Aging Strong: Rehab, Wellness & The Future of Senior Living

In Episode 7 of Into the Pines, Joe sits down with Will Davis, physical therapist and senior living director at LHC Group, to discuss the evolving role of rehabilitation and wellness inside senior living communities. From falls prevention and proactive therapy to operational partnerships and resident independence, the conversation explores how strong rehab integration can improve quality of life and help residents age in place longer. Will also shares insights on the future connection between healthcare and senior living — and the innovations reshaping resident care over the next several years.

Transcript

SPEAKER_01 0:12

Welcome back to Into the Pines episode seven. I am joined here with Will Davis from LHC. And we're going to talk about today a little bit about what makes good integrated therapy services in a business for residents and also just in general for resin health. So super excited to have Will here today and join us. And I want to talk a little bit about, you know, kind of our journey and how we started. And we had a community in Greenville, South Carolina that Will was actually working at at the time at that site. And we met there, and I was so impressed with how his team integrated into our activities program with Daily Exercise, what you guys did with our memory care residents, and really elevated what I thought about therapy services and seeing the benefits to our residents as well as just really the next level of therapy or what impressed me with therapy. But I think we'll just for general knowledge, just share a little bit about your background and your journey and uh kind of how you got in with LHC.

SPEAKER_00 1:12

Sure, absolutely, yeah. And I uh thank you for having me. I absolutely I love any opportunity to sit and chat with you. Um, and and this podcast means a lot to me. I know I've told you several times I listen to every episode, and I think it's a it's a phenomenal podcast that I think really is helping to put senior living on the map, right? Yeah. One that's hopefully going to educate more individuals on what senior living looks like, what it means, how it's changed over the years, because I think there's some negative stigma with it. Sure. Um, and so the podcast's been awesome. I mean, I love hearing your knowledge, expertise, experience, um, but pulling in others, pulling in Luke from Senior Living, uh Senior Analytics, pulling in um, you know, RJ and Lynn has been great. Uh Dushant uh from Sage has been awesome to hear as well. So uh great to hear everybody's uh different different opinions and and mindsets and and how you guys are changing the game with senior living. Thank you. Um yeah, absolutely. So one thing that really stuck out to me from your very first podcast was you talked about the culture, right? And the culture with the pines. You guys talked about the difference between passing through and being a lifer. That's right. And what you want to do with with all of your employees across the board, you want lifers, right? You want those who are invested in the lives of our seniors. And that just completely pulled on my heartstrings and rung a bell to me of like, yes, that that that is said absolutely perfect. That's what I want, that's what I have committed my life to do. Yeah, um, and so I appreciate you saying that. It kind of leads me into my story of being a lifer, right? Um, and so you know, kind of going way back to when I was three, four, five years old, my grandparents were a huge part of my life. Yeah. Uh we uh my grandfather would take me to meals on wheels services. I don't know if you have any familiarity with that, but um, taking meals to those who are less fortunate, those who are shut in, can't get outside of their home. And he really taught me the value of just putting others first and sacrificing um your own time and effort and energy to pour into the lives of others, which was really meaningful to me. And I did that for a great extended period of time. Okay. Um, furthermore, growing up, we we went to the same church, and so I was very involved with anything that my grandparents had going on. So uh they were a part of the Yaws at our church, and the Yaw stood for Young at Heart, which I think is a great acronym that we can take into all of the communities. I think we need to steal the acronym. Steal it. So Young at Hearts, I think, is is an awesome program, and it's one that I'd I loved being a part of um all growing up. And so um, you know, growing up even further into high school and and and even a little bit into college, um my grandparents started to decline as normal, right? And um, we were able to find a home for them. And so we moved them into a CCRC, uh, so so one of the continuum care retirement communities nearby, right outside of the neighborhood that I grew up in. Okay. Um, and so this was an opportunity for us to kind of see the full transition from independent living to assisted living to memory care. And at times my grandmother was in and out of SNF as well, the skilled nursing. Yeah, and so my whole understanding was that there were just nursing homes, right? Didn't really understand the difference that that there was a wide gamut of senior living opportunities. And so I was very involved there, like I said, right outside of my neighborhood, saw my grandparents every single day, took part in the events, um, made sure that I was very present for all of that. Yeah, um, loved being a part of it and and hated to see their decline, but was really interested in seeing how their decline was managed and handled uh throughout the whole entirety of that one community throughout the remainder of their life. Um the only negative side of it was I did take my grandmother to an in-house physical therapy appointment and simply didn't like the way that she was treated. Okay. Um I felt like uh they didn't give her the care and attention that they needed. They kind of stuck her in a corner and told her to do some exercises. Uh that day I remember calling my dad and I explained to him my frustration, and and he said, All right, what are you gonna do about it? Yeah. And and anybody that knows my dad knows that's how he was. He just said, You need to do something about it. Yeah. Um, and so as I progressed from high school into college, started thinking about that a little bit more and decided I wanted to um go a different route with my life from the business management major that I was going. Uh very similar story that you shared with you and your family, where your family kind of had they were all what attorneys and lawyers, and uh my whole family was in finance. Okay. And and I called my dad one day and I said, Dad, I just don't like this. And and he said, Well, exactly what your dad told you, it doesn't get any easier, right? And so I said, you know, I I really am feeling this calling to be a therapist and and to work with our our geriatrics. That's great. And so went into physical therapy school, uh, final year of our program, uh, went on a two-week medical trip to Costa Rica and conveniently got placed into a senior living. And within that, I was in charge of the senior community. We did uh balance program, we did a falls prevention program, um, and really my love just took off from there. From there. It's awesome. And so I came home and uh it was about time to start looking for jobs as I was coming up on graduation and um ended up finding finding this job. And so I've been working for this company actually for my same manager uh ever since I graduated PT school. That's amazing. That's awesome.

