Written Yaffa Liebermann PT, GCS, CEO
1996 Prime Rehabilitation Services. Inc. was founded.
Founding Prime Rehabilitation, Inc.
I entered a stage in my life where I wanted to venture out on my own so I looked into different venues as to what would suit me as a therapist. My experience in providing therapy within nursing homes for 7 years made me look into starting my own company in that setting. I was feeling very comfortable and satisfied while delivering skilled care to the elderly in order to make them stronger in their own environment. The founders of Prime Rehabilitation Services, Inc were my husband Eli, with management experience and Ph.D. in Aeronautical Engineering, and me. After the first year and a half, we were joined by our daughter Tamar Brooks completed her Mechanical Engineering degree. We had good consultants, who knew me from working in the previous companies, and agreed immediately to help us navigate through the establishment and operation of the company.
On April 1, 1997 our first contract to provide rehabilitation in a nursing home was established with Hudson View Care Center in Bergen, NJ. I was the Physical therapist and I had one tech. We drove together for one and a half hours each direction to initiate the program and to set the rules of ethics and quality of therapy. Very quickly we hired PT, OT and SLP. The first Director Of Rehabilitation for PRS was a PT.
Founding a rehab company was extremely time consuming. It was a time of many feelings – excitement, fear, stress, happiness and also required a strong commitment from us to continue to push forward every day in spite of the challenges we faced. Initially, I was the PT during the day and the recruiter during the night until we hired a full-time recruiter. My job was to hire caring therapists who were open to understanding that nursing home residents are not out-patient clients. The patients in a nursing home sleep and eat in their home. We are guests in their home. I needed to explain to the therapists who never worked in nursing homes that the village is our nursing home and we are here to help patients to improve functionally. We screen, evaluate and set appropriate goals to the patients in the nursing home. As therapists, we are really independent in our evaluations and establishing treatment plans – the doctors count on us to create the correct treatment plans. The therapists also needed to learn billing as it relates to Medicare A insurance and what was allowed under Medicare B.
As the program became established, it was a pleasure to watch the group become one unit. They worked together but also supported each other, enjoyed lunch / pot lucks and celebrated birthdays after work. They enjoyed this camaraderie while focusing on helping their patients to achieve their prior level of function in the facility or were ready to be discharged home safely with home program exercises.
Hiring caring and professional therapists: I was brand new to the realm of recruiting. I was accustomed to interviewing therapists after someone else set up the interview. Cold calls on the phone became my way to recruit. First, I had to present myself and explain who I am with my very heavy accent, then I had to make sure I used catchy sentences to make them engaged in the conversation. I had to obey the rules of recruitment and choose my words very carefully. My goal was to discover, through the conversation, if the therapists had a passion for treating the elderly population and a desire to assist them in becoming functionally stronger. The rest of the duties, like acclimating to our system and utilizing software, would come later.
My face to face interviews were long but the decision to hire them was very quick. I provided a tour throughout the facility and was able to gauge their comfort level with both the patients and the nursing staff. I let them talk first to present themselves and convey their expectations. I looked in their eyes, listened to them talk and always asked them to share a success story from their therapy experience. I would proceed to make the decision mostly on how they will treat patients and how they would integrate into the existing team. Sometimes it took two months to hire the full time therapist in order to create a good team in a new facility. When it was time to start a new program in a new facility, we always presented the opportunity for advancement to therapists who were ready to transition to being a director in the new building. The newly appointed directed was responsible for interviewing and choosing the appropriate candidate(s) for their program and a member of the caring team of therapists.
Relationship to the nursing staff: I used to clarify during the interview the relationship with the facility staff by saying: “Prime Rehab is your company and we will pay your salary so please follow our policies and protocols.” Nursing is also responsible for good and ethical care to the resident. We also need to follow their instructions in each building and grow a mutually respectful relationship. Our goals and the nursing goals are the same: to make the patient comfortable, happy and stronger.
Great rehab team: A visitor introduced himself to me in a facility and said: “I was riding the elevator with the rehab technician who works for your company. I was very impressed by the respect and softness that the tech had toward the patient during the elevator ride”. Then came the compliment: “As your rehab tech was so professional and respectful to the patient, I assume that all of the therapists are also providing skilled care with love and compassion”. Of course, he was right!
Yesenia, PT, said to me: “You care so much about providing therapy to patients in the nursing home as well as always educating and teaching us. Please buy a nursing home and that will ensure the care from all departments will be superb like you demand from the therapists”. Well, I did not want to be in charge of the entire nursing home. I am a PT and I feel comfortable teaching PT, OT and SLP new ideas and philosophies in the therapy world. This was more than enough for us.
Teaching Ergonomics to the nursing staff: I came to realize that the Certified Nursing Assistants (CNA) and the nurses, for the most part, did not know how to transfer patients safely using the proper techniques in order to avoid injury to both the patients and themselves. I presented ergonomic in-services to the nursing staff and insisted that a nurse would be present with the CNAs. This allowed the charge nurse to carry over this education and information to other nursing shifts. We made sure to have the nursing staff sign in to the in-service and they would get credit toward their professional continuing education needs which is required yearly. Win /win situation for all.
