Revolutionary rehab. Exceptional Solutions. Innovative approaches create positive outcomes. Customer Corner website delivers business intelligence

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Revolutionary rehab The SunDance Difference Innovative approaches create positive outcomes New rehab program eases memory loss Page 3 Partnership results in outstanding care Page 5 Customer Corner website delivers business intelligence Page 6 SunSolutions SM the new consulting powerhouse Page 7 AUGUST 2011 A SPECIAL SUPPLEMENT TO SPONSORED BY

The Provider of Choice Rehabilitation providers are an extension of your caregiving team. They impact your organization and, most importantly, the well being of those in your care. Don t settle for anything less than a leader committed to getting results. SunDance Rehabilitation has built a reputation for excellence and unwavering dedication to clinical outcomes and financial success for our business partners for more than 20 years. Our local management teams and therapists work side-by-side with you and your staff as resident advocates. This strong communication, combined with the genuine bonds we form with patients, help produce the results you seek from a rehabilitation provider. From the top Sue Gwyn, President, SunDance Rehabilitation Innovation is what moves great endeavors forward. It s true that basic knowledge and steady effort are important, but you also have to keep looking for new ways to solve problems to really thrive. That s why SunDance Rehabilitation is proud to tout its dedication to innovation in this issue of Exceptional Solutions. We are constantly on the move, innovating to get better so you can, too. For example, we ve developed a two-pronged training process that will teach therapists (speech, physical and occupational) how to help people with early onset memory loss. The results have been impressive, as residents have remained more independent for longer periods of time due to this program. We re also proud to highlight our partnership with Lorien Health Systems, an outstanding provider whose strengths mesh wonderfully with ours in prioritizing advocacy and innovation for care excellence. To meet the needs of professionals in this high-tech, high-touch world, we also have developed our online Customer Corner. It s a unique tool that puts an array of customized business intelligence at your fingertips in real time. Users set the parameters, such as diagnostic groups and length of stay trends, to arm themselves with better information for the challenges ahead. We also introduce you to our transformative new division, SunSolutions SM Consulting. Innovative and bold, it offers an impressive array of experts to help you move forward and reach your excellence goals. We welcome the opportunity to share SunDance s exceptional solutions with you. Sue Gwyn For more information about this publication s contents, get in touch with us at: SunDance Rehabilitation 300 North Washington St. Suite 300 Alexandria, VA 22314 (888) 267-2220 toll free (703) 684-1004 phone (703) 684-4993 fax www.sundancerehab.com Contents 3 Revolutionizing 5 A 6 The clinical practice A new skilled rehab program enables individuals with early onset memory loss to manage personal affairs better true partnership SunDance and Lorien Health Systems combine strengths to deliver outstanding care and satisfaction outcomes SunDance Customer Corner The new Customer Corner website provides a variety of rich business information, from caseloads to detailed performance reporting and more 7 SunSolutionsSM Consulting has it all The launch of SunSolutions Consulting gives providers a team of clinical, financial, operational and compliance experts like no other 2

Revolutionizing clinical practice Providing this customized rehabilitation program for residents with early onset memory loss pays big dividends and fosters greater independence Oliver s wife, Loretta, grew increasingly concerned about her husband ever since they had moved into the retirement community. His behavior had begun to subtly change and yet when she questioned their close friends and family members, no one else noticed what she was observing. One day as Loretta was reading the community s monthly newsletter, she saw that the next wellness series lecture, presented by the rehabilitation team for the community, was coming up. It was entitled Adding Life to Years: Managing Changes in Memory. Loretta made a note on the calendar so she would be certain to attend. The day before the lecture, Loretta asked Oliver to go to the presentation with her, but he reminded her that his weekly poker game had been rescheduled for that afternoon. She did not see this on their calendar but did not question him. Loretta arrived early for the presentation and patiently waited for its leader Katie, the occupational therapist whom she had seen for treatment last year for her recurring shoulder problem. Loretta reviewed in her mind exactly what was concerning her about Oliver: his taking extra time for errands and coming home from the grocery store with items that they did not need; his last two missed doctor s appointments that were not on the calendar; and disorganization in their checkbook (missing deposits and check entries) that had never been an issue before. As she listened to Katie speak about memory changes, Loretta came to the realization that Oliver could be one of the many individuals who was showing very early signs of dementia. She knew immediately that she needed to speak with Katie after the presentation and share both her concerns and the information from the lecture about how signs of early memory changes can be managed through therapy intervention with their family physician. Memory loss can begin with subtle changes in how everyday tasks are managed, such as maintaining one s checkbook. Managing Memory Loss Early memory loss (Mild Cognitive Impairment MCI) and the possible development of dementia and/or Alzheimer s disease (AD) is a growing unspoken concern for many. AD is now the sixth-leading cause of all deaths in the United States and the fifth- 3