SPEAKER_01 7:07

Really good, cool story. I appreciate all the background on that, Will. It's it really hits home for me on very similar paths. Um I think you know, one of the things that that makes you stand out from the other groups that I worked with is the passion behind it and the culture that you guys have developed. And I think one of the things for people to understand, and you mention it in your own personal story, is that therapy services 15, 20 years ago were put them in a wheelchair, give them some bands, give them some weights. Maybe you can talk about what not only LHC has developed, but what you've seen develop and and the outcomes of that by being proactive with therapy services.

SPEAKER_00 7:47

Yeah, absolutely. Yeah, great question. I think uh, and in in a lot of it is even from when I first started 11 years ago, just seeing the change. Yeah, I think that having communities that embrace us and embrace our program obviously goes a long way. When you have communities where you're just kind of seen as another face, another third-party provider coming in and out of the doors, there's no real relationship, there's no real connection and communication there, obviously that program's not going to be as beneficial, right? Where when we come into a community and we're invited into the stand-up meetings, we're invited into the collaborative care meetings, the sales and marketing directors bring the potential families by our gym space and want to talk to us about therapy.

SPEAKER_01 8:32

Um, I think in your gym space is impressive. You know, one of the things that I like is you know, a lot of communities will claim, oh, we have a fitness center or we have whatever it might be, but you guys actually utilize the gym, utilize equipment, and then create a lot of other services in that space, which is really unique.

SPEAKER_00 8:51

Sure, yeah, and it and it looks different in every community, right? I mean, there are some communities where we set it up as a Medicare certified gym space, and that is strictly used for therapy only, doors are locked after hours, all that. Um, some of our communities, as you well know, we we set them more up as wellness spaces. So they are community-based, uh essentially community-based gyms. And so our residents have the opportunity to go in there kind of 24-7 and and and make it their own. Um, those are always fun because you can kind of, you know, you discharge somebody from therapy when it's appropriate, leave them with a good quality home exercise program, and they're free to utilize the gym within their own community. Yeah. Um, I think that a gym space in a building can can obviously be a great selling point on these tours as well, be it a gym space for therapy or just a wellness space within your own community. Yeah. Um yeah, 100%.

SPEAKER_01 9:43

I think the other thing, too, that's kind of a misperception out there is it doesn't just have to be Medicare uh certified. You know, people can pay privately for some extra therapy. They're feeling a little weaker after they had COVID or an illness. And what we've seen is that integration into those multi-spaces, they get it comfortable with it and they know their bodies better than anybody. That's right. And so they may come to you guys and say, I really need a little more help with, you know, transferring from my wheelchair to my walker or getting from my walker to a cane, you know, and just really using the devices in the proper way for safety and living healthier lives. And I think that's one of the big misconceptions I still see out there is that therapy is only for the sick. Sure. Right.

