Transcript Generated by AI 00:00 Hi, Mark Parkinson here back with Park Place. 00:03 And I'm very excited because today we have another innovations and innovations 00:08 is such a special part of our website. 00:11 It's really kind of what this whole thing is all about. 00:13 It allows you and your teams to, for free, come and learn about goods, products, 00:18 and services that Mark and I think can really help your buildings usually in one 00:24 of two ways. 00:25 Usually either by increasing the quality, improving the quality measures in the 00:29 buildings, sometimes by making you more money, 00:32 or in some cases both. 00:33 And today we have a service that we think does both. 00:36 It's a particularly special day today because it's Comprehensive Rehab 00:40 Consultants, which is another company that I've gotten 00:43 deeply involved with. 00:44 I think, you know, I wondered and others wondered, 00:46 what would I do in retirement? 00:48 I've gotten super involved in two projects. 00:50 One is Park Place, what you're watching right now, 00:53 but the other is CRC, which is a company that puts physiatrist 00:56 in nursing homes to work with the post acute patients. 01:00 I agreed on retirement to serve on the board, 01:02 but then the more I learned about the company, 01:05 the more involved I wanted to get. 01:08 And so now between Park Place and CRC, I'm practically back at it full time. 01:13 I got deeply involved in CRC because I've seen first hand the incredible impact 01:18 that putting posiatry in nursing homes can have, both for the nursing home, 01:22 but more important for the residents. 01:25 And today we are joined by Justin Molagnoni. 01:29 God, Justin, that's as close as I've come to getting 01:31 your name right. 01:33 And it's so fun to have Justin here because part of what's completely sold me 01:38 on CRC was I shattered with you for a day in a nursing home in Lebanon, PA. 01:43 And I was able to see what this entirely new model of physiatry was doing for 01:49 patients. 01:50 And I'm super fired up. 01:51 I think we need to get this into as many buildings as we can. 01:55 And I think you're the person to help explain why that's important. 01:58 So Justin, before we get into why CRC is different, 02:02 first of all, let me thank you for your work with with 02:05 CRC. 02:06 But if you can just tell the viewers what is physiatry and particularly in a post 02:10 acute setting, what is what is physiatry all about? 02:13 Thank you, Mark. 02:15 So what physiatry is, is we're specialists that are trained in 02:19 rehabilitation medicine, physical medicine, 02:22 as well as pain management and trying to maximize those outcomes for individuals 02:27 in the short tank, excuse me, in the short term community specifically, 02:32 we work with individuals who are there specifically for rehabilitation due to an 02:37 illness in the hospital or an orthopedic surgery. 02:41 And we come in and we integrate with the therapy team as well as other teams 02:45 within the building to try to maximize those outcomes. 02:49 So just a level set for everybody. 02:51 We don't charge the nursing home. 02:53 You're an outside clinic clinician, usually an MDAPA or an MP. 02:58 That comes in Bill's Part B, mainly working with the post acute folks 03:02 to get them as well as possible. 03:05 Now I said earlier on that CRC has developed an entirely new model for 03:10 prosiatry. 03:10 I've talked to folks that have had prosiatry before. 03:13 Some have liked it, some weren't thrilled about it, 03:15 but it seems to really be working with CRC because of this new model. 03:19 So what is it that makes CRC different? 03:21 One of the key things that makes CRC different is we're all salaried employees. 03:25 So that means we can be there for meetings. 03:28 Our time does not need to be dependent on the number of individuals that we see in 03:32 that building. 03:33 Additionally, because we're salaried employees, 03:35 we're there from 8:00 AM to 5:00 PM, the daytime hours when everything's 03:39 really occurring in the building. 03:40 So we can really integrate with everyone in real time. 03:44 I remember when Stacy and I had our buildings, you know, 20 years ago, 03:47 we would see some of these outside folks come in early in the morning, 03:50 late at night. 03:51 But because you're employees, you're there regular business hours at 03:54 least two days a week, is that right? 03:55 That is correct. 03:57 And you're also not paid based on the number of residents that you see. 04:01 Is that and, and what does that allow you to do with, 04:04 with the rest of your time? 04:05 So what that allows us to do is sit in on these meetings. 