Effectively screen those residents

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Shelly Mesure, MS, OTR/L
Shelly Mesure, MS, OTR/L

When you ask your rehab department to screen a resident, what happens? Screening residents is part of our everyday job responsibilities.

But how did we ever learn to do this effectively? Every time I teach my seminars, I always ask every participant (of all types of therapy backgrounds), if anyone was taught how to screen residents during her therapy programs? Every time, no one answers “yes.” So, it's not much of a surprise that many therapists are excellent at everything in their job — except screening.

Do you consider a long-term resident part of an underserved population? In some facilities, I would say yes. We have a tendency to become very involved and focused on our short-term residents, and many times it's to the detriment of the long-term resident. Staffing shortages plague our facilities, fluctuations in census and day-to-day stressors interfere with our motivation to screen our residents. Don't let your facility fall into this pattern.

I truly believe that if the larger therapy companies started implementing better training on screening processes and monitored these results with screen-to-evaluation ratios, many more residents would receive much-needed treatment.

The other difficult situation is when your staff has worked in a facility for awhile. It's easy to become less objective and assume we know our residents very well. The analogy I always use is when you're watching the news about some tragedy. They always interview the neighbor, who 99% of the time says, “But they always seemed so normal!”

Although you say “hello,” to our residents every day, do you take the time to ask in-depth questions and maintain an objective viewpoint during your visits? With every resident?

According to industry standards, 10% of the long-term care population is typically in need of some type of therapy service. So if you have a 120-bed facility, and 100 are long-term beds, 10% of that would mean 10 residents in need of physical, occupational and/or speech therapy at any given time.

To motivate your staff, many times our therapy companies use very long and involved screening forms. Their intention is to prompt you to assess everything during every screen. The forms are usually only partially completed, and don't always promote objective thinking. So how do we break out of this rut?

Let's do lunch! At your next therapy staff meeting, ask all of your staff to say what they look for when they are completing a screen. Create a “Top 10” list of areas that should always be addressed. Make it a group effort. Hopefully, if you have a therapist who is weak in this area, she won't feel singled out and can learn from the more experienced therapists.

Have some fun with this “Top 10” list. Laminate it and give a copy to each employee, frame it and hang it in the therapy gym. But let them know that they set the rules, so they must live up to them every time.

Shelly Mesure ("Measure"), MS, OTR/L, is the president and owner of A Mesured Solution Inc., a rehabilitation management consultancy with clients nationwide. A former corporate and program director for major long-term care providers, she is a much sought after speaker and writer on therapy and reimbursement issues. 


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Rehab Realities is written by Renee Kinder, MS, CCC-SLP, RAC-CT.  She currently serves as Director of Clinical Education for Encore Rehabilitation and acts as editor of Perspectives on Gerontology, a publication of the American Speech Language Hearing Association.