SPEAKER_00 10:22

And it's just the polar opposite. Yeah. Well, and you bring up a great point. There's so many communities that are are asking us, well, how do you get your referrals? And very simply put, the majority of our referrals, patients just come by. Yeah. You know, these residents, they know who we are, they know where to find us, and they come by, and if they're feeling the slightest bit difference, uh, you know, a little bit off than they were the week before, day before, they tell us. They tell us everything. And and and it's uh good, bad, and ugly. The good, bad and ugly. You know, we hear about we hear about food, we hear about drama within other residents, and you know, we hear it all. So um, but no, it's it's great having that camaraderie with them. And and you know, obviously, then we work really closely with the facility management, we work with the physician groups, the nurse practitioners just to to figure out what's going on and and how how is it that we can step in and help.

SPEAKER_01 11:12

Um yeah, you know, one of the big things that we hear about so often is fall prevention and how that ties into wellness. And I was reading a statistic recently, and it was like 3.8 million falls happen every year, or something like that. Yeah, you know, a subset result in death, but many of the others result in some type of therapy services. Yeah, but to me, it's like before you get to the fall, yeah, what can we do? So maybe you can talk a little bit about how you guys help with that.

SPEAKER_00 11:36

Yeah, absolutely. And and and you brought up a great statistic. I mean, I I have some statistics that are kind of burnt in my brain because we do a lot of in-servicing and conversations. Um, one third of individuals who are 65 plus fall every year. Wow. After the age of 80, that increases to one half.

SPEAKER_01 11:54

Wow.

SPEAKER_00 11:56

Out of anybody in that demographic who falls, two out of three of them are gonna fall again within six months. 90 to 95 percent of hip fractures occur from individuals falling. Yeah, and so you can see how the uh a main cause of death and mortality, unfortunately, in hospitalizations are these falls. And so you're exactly right. Being on top of of fall prevention is is huge. I think um, you know, I think we do a really good job at our fall prevention measures. Um, and you know, I have uh uh Jody who Jody Walzonia who um who is on our senior living team, um, one of our leaders there. Uh he is a huge mentor of mine. I think that he is incredibly smart and says it a lot more eloquently than I can, but I'll I'll try my best. Yeah, he is very much on top of how can we do a better job at fall prevention versus fall reaction. So often our communities come to us and they say, Hey, we just had five falls over the weekend. What can you guys do as an intervention? And it's like, well, great. We have interventions that we can put into place, but why in the world did those falls happen? What can we do to mitigate those falls before it's too late? Because, like we just mentioned in those statistics, oftentimes it's too late. Yeah. And so we are really on top of the fall prevention measures. And I think that that truly it starts upon move-in. Upon move-in, we want to know who's coming. We want to meet them, we want to meet their family members, and we want to help set their room up for success. I mean, you've seen it. Yeah, the number of residents who come in and they have 10, 15 throw rugs that they just want to throw all over, you know, the threshold management, the uh lamps. I mean, they'll bring lamps and and put 10 lamps in their living room. There's cords everywhere, extension cords everywhere. Yeah, big huge fall risks. And so that that's kind of where it starts for us. Yeah. Also, setting their room up for success. Do they have an assisted device? If they have an assisted device, we need to make sure that they have enough room to maneuver that, correct? And so we we want to uh we want to make sure that it's it's set up for success, getting from their bed to uh their bathroom with the proper assisted device. Speaking of that, do they even have the proper assisted device? Right. Huge thing that we do is is assisted device um fitting, measurements, and ordering.

SPEAKER_01 14:29

How often do you see that they have the wrong device?

SPEAKER_00 14:32

Oh, all the time.

SPEAKER_01 14:32

Yeah, because they go to like a CVS and pick something up. I know we did for my own grandmother. Absolutely. And then we found out that it was completely the wrong device. So it happens all the time.

SPEAKER_00 14:41

Yep. And in the wrong device happens more so than that, it's the the fitting, right? And so, you know, you'll see a new resident come to a building and they're walking with a rollator or a walker and it's way up here and it's way out in front of them. It's like, oh, nobody lowered that walker for you to the the height that it's supposed to be. And so what we do is we're never gonna come up to a resident and just immediately lower that walker. What we want to do is train them in how to use it properly. Because obviously, if they've been walking that way for five, six years, yeah, they're used to it, even though it's not you know the right way. That's right. And so what we want to do is we want to fit it properly to them, and then we want to teach them how to use it appropriately before we turn them loose with it. And so anytime you know somebody needs a an assisted device, a walker, wheelchair, whatever it may be, we have DME companies all over that we work with to ensure that we are working with their insurance and get them the um you know the best product for them at their need.

SPEAKER_01 15:41

And when you is that an example of the proactive therapy that we always hear about? Maybe you can share a little bit more about that.

