EPISODE 40 – Making the Most of Your Rehab Stay & Being Your Own Advocate

Episode 40: Making the Most of Your Rehab Stay & Being Your Own Advocate

In this episode of the Team Senior Podcast, Jamie Callahan is joined by Breann Drake, a seasoned healthcare professional with over 15 years of experience in skilled nursing and rehabilitation.

Together, they discuss how seniors and families can make the most of a rehab stay after hospitalization—and why advocacy, communication, and understanding the system matter more than most people realize. This conversation sheds light on what rehab is truly designed to do and how patients can actively participate in their recovery.

In this episode, we cover:

• What skilled nursing and rehab stays are meant to accomplish
• How physical, occupational, and speech therapy support recovery
• Common misconceptions about rehab facilities
• Why self-advocacy and family advocacy are critical to outcomes
• Navigating Medicare and Medicare Advantage rehab authorizations
• Planning for safe, successful transitions back home

This episode is a must-listen for anyone preparing for a rehab stay, supporting a loved one after illness or injury, or trying to understand how to move through the healthcare system with confidence and clarity.

At Team Senior™, our mission is to guide you and support you through the maze of Southern Oregon Long-Term Care.

📞 For Team Senior resources, call: 541-295-8230

Or visit our website for more information: https://www.teamsenior.org/

Transcript

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Episode 40: Skilled Nursing & Rehab - What to Expect and How to Advocate for Yourself

Host: Jamie Callahan
Guest: Breann Drake, Regional Director of Business Development, Volare Health

JAMIE CALLAHAN: Hi, this is Jamie Callahan with the Team Senior Podcast. Our goal is to simplify aging. Society grooms us to plan for retirement, but what about life beyond retirement, where the rubber meets the road? Perhaps you've had a stroke, or you've been diagnosed with cancer, or maybe you're forgetting things and now you have dementia. That's our area of expertise, and we are here to share our insight.

And now, the Team Senior Podcast.

Hi, this is Jamie Callahan, and we are in the studio today with Breann Drake. Breann's one of my favorite people in Southern Oregon. She is just such a dynamic, big personality that it's always fun when we get to get together. I'm going to open this up to Breann so that she can share a little bit about who she is, what she does, and why she's passionate about it.

BREANN DRAKE: My name's Breann Drake, and I have lived in the Rogue Valley my entire life. I have been in healthcare 15 years, and I've been in skilled nursing for 10 of those 15 years. So skilled nursing is a huge passion of mine—taking care of anybody that's sick, but elderly especially. They hold a huge part in my life. And so that's something I went into—I took care of my grandparents. I've taken care of all of my family that way. So that's what got me really involved in this. And then to be able to just be with the families going through—I'm in marketing and business development, which is great because I can be in the community and just see the change that we can make out there.

JAMIE: So you have a huge footprint. Tell us all the places you get to go with your job.

BREANN: I do. I have—so now I have six buildings with my company, and with Volare Health, we have 11 in Oregon. Mine are Roseburg—I have two. Grants Pass, Oregon—I have two. Medford, I have one. And then we have a very large building in Honolulu, Hawaii, which I know you are coming to visit soon.

JAMIE: So yes, I am going to visit that building next week. I'm so excited. All right. You work for Volare—Volare Health—and that is a skilled nursing facility. You work in marketing, but that's not where you started.

BREANN: No. I actually started my career as a CNA way, way back in the day. And I actually worked in Ashland at what is now known as Ashland Post-Acute. So I worked out there as a CNA for a little while. Then I moved to Asante Rogue Regional, and I was a CNA there for a good six years. And then I left, and that's when I went into the administrative side. And I switched, and I worked for a competitor back in the day. I worked at Avamere, and that is where I learned everything you needed to know about marketing, business development. I worked under some really great administrators and DNSs, and then I moved to my company that I'm with now.

JAMIE: I love that. So having the previous experience of hands-on being a CNA, seeing all the things that the folks that work inside those buildings are dealing with on a daily basis, I'm sure really helps you in your job today.

BREANN: Absolutely. I think that's the biggest piece of this—is knowing that each one of us in our roles in leadership, especially in my company, has at one point or another started as a CNA or a nurse or somebody, and we were in those buildings in the trenches. And that was what pushed us to want to get to leadership because we saw the changes we wanted to make. And so that's like a big piece of where I'm at now in my career—is I want to help not only my company grow, but I want to help the communities that we live in and give back to them.

JAMIE: That's what makes every good leader—having the previous hands-on experience and then also having the heart to give back.

