Community Rehabilitation Clinic - 2022 Quarter 2 Report

SERVING THE COMMUNITY

As the Community Rehabilitation Clinic pro-bono clinic (CRC) continues to serve the community’s underserved population in its 7th year of operation, we are extremely grateful to those who have provided financial and in-kind support to its growth and development. The community organizations, private foundations, corporations, and individuals providing grants and donations are the heroes of the CRC and champions of its existence. We are most grateful to them for seeing

the vision of what the clinic could and has become and providing the much-needed funding to keep the clinic operating on a full-time basis.

Attributed to the support mentioned above, the CRC has developed into a multi-faceted healthcare clinic. In addition to orthopedic physical therapy, the CRC now offers many other therapy programs (listed below) including a COVID-19 Rehabilitation Program that provided physical

therapy rehabilitation to individuals with current or past diagnosis of COVID-19. The program is made possible through generous CDBG funding administered by Provo City with the support of Orem City and Utah County’s Mountainland Association of Governments.

PROGRAMS & SERVICES

COVID-19

Rehabilitation Program

The post-COVID-19 rehab program is administered by Dr. Hina Garg and is focused on endurance, strength, and mobility training, help with breathing and oxygenation, sinus and lung clearance and cough, and improving mental health such as anxiety and depression. Depending on the patient’s condition, COVID-19 rehabilitation is offered in-person at the CRC or through telehealth appointments. Four new post-COVID patients were treated through 141 patient treatments during the 2nd Quarter of 2022.

Electrodiagnostics

Electromyography (EMG) at the CRC assesses the health of muscles and the nerve cells that control them (motor neurons) for patients and reveals nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmission. EMG at the CRC is administered by Dr. Coleby Clawson. EMG patient

treatments increased from 5 in the 1st Quarter to 19 in the 2nd Quarter.

Health & Wellness Program

The CRC’s Health and Wellness Program transitions patients from rehabilitation to lifestyle management. The Program helps patients with sleep, weight management or dietary patterns, stress management, and other related issues. By participating in the program, CRC therapists worked to help address problems that directly or indirectly impact a patient’s ability to have a full recovery. In the 2nd Quarter of 2022, 3 discharged patients returned to the CRC for additional healthcare treatments.

Multiple Sclerosis (MS) Physical Therapy & Wellness Center

The MS Center at the CRC directed by Dr. Hina Garg, specifically focuses on providing free, high-

quality neuro and physical therapy services to individuals in Utah and nearby counties who struggle to find individualized MS-specific physical therapy rehabilitation. The Center customizes an exercise or wellness program specific to each individual and the challenges that they face. This program meets every Friday from 10am to Noon. During the 2nd Quarter MS patient treatments increased to 307 from 282 in the 1st Quarter.

RMUoHP ServiceLearning Course

Rocky Mountain University of Health Professions (RMUoHP) service-learning opportunity for Doctor of Physical Therapy program students incorporates community service with academic learning. The 3-credit hour course allows students to explore the scope of health issues and rehabilitation needs of physical therapy patients in the CRC and assist them with solutions to resolve their physical problems. During the 2nd Quarter of 2022 6 RMUoHP students continued their enrollment in the course as service volunteers.

RMU Student Run Pro Bono Clinic

The RMUoHP Student-Run Pro Bono Clinic involves university students and faculty operating the clinic at the CRC two evenings each week treating scheduled patients with physical therapy rehabilitation under supervision of RMU faculty members.

REHAB CORNER

Joint manipulation is a type of joint mobilization which falls under the category of manual therapy. Manipulation is a passive, high velocity, low amplitude thrust applied to a joint complex within its anatomical limit. The intent of manipulation is to restore optimal motion, function, and/ or reduce pain. Joint manipulation is categorized as a “Grade V” mobilization under the Maitland Joint Mobilization Grading Scale. Manipulation can be applied to virtually any joint in the body.

References: Mintkin PE, et al. A Model for Standardizing Manipulation Terminology in Physical Therapy Practice. J Orthop Sports Phys Ther. 2008;38(3):A1-A6

During the 2nd Quarter of 2022 there were 197 new patient evaluation visits. During the same period, the total number of patient visits increased slightly from 1,465 to 1,486.

PATIENT VISITS - In Clinic VS Telehealth In Clinic Appointments Telehealth Appointments Total Appointments 1281 84% In Clinic 16% Telehealth 205 1486

The financial benefit is based upon the current Medicaid rates plus cost savings for less visits to discharge. The CRC calculation system reflects the CRC’s financial benefit to the community. The system is based on Medicaid reimbursement rates for specific billing codes had the CRC billed for these services.

PATIENT OUTCOMES

ORTHOPEDIC TREATMENT

PATIENT UTILIZATION CRC NATIONAL AVERAGE

Measures how well the CRC utilizes its resources in the treatment of patients to discharge compared to the national average.

Utilization Rate of Utilization Rate of

CRC

7 Visits Per Patient

The CRC rate has always succeeded the national rate and during Q2 the efficiency was 5 visits less than the national average. This translates into a savings to the patient and their community of $525 per patient discharged or $25,575.

AVERAGE

Average Score of Average Score of

CRC 21.48 94% 21.12 63% NATIONAL

The CRC functional score change slightly exceeded the national average indicating the CRC is comparable to clinics nationwide in improving patients function and health through treatments at the clinic.

NEUROLOGICAL TREATMENT

Neurological patients patient treatments in Q2 placed the utilization in the 99th percentile of the of clinics nationwide.

PELVIC FLOOR DYSFUNCTION TREATMENT

There were 9 pelvic patients treated in Q2 with 5 being discharged. Clinic efficiency rating was 86% compared to the national average of 50% of clinics providing this treatment.

