Renee Kinder

I heard the story hundreds of times as a child. 

My grandfather would smile ear-to-ear and tell us about his time dating my grandmother. He would share that when people asked him, “Where are you going?” he would respond, “I am going to paradise.”

He loved the play on words, you see, because my grandmother lived on Paradise Street in Muhlenberg County, Kentucky.

Muhlenberg County is small, rural and likely a place many of you have never heard of.

You may, however, have heard the John Prine song describing its beauty … “Daddy, won’t you take me back to Mulhenburg County, down by the Green River where paradise lay.”

We lost John Prine, this week, another beloved soul gone to the COVID-19 pandemic. 

In the healthcare industry, the sacrifice of care providers, pain of family members being limited from visits by loved ones, and ever-changing rules and regulations has left many wondering, “When will we ever see paradise again?”

Personally, my current paradise has been the result of purposeful distancing in our community. Painful at first.  But the results include seeing all of my kids running together in a pack of five, the youngest having Dad home long enough to learn to ride her bike without training wheels, digging through and testing old family recipes, making homemade bread, eating way too much (beware “the COVID-15!”), spending time outside, neighborhood evening porch gatherings, and the list goes on … I will ask for future forgiveness for the missed homework assignments. 

Professionally, paradise is evident in all that our therapy groups are doing to advocate for us, promote clinically appropriate lifts on certain restrictions, create specific pages and learning opportunities related to the pandemic, help dissect CDC guidance, encourage benefit understanding for e-visits and telehealth, and explain the specifics around PPE. 

I know their positions are especially demanding presently and believe they deserve our thanks and our patience. I reached out to them for guidance on what I should cover today. I reached out late last night … and they responded — still up late, working to support us.

Finally, I find paradise in simply hearing from therapists in the field. Initially, much focus was on the acute-care side. However, now we see increasingly a shift to the post-acute care spectrum. Patients are coming our way and will continue to for some time. I see pictures of what I am told are smiling faces behind masks, teams with laser-focused care to better support their communities, creative interventions allowing for rehab opportunities at multiple points during the day to further collaborate with nursing teams, and allowing for celebrations of patient milestones including functional gains and life events while seeking methods to engage families from afar. 

The need to distance at the community level seems to have only raised the sense of togetherness in many sites. 

In closing, I hope that within this challenging time you have experienced some forms of paradise. Our daily Amazon delivery just arrived here … a tent! This one they actually asked permission to order, and the kids are bursting at the seams to put it together.

A couple of evenings under the stars this weekend. Sounds like paradise to me.


American Healthcare Association (AHCA)

AHCA COVID-19 Resources

American Occupational Therapy Association (AOTA)


AOTA how to bill Medicare e-visits

AOTA CMS expansion of e-visits

Role of OT in a Pandemic

OT and PPE

American Physical Therapy Association (APTA)

APTA main COVID-19 page

APTA telehealth resources, including guidance on use of telehealth, payer advocacy templates, telehealth research, how PTs are using telehealth

APTA overview of e-visits

APTA e-visit FAQs updated March 20 

APTA e-visit Webinar and slide deck

American Speech Language Hearing Association (ASHA)

ASHA main COVID-19 page

ASHA e-visits info

ASHA state telepractice laws 

ASHA telepractice payment and coverage considerations

ASHA telehealth and private pay

Center for Disease Control and Prevention (CDC)

Preparing for COVID-19: Long-term Care Facilities, Nursing Homes

National Association of Rehabilitation Providers and Agencies (NARA)

NARA Resource Page for COVID 

Renee Kinder, MS, CCC-SLP, RAC-CT, is Vice President of Clinical Services for Broad River Rehab and a 2019 APEX Award of Excellence winner in the Writing–Regular Departments & Columns category. Additionally, she serves as Gerontology Professional Development Manager for the American Speech Language Hearing Association’s (ASHA) gerontology special interest group, is a member of the University of Kentucky College of Medicine community faculty, and is an advisor to the American Medical Association’s Relative Value Update Committee (RUC) Health Care Professionals Advisory Committee (HCPAC).