04:08 And as I mentioned earlier, when we partner with these buildings and 04:11 these teams, it's truly that a partnership because 04:14 we're salaried. 04:15 We can sit in on the UR meetings, which is when the therapy team goes to 04:19 each individual resident and what's going on with them. 04:22 We can sit on the Medicare A meetings, which is when we're talking with the 04:26 insurance companies to make sure we keep these residents getting the amount of 04:29 therapy that they deserve throughout the entire process. 04:32 And we also then partner with the MD's team as well as a social workers. 04:38 And I think the statistic is that only like 35 to 40% of CRC's clinical time is 04:43 spent billing. 04:45 The rest is spent on these other activities. 04:47 Let me just kind of thinking back to when I shattered you. 04:49 I remember one of the first things we did was we went on to the therapy floor and 04:53 you were watching the therapist provide therapy to the residents. 04:57 Why were you doing that? 04:58 Well, that tells us so much when we're able to 05:00 sit there in the gym and watch how individuals are progressing in the 05:04 therapy, not just even physical therapy, speech therapy as well, 05:07 how they're swallowing and their cognition therapy is going so we can 05:11 intervene, try to remove barriers and try to 05:13 maximize their outcomes. 05:15 And you weren't billing for that, but that was just helping you when you 05:18 would later see the resident. 05:20 I remember that there was a resident that had a particular neck issue and you had 05:24 prepared a two or three page memo for the rest of the frontline staff on how to 05:29 care for that patient. 05:30 Can you tell us about that? 05:31 And it's not like a one off thing or is that something that you regularly do? 05:34 Unfortunately, it's not a one off thing as we know here 05:37 in the long term care community, right, that the amount of acuity rolling 05:41 downhill is getting higher and higher. 05:43 We're now starting to see fresh spinal surgery and fresh neck surgeries rather 05:47 than just typical orthopedics. 05:49 And for that, for individual, that individual had something we call 05:53 AC1C2 fracture. 05:54 I mean, they broke their spine right at the very 05:57 top where it connects to the head. 05:59 Now that individual is at significant risk for a lot of complications, 06:03 but one of them is making sure the proper care is done so we don't cause further 06:08 injury to the neck that's already significantly injured that could cause a 06:12 terrible outcome. 06:14 And so we're able to create education for the front line staff so they all feel 06:17 comfortable and confident. 06:19 And that's a big thing that CRC cares about. 06:21 One of the amazing things about CRC is our internal education. 06:25 All the providers who joined CRC go through a very strict curriculum to 06:29 better understand physiatry and become certified in physiatry as well. 06:33 So that memo that you put together, you didn't bill for that, 06:36 you didn't charge the facility that, but that helped the rest of the frontline 06:40 staff hopefully give a great outcome for that resident. 06:42 I remember we had another resident that was about to start physical therapy and 06:46 the therapist noticed that their legs were swollen, 06:49 thought that maybe they had a blood clot and wanted to send them out to the 06:52 hospital. 06:53 They asked you for your opinion. 06:54 Remember that case? 06:55 Oh, yeah, I really do. 06:58 That's again, another unfortunate individual there. 07:00 That's for short term and having complications. 07:03 They were able to contact me and one of the big things that CRC does very well as 07:08 we partner and integrate with the primary care team. 07:11 So when they came to grab me, I could quickly assess, 07:14 understand what's going on, what the potential diagnosis would be, 07:18 as well as start ordering labs and test simultaneously communicating with the 07:22 primary care team so they understand what's going on as well. 07:26 And then we can move together in a very coordinated fashion to maximize that 07:30 individual's outcomes, which we were able to do in that case. 07:33 And, and that that you, you decided that person actually didn't 07:36 need to go to the hospital. 07:37 You need to have some more tests. 07:39 I remember following you on a pain injection and, 07:41 and the woman that you were given the injection to, 07:43 she had me hold her hand during the pain injection 'cause she was worried it was 07:47 going to hurt. 07:47 It ended up not hurting, but the incredible thing about that pain 07:51 injection was she was instantly better, which I wondered if it was the placebo 07:55 type effect. 