BREANN: Absolutely.

JAMIE: Yeah. I love that. So we've talked about Volare, but what is Volare? Who do they own? What are the companies that our local community will recognize?

BREANN: Yes. So Hearthstone here in Medford, and that is our great building sitting over there. Then we have Highland House and Royal Gardens in Grants Pass—our two bigger buildings out here that can hold over 150 people if we need to. And then we have two buildings in Roseburg. We have Rose Haven and Umpqua Valley. And then in Hawaii is Hale Nani.

JAMIE: Hale Nani. That's a great name. I love that. That must make you happy when you walk in the door.

BREANN: It does. It's a beautiful old World War II building. Used to be an old hospital, so it's cool with all the history behind it as well.

JAMIE: So specific to Southern Oregon, if we're looking just at Grants Pass and Medford—Grants Pass is Royal Gardens and Highland House. I have a lot of experience working in and out of those buildings with lots of different families and the hospital and various other touches that we've had there. One thing that I hear on a semi-regular basis about skilled nursing facilities across the board is that nobody wants to be there. They feel like the reputations are bad. They hear all these things in the community, or they've been there before and they don't want to go back. Help us address that.

BREANN: Absolutely. We hear that same exact thing, and I am such an advocate to please tell people: go and tour. Don't call, don't make an appointment. Just show up. Because as anybody knows, that's how you're going to see the best of a building. You are going to see the best of anything when you just walk in and you see what's really going on there. And the fear, I think—just back in the day, people, nursing homes really had the stigma that's where people go to die. That's just really the sad reality of what they thought of it. And that's what we hear a lot. "My grandma was there and she passed away," or "My wife was there and she passed away." And it's heartbreaking to know that's what they think of that. Because really what we are is a 24-hour care facility to rehabilitate and get you back home. Our goal is to get you home. It is sad when someone has to live with us forever, but gosh darn, we love it because they become our family there. But the bottom line is, that's the goal—is get these people medically stabilized, get their physical and occupational therapy in them, and then transition them so that when they go home, they can still get that wonderful care and maybe get home health agencies. And we work so close with all of them. Or sometimes it's even hospice to get them transitioned back to home so they can be with their families in their end times.

JAMIE: Sure. Yeah. We've seen a lot of that firsthand. So when we look at the services that somebody receives in the hospital, they are very different than the services that someone receives in a rehab facility. Let's talk about that first.

BREANN: So in our facilities, they're going to get a little bit more intense therapy training. When you go to a hospital, it's acute, right? You're there to get taken care of, and then that's it. Now they want you to come here because you can't go home yet, so you're going to get five days a week therapies for anywhere from 45 minutes to an hour, depending on what your level is that you'll need.

JAMIE: Which is a rapid ability to make progress because you're getting it five days a week for 45 minutes or an hour.

BREANN: Correct. And so then you're also going to get not only physical, but then we're going to talk about occupational. We're going to teach you how to dress yourself again because you may have had a stroke that, you know, your body isn't working the same, or just all those different things that could have taken that away from you. So we're going to work on occupational, speech. We offer speech, so if you need the swallowing—a lot of people don't understand that's part of speech therapy—talking, relearning a lot of different motor functions that we need to bring back.

JAMIE: Yep. That's—yeah. And I love that you mentioned the speech therapy and that that is the part of the swallowing and learning to eat again, or whatever that looks like. Something that I want to give people as a tool—when we hear people talk so often about not having a good experience in any skilled or rehab setting, let's give them tools. How would you describe the ideal stay for somebody at a skilled nursing facility, and how do you help to empower them to make the most of their stay?

BREANN: Absolutely. That is where communication is the key. You have got to be the advocate for yourself, or your family needs to be that advocate. But know that you're going to have a team in there. And if all good communication is going on, know your expectations. Talk to your team there. You're going to have a doctor that's going to come round on you. You're going to have a full team of nurses. You're going to have a speech therapist and a physical therapist. And just being able to know all of your expectations. And that's something when I go meet with a family, that's what I tell them. And I have brochures that we've made up for just that, so that they can have a checklist, because it is a terrifying time to come in there and not know anything that's going on.

JAMIE: Oh, sure. I know that people are terrified when they don't get to go home. Yeah. And I'm in the hospital because of some unfortunate event that happened, and now I'm leaving the hospital, but I still don't get to go home. I have to go to rehab. And it's scary. You're going to yet another place that you're not familiar with. You may have a roommate, you may not have a roommate. All of those things. So when somebody's entering a facility, how does your team help them to identify what those goals look like so that they have proper expectations, but also so that they know how to advocate for themselves if those expectations aren't being met?