Teaching the CNAs led to Less workers’ compensation claims within the nursing homes: An Administrator from one of the nursing homes said to me that her workers’ compensation claims had decreased in the last 2 year since we started to give the ergonomics presentation to the staff. She then asked me to broaden my presentation to the CNAs by including prevention of carpal tunnel syndrome. How wonderful it is to be able to help the profession who cares for others, not for a reward. If the recognition comes then it feels wonderful, but if not, we should continue to do what is necessary to help people.
Education/ Courses/Meetings: In order to spread our professional knowledge, PRS established a policy in which the continuing education cost is reimbursed by PRS as long as the therapists who attended the course present and share the information / education to their rehab team. This led to wonderful group discussion about new ideas and techniques.
When PPS arrived we went to courses held by the HCANJ Health care Association of NJ which invited the best lecturers to explain the new system. The two engineers in the family understood it immediately. I asked my daughter to make a chart for the therapists that streamlines the new information in order to provide guidance as to how long to provide therapy in each category. Tamar learned and presented the system so well that the Health Care organization asked her to teach the administrators in the yearly conventions.
We also organized quarterly companywide meetings. Therapists provided therapy on the morning of the meeting and then we met for lunch which included an afternoon of awards and education. We asked therapists to prepare and present different skilled care topics and we all participated. We invited lecturers to give talks of leadership and teamwork, how to boost morale and create better support / connection among the team members. The meetings were full of energy and good food! They also served to create a bond between the teams in all PRS locations.
Directors meetings: We also organized our Director of Rehabilitation each quarter attended by all Directors and Corporate management. One meeting focused on learning the PDPM system together. The DORs would then go to their team and share the information with them. Although the pandemic forced us to change our meeting format to Zoom, we have succeeded in maintaining our connections with and among the teams. Information continues to be shared (now on a weekly basis), teams are supported, concerns voiced and problem solved.
Students: We did connect with universities and took part in providing fieldwork locations in order to satisfy educational requirements. The students loved it and have become an integral part of our program. The long term benefit of having a student is that they often came back to work with us as a new grad, after officially graduating as PT or OT. The students would frequently elevated the learning and research atmosphere in the department as the mentors need to be on their toes with correct information. The students are the future of our profession and I always felt that our therapists deserve the opportunity to share their knowledge and contribute to the future of their professions by nurturing students.
Parties and picnics: We celebrate our company’s anniversary on April 1 each year. My husband, myself and Tamar would stand in the entrance and welcome everyone, and another member of the corporate team would take pictures which would be shared among all. The participants were dressed to impress and went into the ballroom to mingle, have a wonderful meal and dance the night away. We also hosted summer picnics in county parks for years which involved the whole families. Children would run around playing, team building activities were done to encourage competition among groups with fun awards. It was beautiful to see the families learning who were the co workers. There was a lot of laughter, smiles and happiness.
Corporate: As we grew in contracts, we had more therapists and therefore needed more administrative people who would assist in running the company in order to allow the therapists to concentrate on the provision of therapy. Vanessa Cardenas joined us and became the COO of PRS after Tamar left. Vanessa is the train conductor making sure that PRS would move forward at the right speed and stay on tracks. Erin Berkowsky OT, who became the program coordinator making sure that all the programs would be with the correct number of therapists and all the patients would receive the skilled care they needed. Vanessa and Erin worked together to ensure facility conflicts or issues were resolved quickly and fairly. Sheila Francis became a regional PT supervisor, where she developed programs and visited the facilities to teach and treat alongside the teams. Veola Fuchs focuses her energies on insurances, pay role and many other activities which have assisted PRS to grow and flourish. Our newest addition, Amy Rosario is an administrative assistant who has helped to streamline organization of the office as well as working hand in hand with Veola to ensure employee files are kept up to date.
Our corporate people are the best. They run the company flawlessly. If therapists have a problem we all stand behind them, there is not a difficulty that can arise and we will not solve it in the best way for the therapists. If there is an issue in the facility, we would drive or talk immediately, with the administrator and solve it to their wish. The corporate people are dedicated and available 24/7 to any possible emergency. When the COVID-19 pandemic erupted we had conference calls and zoom among corporate and staff. We were all in it together and continue to provide therapy every day to all the patients of need.
My role, as I saw it, was to visit the facilities, often meeting with administrators and DONs and problem solving any issues that arose within the therapy teams / department. I would also frequently treat patients and educate the therapists on new and renewed issues in therapy. My goal was to sit together with the group and observe their dynamic among themselves and with the nursing staff, to boost their interests and their morale.
We are lucky to have a company with great therapists run by a great corporation whose primary focus is to provide the best skilled care to the patients.
The blogs will continue presenting some programs that PRS developed.