Providing follow-up cognitive testing is just one strategy SunDance therapists use to treat individuals with memory loss. leading cause of death in Americans aged 65 years or older. These statistics are alarming, stated Linda Karacoloff, Vice President of Clinical Practice and Training for SunDance Rehabilitation, considering that we are in the beginning stages of the aging of the baby boomer generation. However, she continued, what is not well known is that there are interventions available through skilled rehabilitation that can assist those with the start of early onset memory loss to manage in their current community environment. Karacoloff and SunDance s Directors of Clinical Practice and Training have developed a program to educate occupational, physical and speech therapists about the interventions available for treating individuals with memory loss through a two-prong training approach. A tool kit for therapists All SunDance therapists receive a resource tool kit as part of their training on providing rehab interventions to manage memory loss. The SNF tool kit includes some of the following clinical resources for use with residents with dementia/ Alzheimer s disease: Overcoming communication difficulties Identifying residual strengths and abilities A crosswalk of cognitive and physical functioning characteristics The hierarchy of task presentation for OT, PT and ST Discipline-specific goal banks Transitioning from skilled into activity based programming The first step of the SunDance approach is to identify any changes in the individual s performance of daily tasks in a SNF environment. Therapists receive extensive training within both classroom and clinical lab settings in how to assess the subtle memory and cognitive decline that may be occurring. Changes identified are clarified through the evaluation process for each individual, with particular attention to the functioning of short term and procedural memory as well as executive function. The nursing team has a critical role in providing support to these residents, so nursing caregivers are included in a half-day training session, noted SunDance Director of Clinical Practice and Training Dana Tingley. It is imperative that the interdisciplinary team is focused not only on the needs of the individual with dementia and/or AD, but also uses common strategies during individual interactions to minimize behavioral issues and to structure the resident s day and activities. In-depth training helps the full interdisciplinary team to provide the consistent approaches most beneficial to these residents. The second step of the SunDance approach focuses on developing integrated interventions to assist residents with managing early memory loss and mild cognitive impairment. Defined strategies are implemented to support the resident and optimally preserve independence by using a partnership approach with family, nursing and therapy department members. The program is tailored to assist individuals with early onset memory loss or mild cognitive impairment residing in independent and assisted living settings, as well as continued care retirement communities. Familiarizing the full team Orientation of the interdisciplinary team on normal aging versus signs of developing MCI and establishing a referral process to rehab is needed. The team is taught about tests and measures to use in their evaluation process; rehab interventions for this population; and the need for follow-up cognitive testing. This program complements the existing wellness lecture series offered on a monthly basis by SunDance therapists. We need to educate the consumer, family, executive director, nursing staff and caregivers that changes in cognition may not be normal for the individual s age or educational level and that early intervention through skilled rehab should be considered because it will allow the individual to age actively in the community, stated Gail Johnson, Director of Clinical Practice and Training. Karacoloff agrees and adds that SunDance therapists already act as resident advocates in the SNF environment and are now poised to meet the needs of the aging population by identifying and treating those individuals demonstrating early signs of MCI. n 4