BREANN: So we will sit down—basically within the 24 to 48 hours of when that patient comes in—and the team is going to come in, and we're going to set those goals right then and there. We're going to talk about, "Okay, what is your goal? What are your therapy goals? What are you needing to get back to?" And then we also want to talk to them about what's a realistic goal. We don't want to set unrealistic goals. You're probably going to come in, and maybe you had a hip surgery, maybe you had a knee replacement, something like that. That's a little bit easier to recover from. And so yeah, your goals are going to be a little bit quicker and realistic. We can get you back in maybe two weeks.

JAMIE: Yeah. We want to run a marathon in four months.

BREANN: Yeah. If you had a knee replacement, maybe that's possible if you're really aggressive in rehabbing.

JAMIE: Exactly.

BREANN: But if you, in reality, had a stroke or you had a heart attack that has just completely transitioned your life, so now not only are you mentally dealing with that—you need to know what real expectations are. And if our team and your family and you are having real expectations—and I think that's the biggest piece we try to talk to them about—is just knowing this is the reality and the expectations. And we want to give you—if you are only going to get 70% back, we want to give you that full 70% so then we can give you the tools to get you back to that 100% with the best care that you can get.

JAMIE: So it sounds like you are sitting down with people to develop a personalized care and rehab plan for each resident.

BREANN: Yes. Each one will have their own identified specialty care plan, we call them, so that every week they're having a meeting to follow up to see, "Okay, this didn't work this week, but this is what we can do next to try to progressively move forward," because nothing's more frustrating than not having answers. And that's what I think really gets people the most is lack of communication.

JAMIE: Yeah, lack of communication and lack of motivation. So I would imagine it's hard for patients to stay engaged and motivated and active during their stay. I know that accelerates their improvement. But when you are in a place where you're not seeing your family, you really don't have the freedom to come and go as you please, how do you guys encourage people to do that?

BREANN: That's a great one. We have tons of activities that are always set up so that at least they're socializing a little bit. And the biggest piece is we as healthcare providers are coming in and encouraging—our CNAs are coming in and encouraging—"Let's get up, let's stay in that routine. Let's get your—just the simplest things—brushing your teeth, washing your face, getting dressed every day, getting out of that bed." You are there to get up and move your body. You can get into depression very quickly coming into a skilled nursing facility because you are losing some independence, and that's a hard thing.

JAMIE: And you're isolated.

BREANN: Absolutely isolated. Yeah. That's the biggest hurdle since COVID that we've dealt with is that isolation that people have felt. And so being able to take and show them, "Let's go outside. Let's do some therapy outside. Let's do some exercises out there." And just really getting them involved and seeing that this is temporary, and then we're going to get you home.

JAMIE: Yeah, and I think that's the biggest misconception—is that when folks grade skilled nursing facilities, they are looking at the 23 hours that they are not with the physical therapist, but the purpose of them being there is for that one hour that they are with the physical therapist, right?

BREANN: Right.

JAMIE: So we've rehabbed someone, or you guys have rehabbed someone, and we know transitions are risky, right? They're going to go back home. What are the supports that you help to coordinate so that they can go home safely?

BREANN: So the first things that our team is going to do is reach out. We're going to offer every home health agency known to mankind in this area to them, and then we're going to let them decide which one. Everyone will come in and talk. And really, that's the big thing. We really try to push home health to them because it is so imperative that they continue with their therapy. We get them set up with outpatient—the physical therapy or occupational, if it's needed. Speech therapy, same thing. If we can get them set up, we also really encourage them: please get your PCP set up if we haven't already done that. As we all know, getting into a primary care provider these days is very hard.

JAMIE: Very hard.

BREANN: So that's another thing, because the sooner they can continue everything that we've been doing, the better their success rate will be at home so that they don't have to try to return back.

JAMIE: Yeah, absolutely. And I think that one thing that all the skilled nursing facilities do is they really truly try to discharge folks with home health. Home health is an important part of that transition because you're going to go from getting stronger every day in a rehab facility—because again, you're getting those therapies five days a week for an hour—when you go home, if you do not continue those therapies, there's a really good chance that you could decline, you could plateau, you could end up back in the hospital, whatever that looks like. So home health can follow you. And home health, again, is paid for 100% by Medicare. So I don't know why anybody would ever say no to that.

BREANN: Yeah, same. And I think, again, it's the stigma, right? Like with skilled nursing, same with home health. It's that feeling of loss of independence once they go home, too.

