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One-on-one with… Kristy Brown

May 23, 2013
by Julie Thompson
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Kristy Brown, MS, CCC-SLP

Kristy Brown, MS, CCC-SLP, believes long-term care (LTC) providers need to rethink the industry in order to stay competitive. And that might mean partnering with entities they once deemed their competitors.

That’s what Brown did when she combined two providers—Augustana Therapy Services, part of Augustana Care, with Ebeneezer, a senior housing arm of Fairview Health Services. The result was Centrex Rehab, a Minneapolis-based provider of occupational therapy, physicial therapy, speech therapy, mobility solutions and wheelchair solutions.

Brown, president and CEO of Centrex, is huge proponent of considering new ways to meet the growing needs of today’s older adults, both at long-term care settings and inside their own home. In the five months since Centrex’s inception, the company has doubled in size—the company’s 250 staffers now serve 3,400 patients.

Long-Term Living recently spoke with Brown about the new joint venture.

WHY IS THE TIME RIGHT FOR A COMPANY LIKE CENTREX?

The market says the time is right for us to become partners with our competition. We can’t be in competition with the same people we were in the past. We have to instead join them. A hospital I recently met with has a huge waiting list [for therapy services]. So why not have them send patients to an outpatient clinic that we have? Why not hire some of our therapists to come in and help them? How can we make sure that the patients are getting kindly, quality care not only in a proactive manner, but in a reactive manner? The timing is absolutely pertinent that we look at our former competition and work together instead of fighting against each other in the marketplace.

HOW IS CENTREX'S BUSINESS MODEL DIFFERENT FROM OTHER REHAB/THERAPY SERVICES?

It’s all the about the relationship that we have. Our company is a former non-profit company, [but] now because of the legal way we set it up we are for profit. But, I tell my staff we still have to operate with the non-profit mentality. We are here to make sure we are meeting the needs of patients, but that doesn’t mean you always have to push them to the highest care level. You have to have a bottom line to keep providing the great care you provide, but it doesn’t have to be to the degree that it affects the clinicians that they don’t even have time to document. So taking that non-profit mentality and putting it into a great model of care while still knowing there has to be a bottom line—it’s kind of a balance. It has been extremely beneficial to our company, not only in attracting clinicians, but our retention level is very high.

WHAT OPPORTUNITIES DO REHAB SERVICES HAVE WITHIN SENIOR CARE?

I think there is a definite time and place for therapy and there will always continue to be. We provide an area of wheelchair solutions. We have people go in and put people on pressure mapping devices and look at other attributes that are adding to their discomfort or behavioral outbreaks. I think it takes the skill of an OT to provide the best recommendation for wheelchairs for people. I have been in the field for 25 years and the therapy that I saw when I first started compared to what I see lately… it has come through a lot of changes mostly due to the restriction government is placing on us. We have to work within the means that we are given and also continue to be advocates for these patients.

HOW SHOULD AN LTC FACILITY GO ABOUT SEEKING A REHAB PARTNER?

This is very important. Therapy in the skilled nursing is looked at, first of all, as “are they making me money?” Secondly, it’s “do they like the therapist?” What I am trying to tell administrators is that they need to know the therapy service better. Because it is your provider number that goes up against scrutiny if, for example, [therapists] aren’t documenting appropriately. I don’t think some of them realize that. Also, look at your productivity expectations of your therapist. Some companies expect 90 to 95 percent of their day is spent doing billable patient care. One person asked me, “Well, when are they suppose to do their documentation?” Documentation is a non-billable thing and I couldn’t answer that. You have to make sure they are making money, yes, but do they have everything in place so that you could stand up to a huge audit? One of the first things I would ask a therapy company is whether or not they do their own audits. If they don’t, then you need to ask them if they will. Another thing you need to ask is for their efficiency expectation. My efficiency expectation is 75 percent. In the whole realm of things I feel like giving them that extra time to finish documentation and consult with nurses, doctors and families is necessary to have a quality therapy product.

DOES CENTREX HAVE PLANS TO EXPAND?

We have been talking to people in Iowa and Wisconsin, and Augustana owns places in Colorado. Right now we are in the stabilization mode, but give us a month or two and then we will start talking to people.

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