A true partnership SunDance Rehabilitation and Lorien Health Systems Displaying an effective model of committed teamwork, SunDance Rehabilitation and Lorien Health Systems have prospered Partnership can be defined as an arrangement where two parties agree to cooperate to advance their mutual interests. With a mutual interest of providing quality care for seniors in a compassionate manner, the partnership between SunDance and Lorien Health Systems has thrived. Lorien Health Systems is a leading senior care provider operating seven senior living communities in Maryland. What started as a standard contract arrangement in 2003 between the organizations has grown into a model partnership. Both organizations share a true passion for serving the senior community and a willingness and desire to be on the cutting edge of the profession. Amazing things have happened, as demonstrated by the following examples: Advocacy At the heart of our partnership is the core belief that we must be advocates for residents we serve. With an advocacy mindset, we develop, implement and maintain programs that proactively identify and intervene when resident declines in function are detected. All Lorien communities embrace an active Hey Therapy referral system which energizes and motivates ALL team members, from administrators to housekeeping staff to volunteers, to be consummate advocates in identifying potential needs for therapy intervention. The Lorien team has embraced the Hey Therapy program which empowers them to advocate for the residents well-being stated Wayne Brannock, Vice President of Clinical Affairs with Lorien. Pathways to Wellness services offer a multidimensional approach to maintain health and wellness in the communities. Innovation Through the use of SunDance s clinical outcomes system, our combined care teams monitor and provide resident specific outcomes data to families, physicians and referral sources. Clinical and billing interfaces allow for real time tracking of outcomes for clinical and financial results along with community specific and consolidated reporting for Lorien s leadership team. Real time measurement enables real time intervention when a course correction is required. State of the art modality and therapeutic equipment are provided at each community, with many of the programs serving as demonstration sites when new technologies and products come to market. Partnership Working through another time of change, our organizations proactively embraced MDS 3.0 and RUG-IV with a series of training and preparation courses prior to the October 2010 implementation. During the MDS 3.0 transition, our teams collected data, met regularly and shared results from multiple sources within the companies to improve preparations. Planning is under way to prepare for the potential changes in the PPS Rule for 2012. SunDance has improved all aspects of our rehab program, focusing first on the quality of care which has translated to improved reimbursement. Most importantly, patient satisfaction is superior. They really are that good, says Lorien Health Systems CEO Lou Grimmel. n 5

The SunDance Customer Corner Our winning combination of outstanding clinical, patient management and reporting technology helps SunDance provide unparalleled customer service SunDance s high tech, high touch approach combines technology with our service offerings in our Customer Corner. The online Customer Corner website can provide a variety of information, from a snapshot of your center s caseload to detailed reporting of our performance with each diagnostic group. The ability to access business intelligence in real time through the web is a valuable asset for our partners. As our industry prepares for the outcomes and quality reporting that will be required to succeed under the emerging Accountable Care Organizations model, being able to monitor trends and communicate results will become an even more important process. The ability to illustrate the clinical efficacy and outcomes of treatment, as well as to market to potential ACO partners will be critical for those centers that wish to become part of the new shared savings models. The Customer Corner was designed to make that data readily available. SNFs can access reports on length of stay, cost, revenue and diagnostic profiles by payer to share as needed. With the new demands for interfaced information and coordinated care management, the Customer Corner is an exciting tool for illustrating each center s most important rehab metrics. It can be easy to become overloaded with technology and information these days and lose focus on what s really important: the residents we serve every day in our centers. SunDance Customer Corner features allow each business partner to specify the parameters of interest, including the information they need most. This allows for customized reports that encompass only the desired level of detail. The parameters and metrics included vary by report, so you don t have to wade through data that is not relevant to your interests. Whether it s length of stay, diagnostic group mix or discipline-specific rehab census, it s all accessible at the Customer Corner. Listed here are some of the highlights of this value-added reporting we provide to strengthen our relationships with our business partners. Rehab utilization Real-time RUGs Distribution and RUG Distribution Days highlight this section. Length of Stay can be viewed across diagnostic groups. The intensity of therapy services is displayed via Therapy Index results with specific drilldowns available to view units of services by payer source across customized time periods. Clinical outcomes Reports include Discharge Destination results customized by payer and date range. Additional information on the degree of functional improvement (Measured Skills Improvement) is also available. Financial information Management tools provide real-time data for centers key performance drivers. Customers can track results month by month. Rehab service statistics Customizable reports summarize caseloads, admission profiles and visit/unit data. The SunDance Customer Corner is a vital component in Linking People Partnership Performance. As a premier provider of rehabilitation services, SunDance is committed to providing the right information at the right time through this new technology touch point. 6

