- Carpal Tunnel Syndrome
- Total Hip Replacement
- Rheumatoid Arthritis
- Multiple Sclerosis
- Patella-Femoral Syndrome
- Osteoarthritis
- Knee Meniscus Tears
- ACL Rupture/Reconstruction
- Hypertension
- Shoulder Impingement
- Rotator Cuff Tears
- Fibromyalgia
- Achilles Tendon Rupture
- Cerebrovascular Accident
- Cervical Strain

Application: There are numerous ways Reso-Care can help nursing home facilities.

Facility Administrator: Marketing- Administrators are constantly looking at ways to improve the quality of care for their patients and at the same time advancing their reputation within the community. Adding optional wellness services enhances the quality of care after patient’s rehabilitation and ensures the families that your facility is the top choice if and when the need arises in the future. Marketing for wellness program is done in house through staff effort. The only financial outlay would be the development and printing of a brochure outlining the benefits, guidelines and expectations of the program to patients and their children.

Facility Rehabilitation Director: Post Rehabilitation Fitness is a designed program that helps an individual transition from occupational and/or physical therapy to home activity. There’s no competition between O.T. or P.T. and post rehabilitation fitness programs. Fitness programs are general in nature; typical rehab. is more about relieving pain and improving function in specific areas. Therapists must keep in mind the big picture; if a patient gets better care they will return to your facility for more care.

In Home Care: Once a patient is discharged occupational therapy is sometimes necessary. In order to advance a patient back to somewhat normalcy, additional exercise and nutritional planning can be an option. Transitioning a patient from occupational everyday activities to progressive strength, flexibility and stamina is vital.

Facility Administrator:

Administrators, how do you improve on quality care, run a profitable facility and most importantly continue to expand your PR campaign within the community? These are all challenges as the nursing home markets continue to become more competitive.

Expanding Public Relations:

Your name in the community is golden. Notoriety of service and care is the driving force of a successful facility. The more options a patient has at your facility the more the family will consider utilizing and recommending you to others. Post rehab fitness programs are perfect ways of continuing care and contact with patients and their families. The more complete services you offer the more the community will consider your facility as the place to be the first and possibly the last time.

Quality of Care:

Seen as just a number and patients won’t always return, treat individuals as such with more than they expect and they will return and tell someone else every time. Post rehab fitness programs are common sense extension programs of the other rehab services you offer. The more you give them, the more they will give back to you.

Medicare Reimbursement Advantages:

Looking for ways improve cash flow? While tangible, Post Rehab fitness programs may not be so measurable on the front end. Let’s face it, you want as many patients to consider your facility and return if need be down the road. If you (PT or OT) can show improvement then repeat business is possible. What if by offering such service increases your business one percent, why not?

Rehabilitation Directors:

Skilled Care Rehabilitation:

For any wellness and post rehabilitation program to succeed the most important position in the facility is the Rehabilitation Director. When developing such a program five important questions must be answered;

• What is the difference between Post Rehabilitation Fitness and normal skilled care therapy?

• Is skilled care and post rehab fitness programs competing services within the nursing home?

• What are the benefits to the department?

• What’s in it for the director and staff?

• How does the program fit within the facility?

What is the difference between skilled care rehabilitation and Post Rehabilitation Fitness?

For orthopedic injuries, the first thirty days are typically devoted to physical therapy with care focused upon the reduction of pain. Only after the patient is comfortable are “stabilization” exercises initiated to restore the injured area; even in these late stages of rehabilitation, care is focused exclusively upon pain and the injured area. For many, the completion of skilled care rehab does not necessarily mean they are ready to resume activities at 100%.

The average time period for skilled care therapy is less than thirty days. Following rehab, most could use a broad range of exercises for general strength, flexibility and stamina in order to transition back to home activities. Post Rehabilitation Fitness is primarily the implementation of such exercises once skilled care rehab is completed. Reso-Care proposes we continue to help the patient after their rehabilitation. It’s not a matter of replacing occupational or physical rehabilitation, but furthering the patient to getting back to a better quality of life. All observed by a Certified individual who is qualified to work with post-rehab clients.

Is skilled care and post rehab fitness programs competing services within the nursing home?

Absolutely not! Rehab is just that; rehabilitating a specific area back to normal use and to the point without pain. Fitness is more general to the body. Fitness programs consist of exercises that fit in with everyday activity. Furthermore, fitness professionals are not qualified to administer medical base therapies; nor should they.

Rehabilitation directors must understand that fitness services will encourage patients to think of their facility in the future if and when they need more rehab. Patient’s going through a fitness program does not mean that rehab is being eliminated.

What are the benefits to the Rehabilitation department?

Public Relations: Better care means more care in the future. The more well rounded a facility is in their services the more likely that person will return; its free advertisement. More people means more hourly wages, it’s just that simple.

What’s in it for the director and staff?

Incentive Programs: In some cases, facility administrators and rehabilitation directors can put monetary incentive programs together for staff members. Again, it’s really about giving patients the best quality care, and to make a name for your facility. Better the care, the more people will come back and the more staff gets paid.

How does the program fit in within the facility?

Post rehabilitation fitness can fit into a facility in a combination of three ways; with the nursing home, at patients home or an off site facility in St. Matthews.

On Site: A designated area close to the rehabilitation department may lay out to conduct fitness programs.

At Home: Patients and their families may decide that it may be more comfortable to have a fitness staff member come to their home.

Reso-Care for seniors

Seniors are the fastest growing demographics; no other population suffers more from rehabilitation atrophy, general fitness or lack of confidence than those over the age of sixty-five. There may be no better vehicle than exercise programs for those later in life. There may be no better way of helping individuals than with a combination of rehabilitation and fitness.

Resolutions Weight Loss and Nutrition Studio in St. Matthews, offers through its Reso-Care division an environment that is conducive to fitness and exercise. Showers and bathroom facilities (handicap accessible) are also available. Each nursing home has the option to send any short term rehabilitation patients off their site to Resolutions for further fitness, diet or rehabilitation. Once at home the patient and his/her children may opt to come to Resolutions Fitness Studio for further evaluation and exercise. Resolutions has the flexibility to expand their facilities if need be to further assist a nursing home who would like to offer any of their own services.

Implementation of Program:

Facility Marketing: Some form of literature such as a brochure should be created to distribute. The brochure should list the benefits of the program, qualification of the staff, and a brief outline of specific exercises and programming notes that come with a post rehabilitation fitness program.

Facility Staffing: The facility may opt to out-source this service. Post rehabilitation fitness may be conducted with a certified fitness instructor or existing staff member such as a physical or occupational therapist. All exercise staff must work closely with facility rehab directors.