MEDICAL REHABILITATION–A SERVICE & A CAREER
VERSION OF THIS ARTICLE POSTED “LAS VEGAS REVIEW JOURNAL”
By Chet Yarbrough
In the last century, we have received the mixed blessing of living longer. Mark Twain said, “It is sad to go to pieces like this but we all have to do it.”
Rehabilitation protects and perfects the health of young and old by improving the quality of a long life. It offers many service and employment opportunities. Big and small Las Vegas Valley businesses serve the rehabilitative needs of a growing population.
The biggest medical rehabilitation company in our area is HealthSouth Corporation. Ms. Tovah D’Ambrosio, Director of Human Resources, left a “can’t wait for your call” message when asked for an interview. She suggested a meeting at the Desert Canyon Rehabilitation Hospital at 9175 W. Oquendo Rd.
DAmborosio explained, “HealthSouth has 20,000 employees nationwide. They employ 700 people in the Las Vegas Valley at four HealthSouth rehabilitation hospitals and one outpatient facility. The Desert Canyon Rehabilitation Center alone employs 140 people.”
D’Ambrosio introduced Ed Hladek, one of six resident Physical Therapists at the hospital. Hladek greeted the interviewer with a strong hand shake. He outlined a typical work week and what a patient would experience at Desert Canyon.
He said, “Every day is different, cases are different, and personalities are different. Patient maturity ranges from youthful to aged. Once a week, our Therapy team meets to evaluate new patients and the progress of current patients.” At this evaluation meeting, Hladek explains, “We divide patient service based on their needs and our skill and experience. We schedule therapeutic service for the week and begin work on our first patient of the day.”
HealthSouth’ Therapists serve stroke victims that have lost motor skills because of blood flow interruption to parts of their brain. They help convalescents relearn simple things like pour a glass of water. They offer rehabilitation for hip replacements, spinal cord injury, traumatic brain injury, and degenerative orthopedic disease. HealthSouth’s goal is to get patients back home and back to work.
Hladek said, “I recently treated a paralyzed patient that could not lift his head when he was wheeled into the hospital. I began working with him for 3 hours a day. At the end of his stay, he used a walker (a 4 post gizmo) to walk out of the hospital.”
HealthSouth is a one stop service for rehabilitation. They come to your home if necessary, evaluate your condition, and determine whether rehabilitative therapy will help. They will contact your regular physician to help you with a referral. They can begin the admission process from your home.
When admittance is required, the average stay at HealthSouth is two weeks and most patients go home rather than to another facility.
Hladek explained, “In some circumstances, a patient will continue therapy in their home or with visits to the HealthSouth outpatient clinic for further treatment.”
HealthSouth is always looking for good employees. Its website (www.healthsouth.com) has posted job openings and a job search application. When writing this article, the key word “rehabilitation” was used to find 16 openings in the Las Vegas Valley. Just as HealthSouth is a one stop shop for rehabilitation, it is a one stop employment opportunity.
D’Ambrosio said, “Job openings in Physical, Occupational, and Speech Therapy require world wide employee searches because it is difficult to find enough qualified candidates locally.”
She said, “HealthSouth is a great place to work because a Physical Therapy team creates a family atmosphere in their treatment of patients.” Job satisfaction is buoyed by a Therapeutic team’s success in returning patients to their homes, to their families, and to the routine of independent life.
A specialized category of care is provided at intensive care rehabilitation facilities called Long Term Acute Care hospitals. An LTAC facility is staffed and equipped to offer rehabilitation to patients with acute, often multiple, medical issues that require 24/7 attention by physicians, nurses, and rehabilitative staff that is organized to care for patients with life threatening disabling injuries or illnesses.
Las Vegas has six hospitals classified as LTAC facilities; HealthSouth’s Tenaya hospital, Horizon Specialty Hospital at 640 Desert Ln., Vegas Valley Rehabilitation at 2945 Casa Vegas St., Progressive Hospital at 4015 South McCleod, and Kindred Hospitals at 5110 Sahara Ave. and its satellite facility at 2250 E. Flamingo Rd (on the fifth floor of Desert Springs Hospital).