SunSolutionsSM Consulting Has it all SunDance s new division provides effective solutions for assisted living and skilled nursing operators SunDance Rehabilitation is proud to announce the launch of SunSolutions SM Consulting. The full service consultative provider specializes in operational solutions for SNF, ALF, IL and post-acute care settings with a unique approach that focuses on resident advocacy and facility operations in tandem. SunSolutions Consulting s innovative approach is customized to clients needs and encompasses support from SunDance Rehabilitation s full range of expert clinical, financial, operational and compliance teams. As the industry faces challenges from CMS s 2012 PPS Rule to preparing for the ACO environment, SunDance believes the expansion of our consultative services division is timely for providing long-term care operators and business partners with solutions for thriving under the pressures of regulatory change. During times of uncertainty, SunSolutions Consulting assists providers in finding new strategies pertaining to resident assessments, the Medicare landscape and business processes that will benefit the residents, staff and facility operations. At SunDance, we began a consultative partnership approach with our customers by offering monthly educational teleconferences focusing on industry and regulatory updates. Prior to October 2010, SunDance delivered national CE-credited MDS training seminars that educated our customers interdisciplinary teams on strategies for thriving under the MDS 3.0 and the RUG-IV process. Due to the overwhelming success of the seminars, we realized that our partners were in need of ongoing education and consultative support services, which resulted in an execution plan for the launching of the consulting division. SunSolutions Consulting also has recently launched Medicare Scholar and MDS Institute Seminar programs that offer CE credits to attendees. In addition, SunSolutions Consulting provides customized services based on individual customer needs. Here is a sampling of onsite consultative offerings that facilitate provider solutions SunDance s new consulting division offers scholar and training programs that provide CE credits. It is one of the newest innovative wrinkles that illustrate the SunDance Difference. for today s operational challenges: Medicare Compliance Assessment and Training PPS Case Management Analysis Case Mix Review and Training RAC/ADR Preparation and Training Final Rule Implementation Navigation Clinical Systems Development, Support and Training Mock Survey SNF and ALF MDS 3.0 Revenue Cycle Management and Rug-IV Training MDS 3.0 Coding Strategies In-House Therapy Analysis Nursing and IDT Documentation Restorative Nursing and Part B Program Development Market Study/Market Analysis/Niche Feasibility Independent Review Organization (IRO) Assistance The consulting team of experts looks forward to providing effective solutions to optimize best practices and drive home facility operational success. Contact us to learn more about our artillery of experts specializing in clinical, compliance and advocacy consultative products. Contact SunSolutions Consulting at sunsolutionsconsulting@sunh.com or visit the SunDance website at www.sundancerehab.com. n 7

ADAPTATION INNOVATION Is your therapy provider on the edge of innovation? At SunDance Rehabilitation, we believe that advances in technology also mean advances in care. SunDance combines outstanding clinical management and reporting technologies to provide you with the quality customer service that you need to meet today s demands and successfully anticipate and adapt to tomorrow s transitions. Get the innovative support you need and rise above the rest. ¼¼ Web-based,¼real-time¼data¼that¼integrates¼clinical,¼billing,¼ regulatory¼and¼patient¼management¼along¼with¼financial¼ management¼information ¼¼ MDS¼Toolkit¼for¼improved¼MDS¼completion ¼¼ Customized¼patient¼and¼facility-specific¼data¼to¼identify¼ opportunities¼and¼enhance¼clinical¼results (888) 267-2220 www.sundancerehab.com advocacy innovation competency versatility partnership