07:55 But your, your experiences now this this seems to 07:58 work. 07:58 Yeah. 07:59 I mean, placebo is a very real effect for 08:01 individuals. 08:02 However, I, I have done this long enough that I have 08:05 seen time and time again individuals who have severe osteoarthritis in their knees 08:09 and their shoulders. 08:11 A simple injection with steroids and lidocaine can give them free pain relief 08:15 for up to three months. 08:16 And that is such a significant thing in the short term stay environment because 08:21 pain is a real problem when you talk about rehabilitation. 08:24 And then I remember right afterwards you called her daughter and her daughter was 08:27 obviously very relieved. 08:28 So it's fantastic, fantastic outcome. 08:31 Now the care of these residents. 08:32 And this is one of the things that really sold me on CRC doesn't end when they 08:36 leave the nursing home. 08:37 It it continues after that. 08:38 Can you explain that? 08:40 Yeah, one of the incredible things that CRC 08:42 does is we follow up with the residents once they're discharged up to 90 days, 08:47 twice a week. 08:48 We have an internal team reaching out and contacting them. 08:51 They get called. 08:52 They get called twice a week for a 90 day. 08:53 Yep, exactly. 08:55 And just to make sure that if any problems are coming up, 08:58 we get ahead of them to keep them out of the hospital. 09:01 Or if things are going wrong, we make sure we integrate then with their 09:05 home health team that's there so we can get our hands around it and maximize our 09:09 outcomes again. 09:10 Well, it's not surprising that the data 09:13 reflects that this has a great result on the residents and, 09:17 and for the facilities themselves. 09:19 I mean, there's a lot of data that shows that was 09:22 CRC falls drop, quality measures improve and even PDPM 09:25 rates can go up. 09:26 What, what are some of the outcomes that you've 09:28 seen? 09:29 I mean, if we start off with the PDPM rates, 09:32 CRC has this incredible service with our internal team as well where they're able 09:36 to go through the discharge documents in the hospital to make sure that we're 09:40 capturing as many NTA points for the nursing home only. 09:44 So we're maximizing and getting them the compensation they deserve for the care 09:47 that they're providing. 09:50 Outside of that, what we then are able to do is we're able 09:53 to go through partner with the primary care team. 09:57 I know I mentioned that a couple times already. 09:58 One of the big things about partnering with the primary care team is we can each 10:02 see the same individual on the same day and we can each bill for it because we're 10:06 approaching this from 2 significantly different lenses. 10:09 Outside of that partnership. 10:10 Then we then partner with the director of therapy, the director of nursing, 10:15 the administrator as well as then the social worker. 10:18 So we're setting everything up across this entire continuum to maximize the 10:23 results. 10:24 Well, Justin, it seems like a pretty amazing value 10:26 proposition. 10:26 It doesn't cost to providers anything. 10:29 Their residents can get better. 10:30 Sometimes PDPM rates can go up and because of the post discharge follow up, 10:35 we admits decline a lot. 10:37 Thank you so much for the work that you do in your buildings and for the work 10:40 that you do with CRC. 10:41 And I, I would just close by saying that again, 10:44 if you don't have physiatry in your buildings or if you have it and you're 10:48 not happy with it, you need to contact CRC. 10:51 I've seen first hand the incredible impact that they can have for you. 10:56 And I really encourage you to to reach out. 10:59 Thanks again for joining us here at Park Place and with innovations. 11:02 I'm you can tell I'm so excited about this and this entire project. 11:06 We appreciate your support. 11:08 Oh my God, if you're still watching this, this means that you watch the end of a 11:13 very long video on Park Place. 11:15 I'm not sure what that means. 11:16 It says something about you or maybe there was just nothing else to watch 11:20 today or maybe your priorities are a little bit off. 11:23 But whatever it is, we really appreciate your support. 11:26 And if you want to continue to follow us, follow us on LinkedIn, 11:29 on our various social media sites and, you know, 11:32 try to find something else to do.