SPEAKER_00 15:47

Yeah, that's absolutely one of the proactive approaches that we take. Um, some other activities that we're involved in, as you well know, are our exercise classes. Exercise classes are huge for us. We think it's a great way to offset some of the burden that you guys have in your communities. Lord knows your activities directors are busy enough and they are they're swamped and pulled in a million different directions. How can we as therapy providers assist and bring in our knowledge of therapy and in movement in order to provide maybe these exercise classes? And within those exercise classes, we see the same people every week, right? And so we're able to see if there's any kind of decline or any slippage, anything going on with them. Um, we also do a very proactive approach with our our balance screening. So we'll do uh balance clinics where we have everybody come through and we check balance and we we check, once again, we'll check their assistive devices and making sure that they're uh they're utilizing those properly. And then our screening tool is is a top priority of ours. And so we have a tool that is uh that's physician-based, and so um usually comes from a physician request, physician order, nurse practitioner, community itself, says, hey, you know, Miss Jones has had a significant decline, be really beneficial if we could look into her and see what's going on. And so a series of questionnaires just asking them how they think that they're getting around their community, how they feel uh like they're doing with their balance, and then it leads us into some options for hey, therapy may be a great option for you right now, or it may be a good option for you in the future. We can do this test again in a couple of months and see how you're doing. And the idea is that we keep the test in a book, and if we notice a setback with Miss Jones in six months, a year, we can look back and say, all right, here's how she was doing upon move-in, right? So it allows us to establish that baseline. I love it.

SPEAKER_01 17:40

So, well, one question I wanted to ask you is the warning signs. A lot of times we see, you know, an adult child come in and inquire about our communities, and they'll say, Well, my mom doesn't need it yet, but I have a concern. And it usually stems with maybe the way they walk or their environment in their personal home. Uh, what are the warning signs that adult children should look for with their loved ones?

SPEAKER_00 18:06

Well, and that's a great point about the adult children. They are kind of our our first line of communication, right? I mean, I I think a lot of individuals there, the residents themselves, don't always know exactly what to tell us. Sure. And and they may or may not notice that they're having a decline. And so we notice it. The families especially notice it. And so that's where we rely a lot on that information. Um, even when we're doing our assessments and we're trying to get a prior level of function, hey, how was mom doing, you know, five years ago or even right before she moved in? Um, they're kind of a lifeline for us, and we certainly look look to them for that. Um, I think it's also important to know. I mean, we've we've talked a little bit about the assisted devices. Um, it's important to know that that a lot of individuals they come into our communities and um they don't have anything. And so we try to stay really on top of that with with managing them, looking at the way that they're moving. Um, you'll notice some individuals over time start shuffling their feet a little bit more. Yeah, you'll notice improper footwear.

SPEAKER_01 19:09

Okay, you'll notice uh footwear is a big one, right? Footwear is a big one. I've seen residents come in with shoes they've had for 30 years. Oh goodness. And I'll say to the adult children, they need a new pair of shoes. Yeah. And their mom loves that particular pair, but I see that a lot.

SPEAKER_00 19:22

Yeah, absolutely. It's a great point. I mean, you know, they they pick up this brand of shoes that were on sale and they were good, good brand. You know, the the little sweet little ladies, they love to wear their little slip-ons, or maybe they have a little heel on the back and good night. That's our worst nightmare, isn't it? Exactly. And so trying to help encourage them in finding the proper footwear is huge. Um, I know you and I share love for for our on-running shoes. Yes. And and so those are something that we've we've suggested to a lot of our residents. Sure. Um, I think that's a a wonderful thing. Um, you know, just proper footwear is huge. And then just making sure that they have the right assist device at the right time. Okay. Um, but you'll notice residents who are are stumbling more, they're tripping more, maybe they're dragging a foot. Um, and and a lot of times that's a trigger for maybe needing an assist device, but more so than that, maybe it's time for a tune-up. Maybe it's time for them to get a little bit more involved in exercise class or more involved in therapy sessions that we can actually work on that leg strength and picking up their leg and working on the foot clearance.

SPEAKER_01 20:29

And when you're developing all that, what would you say the largest impact is back to a community? I know statistically for us, it's longer resident retention. Yeah. But I know clinically there's a whole nother aspect.