The two Kindred Hospitals offer 92 LTAC beds, 40 on the fifth floor at the Desert Springs Hospital off Flamingo, and 52 at Kindred Hospital on Sahara.
A significant part of the Kindred group policy is its continuation of care after patient discharge. Often rehabilitation must continue on an out patient basis; in some cases transition may be to another care center that offers a less expensive but more appropriate level of care; Kindred assists the patient in that transition. Its rehabilitation goal is to return patients to live and work as normally as possible after a disabling injury or illness.
The Kindred hospital group publicly announced in February of 2011 an expansion of its service area and capability with the acquisition of publicly held RehabCare Group, Inc. for 1.3 billion dollars. The acquisition will make Kindred the largest Long Term Acute Care company in the United States.
Kindred’s website offers insight to their personnel management philosophy. It offers job related education incentives to full time employees that have completed at least 90 days of employment. Kindred Healthcare publishes an annual nurses’ report that summarizes employee surveys showing job satisfaction. Also, like HealthSouth, Kindred’s website offers a job search application for interested job seekers with access to job openings throughout its network of hospitals.
Chrysalis, though one of the smaller rehabilitation services in Las Vegas is an important part of the industry. Chrysalis opened its business in 1985 with 14 people in Heber City, Utah. Their Las Vegas valley office is at 3011 N. Coleman St., North Las Vegas 89032. Ryan Giles is the Managing Director of the Las Vegas Valley office.
Chrysalis is a unique rehabilitative business that serves approximately 500 patients, with cognitive disabilities, in various 3 and 4 bedroom group homes throughout Utah and Nevada. It contracts with various State agencies and private paying families to provide rehabilitative service; i.e., from creating a specialized diet to integration or reintegration into society for mentally or physically impaired patients. Chrysalis works closely with organizations like Opportunity Village.
This is a labor intensive service with employees that go to work in individual group homes that have 3 to 4 clients in each home. Staff is hired to be in the homes at all times that clients are present (clients often have jobs outside the home). There are approximately 150 employees in the Las Vegas Valley.
Giles said, “New employees have a minimum high school education, and after submitting to a background check, are entered into a 16 hour training program to understand how to manage situations that may occur in a group home.”
In a subsequent telephone contact, Giles explained, “The total training time which includes CPR, First Aid, human rights training, diversity training, and medication management is between 50 and 60 hours prior to working in a home.”
Training may involve role playing with explanations of how to handle confrontation through a range of conflict resolution strategies to, in extreme cases, restraint. Giles advises that entry level positions do have high turnover because of the labor intensity of the work but he notes that an entry level position is where he began 17 years ago.
Diseases like Prader-Willi syndrome require extensive, often long term, rehabilitative help; a specialty of the Chrysalis Company. Prader-Willi Syndrome is described (on its web site, www.gochrysalis.com) as a genetic disease with characteristics that include weak muscle tone, poor growth, and delayed development. People with Prader-Willi syndrome typically are diagnosed with intellectual and developmental disabilities and often have behavioral problems.
Chrysalis advertises for employees by saying it is looking for people who care. In going to its website, you can learn about the company, what they do, and who they are. The web site has the additional feature of job listings that are available in the Las Vegas valley.
Giles said, “Chrysalis is always looking for entry level employees and, right now, we are looking for a professional Behaviorist.”
Another of the many rehabilitation businesses in the valley is Las Vegas Recovery Center. LVRC deals with addiction, a disease that exemplifies rehabilitative treatment as an art as well as a science.
Addiction is supremely difficult to successfully treat; there are so many facets of addiction, like the guilt associated with it, its insidious appeal to the fundamental nature of man, and its devastating impact on families and society. Treatment is rehabilitative for one person but its import spreads through a community.
LVRC notes on its website (www.lasvegasrecovery.com) that addiction is a chronic disease that lasts a life time. Rehabilitation for addiction is a minimum three month commitment that takes a life time to process. The National Institute of Drug Abuse reports that “research indicates that for most patients, the threshold of significant improvement is reached at about three months in treatment. After this threshold is reached, additional treatment can produce further progress toward recovery.”