JAMIE: Absolutely. Mistakes. What are the mistakes and pitfalls that folks make when they are in your facility and then leaving your facility?

BREANN: Big mistakes. I think it's just a normal feeling of—they don't want to give up that control. They don't want to give up—so it's easier just to go home and go back to what's normal, what's known. They don't want to burden anyone. They don't want to ask for help. They don't want to—or they don't want to rack up another bill. They don't want to have to do all of these things because it can become very expensive very quickly. And so I think those are all—pre-planning. You and I have talked about that multiple times, and I think pre-planning and being ahead of the "what ifs" in our life, unfortunately—

JAMIE: Oh, sure. Absolutely.

BREANN: As they're aging.

JAMIE: Yeah. I feel like human nature in general wants to cling to a sense of independence, whether you are 20 years old or, in my son's case, 13, or a senior. And I see that even in my own parents when I go over, and I heard that my dad just replaced all of the bulbs in his garage by getting on a ladder. Like, he can barely walk. Why are you on a ladder? But he wants to prove to everybody, himself included, that he's independent.

BREANN: Yeah, exactly. And that's the biggest, I think, mistake that a lot of people make coming in or going out of—is they just—they're stubborn. We're stubborn. We as humans are stubborn.

JAMIE: Yeah. And that's not a senior thing. That's a human nature thing. I'm probably the most stubborn person in the world. I'm going to hate it when my kids are trying to help me with all of these things. It's going to be a miserable experience for them.

BREANN: Exactly.

JAMIE: Especially since I work in the industry. I'm going to come at it like I know everything.

BREANN: Exactly. We do.

JAMIE: So I want to close with giving you an opportunity to let folks know about how things get paid for and how admissions happen. So I know historically that straight Medicare—if you don't have an Advantage plan, but straight Medicare plans—you need three overnight, like midnight stays in the hospital in order to get admitted to a skilled nursing facility. You can't just walk up to a skilled nursing facility if you have straight Medicare and be like, "Hey, I need to rehab. Can you take me?" But there is a workaround to that if you have an Advantage plan through Medicare. Talk us through how that works.

BREANN: Yeah, so that is where if you're at home and you know you just—you failed. You failed, and it happens all the time. Or you're deconditioning, or you get very sick. Instead of having to go and sit in an ER, wait for this doctor—if you've gone to your doctor and your doctor says, "Yeah, you really are—you need some more therapy. You need some of this, you need that."

JAMIE: You benefit from therapy. You are declining.

BREANN: Exactly. That's where you yourself, or the doctor's office, can give a skilled nursing facility—any one of mine—a phone call, and they can say, "We just really need to get in there." And we can call your insurance company and get an authorization. Sometimes it can take a day or two to get that authorization, and then that doctor will write us an order, and we're good to go. We can bring them in.

JAMIE: That's awesome. All right, so let's empower people to know how to contact you. If they wanted to utilize their Advantage plan, reach out to Volare, any of your buildings, and try to get some rehab, how do they contact you?

BREANN: So the first place they're going to reach out to is any one of our buildings—Royal Gardens, Highland House, or Hearthstone. You can find us on the websites, and each one has their website. You Google the name, and it'll pull it right up.

JAMIE: So Highland House, Royal Gardens, or Hearthstone?

BREANN: Correct.

JAMIE: In Southern Oregon. So they have plenty of buildings all over the place, but if you're here in Southern Oregon, which is the area that we mostly serve, then those are the names of the organizations that you would reach out to?

BREANN: Absolutely. And then each one of mine has a marketer that they could directly call, and they will help 24 hours a day, seven days a week.

JAMIE: That is very good to know, and I will share with you again that if you are feeling like you could benefit from a skilled rehab facility and you can't remember the names of the places or their phone numbers or any of those things, please always know that you can just reach out to Team Senior, and we will get you connected immediately. We have all of the backdoor phone numbers. We know who to call, we know how to get you connected for services. So again, if you forget how to reach out to them, you can always call us and we'll help get you connected.

BREANN: Perfect.

JAMIE: All right, Breann, thank you so much for coming in the studio today. This was a wealth of information, even for me, and we look forward to having you back someday.

BREANN: Thank you. Have a good day.

JAMIE: Thank you for listening to the Team Senior Podcast. We're here every week sharing new and relevant information. Remember that we're just a phone call away. Team Senior can be reached at 541-295-8230. Again, 541-295-8230. Until next time, this is Jamie Callahan.