SPEAKER_00 20:41

So yeah, sure. I mean, I I think uh if you look, you know, you speak on speak on resident retention. I mean, that is that's kind of bread and butter, right? That is that is where we excel and that is where we want to shine for you guys. Uh I'm very open and honest with saying uh you're not seeing me driving around town and and saying, hey, you need to come move into this community, like this is where you need to be. Our efforts are are within that community, right? And so it in the same light, you're not gonna see a lot of fancy, uh shiny sales and marketing advertisements from us because what it sounds cliche and it sounds corny. We're very focused and driven on that patient care and and patient outcomes. And how many states are you in now, Will, nationwide? So we're at uh over 500 communities is is uh what our company is in. That's amazing growth. Yeah, yeah. So myself, I cover five states. I didn't introduce that well enough in my introduction, but um, yeah, so I cover Virginia, Kentucky, Alabama, Georgia, and South Carolina, um, and a number of communities there. But yeah, our company has grown significantly and and um we continue to to grow every day. And it's it's exciting because we we truly feel like we have a product that that is not out there, a product that no one else offers. Sure. Um The opportunity to seamlessly transition from home health to outpatient, outpatient to home health when it's clinically indicated is something that other companies aren't doing. I think that that's a it's a huge misconception in senior living, right? It's when is the most appropriate care at the most appropriate time for the residents? And that that always has to be thought about. And I think there's a lot of companies out there who um see home health companies that see outpatient as a competitor or outpatient seeing a home health company as a competitor. And what we have is an all-in-one model where we're able to completely give each community everything that it is that we have to offer, all within house. Love it.

SPEAKER_01 22:45

My famous question that I like to ask all groups where do you see the future of senior living going?

SPEAKER_00 22:50

Yeah, that's a that's a great question. I've I've mentally prepared for that because I've heard you ask it several times. Um, and you know, I go back to to you and RJ, um, y'all's second uh podcast here, um, when you talked about the the kind of the negative stigma surrounding yeah uh assisted livings, senior livings in general. And I think that it gets so grouped into uh nursing home, right? And everybody always calls it a nursing home, even people in my family who who know better, right? They'll say, oh, well, we'll we'll works at a nursing home. And I'm like, I but I don't, I don't even know what a nursing home is at this point, right? Like it's changed so much. And and I see the change continuing to happen. So to answer your question, um, but senior living has so many options and so many opportunities from true, you know, active adult programs, 55 plus communities, to um independent livings, assisted livings with a variety of levels of care, memory care with a variety of levels of care, skilled nursing facilities. Um, you know, I I always joke there, I've been to some, I mean, you guys have some beautiful communities. I've been to some beautiful communities. There's one community I went to, it had an Olympic-sized pool with a diving board, it had a full cabana with grills, it had a tiki bar in it, fully stocked, it had a putting green out there, it had lawn games, bocce by the burnhole and everything. And I was like, oh my goodness, when can I move in? Right. And uh, you know, I was thinking my kids would love it here. Sure. So uh and and I think that people don't realize that's out there. People just have that stigma of of a nursing home to where that's kind of the end of life, and it's it's sad. And I I hope and I think that podcasts like this, conversations like this, will help to open up others' eyes on the different possibilities there are out there. Absolutely. Because there's there's some wonderful communities that you can move into. Um, share another quick little story. There's a community in a large college town that I visited, and just a beautiful community. And um, obviously, being in a big college town, they had individual uh townhomes for rent on their property for families to come stay with their loved ones over game day weekends, and they were fully furnished as a tailgate package. Nice. So they had fully outfitted fridges, food, the grills, everything.

SPEAKER_01 25:24

What great integration, right? What great integration.

SPEAKER_00 25:27

And I think that that's becoming more common, right? And and you've seen it, I've seen it, all these communities have have renovated, they're flipping, they're catering to a more wide range of individuals. And I think that what we'll see, and I hope that what we'll see, less people waiting too long to move in. Yeah, you know, I don't want to say they move in too late, but it takes them a while to move in when they could be more appropriate to move in. I agree.

SPEAKER_01 25:56

Yeah, more successful residents move in earlier and really enjoy all the services and what we can offer. Absolutely. Why would we wait until they can enjoy all the services, right?

SPEAKER_00 26:04

That's right.

SPEAKER_01 26:05

Yeah. Awesome. Well, Will, this is my pleasure to have you here today and and your group. We're so proud of your growth and just continuing to see your own personal development. Absolutely. Absolute pleasure. So good to see you. Absolutely great to see you. Thank you for having me. Absolutely. Thank you. Thank you again for tuning into the Pines. Super excited for the June episode. We're going out into the field, so we'll be leaving the home office here and heading out to interview one of our executive directors at our community and get a perspective on senior living directly from our executive directors. So stay tuned for episode eight in June. I think you're gonna really like that one.