Beginning treatment at LVRC is a 3 phase, 3 month program that involves the client and his/her family. Contrary to a myth that a client must “want” to be relieved of addiction to succeed, LVRC explains that most clients think and believe they can control their addiction; they can choose to stop their addiction any time they want; consequently, addicts do not seek help. It takes a family (a related family or created family), and an organization like LVRC to beat addiction.
Dr. Mel Pohl, a general practitioner, is the Medical Director of LVRC. He is joined by PHD Psychologist, Dr. Rob Hunter, and Dr. Claudia Black, a published author, trainer and speaker about addiction.
Most families have a mother, father, sister, or brother that is in the final stage of their lives. Everything is harder and takes longer as we get older.
A new facility, Advanced Health Care of Las Vegas, is opening its doors this month at 5840 West Sunset Rd, at the Jones Blvd. exit off 215 West loop. Brigham Church, Nursing Facility Administrator, and Travis Winward, Admissions Director, are prepared to welcome their first clients to a 38 bed, first class rehabilitation facility. As of April 12th, Church has hired 12 employees with plans to hire 68 more, ranging from Physical and Occupational Therapists to building maintenance and kitchen help.
When an older patient knows their hip needs to be replaced, Church said “A first stop before scheduling surgery may be at Advanced Health Care of Las Vegas to check bed availability for rehabilitation after the operation.” Church has been in touch with some of the area hospitals to make them aware of AHCLV’s service.
According to the AHC website (ahcfacilities.com), an Advanced Health Care team is created to provide customized rehabilitation for their residents that may include wound care, IV therapy, medication administration, and assistance with dressing, bathing, walking, and dining. AHC is not an LTAC facility but it does provide short term care that may be prescribed by a patient’s personal physician. The average patient stay is two to three weeks. The objective of AHCLV is to return residents to independent living as soon as possible.
Church explained, “Every patient has a private room, microwave, refrigerator, bath room, and amenities like cable TV and internet services.” Common areas include a reception area, spa, beauty salon, small outdoor park with benches, dining room, library, and fully equipped physical therapy room.
In the Mesa, Arizona facility, which is a mirror image 38 bed center, 95% of Advanced Health Care’s patients are Medicare recipients; Church said, “I expect similar Medicare patient percentages at this new Las Vegas Valley facility”. He continued, “That unlike nursing homes with nursing assistance staffing ratios of 1 to 12 or 15 patients, Advanced Health Care of Las Vegas will have a ratio of 1 to 8.”
Some jobs are more difficult to fill than others because of education and licensing requirements but AHCLV is determined to hire licensed therapists as full time employees of the company to insure quality of care. Church said, “Employee turnover is low because it is a great place to work”. After talking to Church and Winward about management of the company, it seems AHCLV offers real opportunity to grow, personally and professionally.
Cost of rehabilitation is often covered, at least in part, by private insurance or Medicare. Coverage needs to be discussed by the patient with their insurance carrier when a plan for rehabilitation is determined. Companies like HealthSouth, Kindred, Chrysalis, Las Vegas Recovery Center, and Advanced Health Care of Las Vegas are staffed to help you understand your financing alternatives.
Rehabilitation jobs are available but what about training and education in the industry?
Jobs like Occupational, Physical and Speech Therapy require post graduate education for licensing in the State of Nevada. As noted earlier, there are many other types of jobs related to the industry but those three disciplines require post graduate degrees.
After interviewing several companies and schools in our area, it seems Speech Therapists are difficult positions to fill in the Las Vegas area. To be a licensed Speech Therapist, a student must have a Post Baccalaureate degree in Speech Pathology. Nevada State College in Henderson offers a Bachelor’s Degree in Speech Pathology but no advanced degrees in the subject.
The State of Nevada, through the Department of Education-Teacher Licensure offers a restricted Speech Therapy license to Nevada State Speech Therapy’ graduates but only to work in the Nevada school districts for Kindergarten through grade 12. No Speech Therapy post graduate programs are presently available in the Las Vegas Valley. Consequently, hiring a Speech Therapist requires a global search for candidates.
The College of Southern Nevada can be a good starting point for a professional position in rehabilitation. CSN offers students an Associate of Applied Science Degree in Physical Therapy and Occupational Therapy for employment as a Physical or Occupational Therapist Assistant.
