From Buses to Putting Greens, SNFs Align Rehab with Everyday Life

As operators in the skilled nursing industry seek to offer higher-end services, some providers have turned to outside-the-box rehabilitation equipment geared toward residents’ lifestyles — from putting greens to throat-controlled video games to a decommissioned city bus.

For Legacy Healthcare, that means branding one of its rehab units as a “penthouse.” The Lincolnwood, Ill.-based firm provides transitional, rehabilitation, and skilled nursing services across the greater Chicago area, with a portfolio consisting of 27 facilities. The chain includes five “boutique” buildings scattered across Chicagoland, including a nine-story building in the city’s affluent Gold Coast neighborhood.

Situated on the ninth floor, Warren Barr Gold Coast’s “Penthouse Rehabilitation Unit” is an 8,000 square-foot facility, offering sweeping views of Chicago’s skyline. The facility’s rehabilitation team employs 31 full-time staff members.


While Warren Barr has seen its share of private-pay patients, the majority are on Medicare or commercial or managed insurance, according to Lauren Lorensen, director of rehabilitation at Warren Barr Gold Coast.

And despite gearing its rehabilitation program to address the specific needs of the city’s older demographic, the facility still focuses on health issues common in the overall geriatric population, Lorensen explained.

“As a company, we went as broad as we possibly could in scope, while still being appropriate to the geriatric population,” Lorensen told Skilled Nursing News. “If you look at a sampling of the different ailments or diagnoses that geriatrics may have, this is kind of the top set for what we would do here.”


The subacute facility offers a full range of rehabilitation programs, including orthopedic, neurological and cardiopulmonary rehabilitation; post-surgical intervention; cancer rehabilitation; and speech and cognitive therapy, among others.

A physical therapy and occupational therapy evaluation is administered to every patient upon admission, according to Lorensen.

“If people are coming in more for a custodial stay, we still screen all of those people just to see if … they could benefit from a short rehab stint or a couple days a week of therapy,” she said.

Patient lifestyle

A focus on the patient’s return home is central to Warren Barr’s rehabilitation program, with a specific eye toward city life.

Perhaps the most visible part of that strategy is the front end of a Chicago Transit Authority bus that Warren Barr was able to save from the scrap yard. The installation, which includes the front door of the bus and several seats, allows the facility’s urban dwellers to ease back into their everyday routine, according to Lorensen.

“We’re located smack dab in the middle of the Gold Coast, where patients are regularly taking the bus, so it’s more functional for them not only to practice the maneuvering, but actually the different kind of positioning and balancing that’s entailed to taking the bus,” she said.

The demonstration bus is also adjacent to a concrete curb to help patients practice their walking on a textured surface, Lorensen explained.

Just around the corner from the bus, the facility has a full-scale condo mockup where therapists can help patients model movements and maneuvers they perform in the daily lifestyle — from getting in and out of bed to reaching for actual food in the cupboard. In addition, the facility has a putting green on the patio, which helps both golf enthusiasts and non-players alike to get back on their feet.

“Ambulating on a soft surface, or ambulating from a hard surface to a soft surface, is important not just on a putting green, but translates into the community,” said Lorensen. “And also looking at the clientele that we serve, the geriatric population and [the Gold Coast clientele], people want to get back to their golf game. We literally utilize putters in the putting green for balance exercises to be able to feel comfortable and confident in what your personal activity of daily living is.”

Updating rehab’s image

The Kansas City-based Tutera Senior Living also employs putting greens as part of its rehabilitation plans, but the skilled nursing and senior housing provider offers demonstration cars instead of buses. While recovering from surgery or other health episodes, seniors can practice moving from the grass to the sidewalk, pushing a grocery cart, or navigating the threshold of a commercial-grade door that they might find in a store or other public space, CEO Joe Tutera told SNN.

Tutera admitted that he isn’t the only provider to offer mock bathrooms, kitchens, and laundry rooms.

“That’s not earth-shattering,” Tutera said. “There are facilities that are doing that. We’re making that as realistic and functional as possible.”

But for the company, which operates 51 communities in 11 states and offers a wide variety of different care settings, the fancier rehabilitation options are part of a plan to bring a more upscale, hotel-style feel to the clinical world of SNFs.

“Here’s all the elements that would happen in the environment. Let’s do that in a hospitality-type feel,” Tutera said.

Hop to it

Warren Barr has also worked closely with the Reno, Nev.-based medical supplier ACP, which developed a machine that allows residents to complete speech therapy with the help of an animated kangaroo.

ACP’s Synchrony therapeutic tool aids in therapy administered to patients suffering with dysphasia, or difficulty swallowing. The tool monitors the strength and reaction of a patient’s throat muscles as they swallow, but is presented as a game for the patient, in which each swallow helps a kangaroo collect coins.

This two-fold benefit allows the patient to be fully engaged in the therapy process, according to Lorensen.

“It’s both levels of the scale — it really can show you the analytics for that person who… really likes the numbers and the output, and then the other hand, you could just see that it’s something that is fun and different,” Lorensen said.

Written by Carlo Calma and Alex Spanko

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