However, to become a licensed therapist students have to complete a Bachelors Degree with stipulated prerequisite classes to be able to apply for a post graduate degree in Physical Therapy at UNLV or Touro University. (Touro University also offers a graduate degree in Occupational Therapy.) “Able to apply” are carefully chosen words.
Meeting with Dr. Sue Schuerman and Dr. Daniel Young to discuss UNLV’s Graduate Physical Therapy program was an adventure in the perils of American education.
Schuerman, the Director of Clinical Education at UNLV said, “100 % of our students find a job after graduating and some have jobs before graduation.
However, Schuerman, explained, “Out of 500 applications to the graduate school of Physical Therapy this year (250 had nearly perfect applications), 80 interviews were given and only 30 student applications were accepted.”
“We just do not have the staff or facilities to accommodate more students,” said Young, Assistant Professor of the Dept. of Physical Therapy.
A big part of UNLV’s Physical Therapy Graduate Program, is its Clinical Affiliation training. Dr. Harvey Wallmann, the current Chair of the UNLV Physical Therapy Department, trail blazed UNLV’s Clinical Affiliation Program. The Physical Therapy Department contracts with local Rehabilitation hospitals, Acute Care Hospitals, and Outpatient Facilities to give UNLV students an opportunity to learn and train with licensed Physical and Occupational Therapists in a clinical environment.
Schuerman and Young explain, “UNLV is in the 90th percentile of American schools that have Physical Therapy graduates that pass the national exam for Physical Therapy on a first try.” This puts UNLV in a select group of schools that offer this kind of graduate education.
Young said, “80% of this year’s students admitted to the Physical Therapy Graduate School are from out of state.” Young explained, “In spite of doubling tuition prices, the demand for education in Graduate Physical Therapy is unabated.” Ironically, in past years of this program, 50% of the students came from Nevada but not this year.
UNLV is a great place to go to school for a graduate degree in Physical Therapy, if you can get in.
Touro University started in New York with campuses in San Francisco, California and Henderson, Nevada. After meeting Dr. Mindy Renfro, a faculty member in the School of Physical Therapy, there is a sense of progress in Rehabilitation for the Las Vegas Valley.
Renfro said, “The Henderson campus (at 874 Pacific Dr.) offers post graduate education in Physical and Occupational Therapy that can lead to licensing by the State of Nevada.”
She explained, “Touro’s Post Graduate Rehabilitation program is in its inaugural season. After graduating its first Graduate students, Touro University will have an accredited Post Graduate School of Physical and Occupational Therapy.”
Renfro introduced two students that are in Touro’s inaugural class.
Tolu, one of the two students, said, “I came to Touro after receiving an undergraduate degree in Orthopedic Sports Medicine from UNLV.” Nicole said, “I came after graduating with a joint major in Biology and Computer Science.”
Both students plan to be in next years first Touro University’ graduating class of the new Post Graduate School of Physical Therapy.
A major part of Touro University’s philosophy of education is to be a service to their community. Renfro explains some of the curriculum characteristics of the school; a requirement to intern with Las Vegas Valley rehabilitation companies, and to acquire a minimum 18 hours of volunteer service in the community. Touro University conducts a Henderson Health Fair every year that includes free screening for balance, cholesterol, diabetes and blood pressure.
Renfro said, “When they started the Health Fair in 2007, 30 to 35 people showed up; last year, more than 300 attended.”
Tolu’s and Nicole’s enthusiasm for Touro’s Graduate School of Physical Therapy, 18 hours of community service per graduate student, and the Henderson Health Fair are convincing evidence of the real contribution this private University makes to the Las Vegas Valley.
Nevada State College, College of Southern Nevada, UNLV, and Touro University are major contributors to the quality of rehabilitation in the Las Vegas area. Each school serves our community by offering student options in pursuing a career in Rehabilitation.
There are many jobs needed in the Rehabilitation industry (other than Physical, Occupational, and Speech Therapy positions); from doctors, nurses, dieticians, etc. to nursing assistants, therapist assistants, food servers, and building maintenance personnel. Rehabilitation is a 21st century growth industry.
Yes, Las Vegas is a great place to pursue a career in rehabilitation.