CARDIOVASCULAR & PULMONARY TREATMENT

Cardiovascular patient treatments in Q2 placed the clinic in 99th percentile nationwide for clinic utilization. The effectiveness of the patient treatments was a functional score of 37.3 compared to the national average of 15.2, placing the CRC in the 99th percentile of clinics nationwide providing treatment in these areas.

CRC VOLUNTEERS

A total of 1,539.9 hours of service were donated this quarter. Thank you to all our volunteers for your service.

Volunteers Hours of Service

RMU Volunteers 18.4 Hours

RMU Students 277.9 Hours

BYU Students 435.1 Hours

UVU Students 80.1 Hours

PT Volunteers 135.3 Hours

Interns 66.4 Hours

Other Volunteers 526.7 Hours

1539.9 Total Hours

BYU & UVU Student

Volunteers:

• Anna Eliason

• Ashlee Henrie

• Baylee Sturm

• Ben Barker

• Bradley Embley

• Bryan Fugal

• Charlie Fabrizio

• Courtney Walker

• Diana Brown

• Elle Payne Hernandez

• Ellie Mann

• Emily Douglas

• Hailey Winterton

• Hi’ilei Chan

• Ian Wells

• Isaac Johnson

• James Anderson

• Jessica Anderson

• Jose Gasper de Alba

• Julia Bellon

• Kevin Cayabyab

• Maggie Scribner

• McKay Harding

• Megan Nebeker

• Michael Bown

• Natasha Acosta

• Nathan Benson

• Phillip Ellsworth

• Rachel Corry

• Rebekah Rough

• Robert Millward

• Ryan Pilgrim

• Sariah Christensen

• Serena Green

• Sterling Jones

• Toni Brown

• Tyrell Nelson

BYU Interns:

• Anna Eliason

• Hudson Ghiya

• Jonathan Brown

• Jose Gasper de Alba

• Ben Barker

RMU & Community Volunteers:

• Asher Long

• Britt Hawley

LDS Service Missionary:

• Ramsey Anderson

VOLUNTEER SPOTLIGHTS

Emily Douglas

I graduated recently, but I’m a remote medical interpreter and wanted to get experience interpreting in person. I wanted more opportunities to help in the community and I heard about the CRC from Josh Jordan.

Volunteering here has been so fulfilling! I love learning and experiencing more things, getting to improve my interpretation skills,

and meeting so many wonderful patients, staff, and volunteers!

Megan Nebeker

I’m a current student at BYU and had been looking for places to volunteer and get PT experience. I plan on going to physical therapy school, and this has been a great opportunity to learn more about the career, as well as start learning how to treat patients. I love how engaging all of the physical therapists are with the volunteers/students and they help teach us as much as possible with each patient.

One of my favorite things about volunteering at the CRC is being a part of the multiple sclerosis clinic. It’s been a great opportunity getting to know the patients individually, and to learn about more specific physical therapy treatments. Some of the things I assist with each week are helping patients with their exercises, cleaning equipment, and keeping the clinic clean. I look forward to coming in every week to see the patients, as well as the staff and other volunteers at the CRC.

PATIENTS OF THE MONTH

Samantha Month of April

I got covid in March 2020, which ended up being long-haul covid. After about 4 months I recovered, but in 2021 I came down with pneumonia, which retriggered the long-haul symptoms. At the time of referral to the clinic, I had been suffering from ongoing symptoms for almost 6-months. Prior to the pandemic I was an extremely active and physically fit 34 year old, who loved skiing, hiking and running marathons.

The long-haul/post viral symptoms completely took my life from me. I was unable to work due to extreme fatigue, brain fog, and difficulty concentrating. I always felt like I had the flu because my body was so tired, weak and achy, and at times I could not even watch TV or hold conversations without experiencing vertigo, double vision, and headache. Household chores were exhausting and I could not walk more than 1 block. All of these symptoms had been ongoing and I was off work for

the 6 months prior to coming to the clinic. I have had 3 appointments in the clinic over the last 6 weeks and they have been life-changing. I have had countless doctors appointments throughout the illness but the clinic is the very first place that made me feel listened to, believed, and was able to provide answers not only to address the symptoms but also to all of my questions.

I am so grateful for the time and care that was spent to make me feel heard. Everyone I have encountered has been so supportive and friendly and I have never felt dismissed or rushed, the way many of the doctors

I had previously seen made me feel. Before coming to the clinic, I would often feel hopeless and cry. I truly believed there was a good chance

I would never work or run or do more than the most basic activities again. Immediately since my first appointment, my mood has soared.

I have been so much more happy and hopeful and confident and have not cried once since coming here.

I have progressed from barely walking to going for 30 minute brisk walks daily. I haven’t experienced any vertigo since coming here and the achy flu-like feeling has greatly reduced. My overall fatigue has reduced greatly, allowing me to do multiple activities per day, including spending time socializing or working on a computer without triggering any further symptoms. I have started learning Spanish to help with brain fog and concentration. I better understand what is happening with

my body and why, how to monitor it, and how and when to pull back or progress.I can go for walks outside and have even started jogging for 30 seconds at a time! I can go to the grocery store without collapsing. I can spend time with friends and family without feeling exhausted and unwell. I can soon return to work on a part time basis. And most importantly I can understand what is happening to me, why, and how to improve my situation. Some days are now entirely symptom free. I can live like a normal person again and have hope for my future.

Photo Withheld

Kevin Month of May

I needed physical therapy because I tore my ACL meniscus and MCL playing soccer. The worst part about my injury is that it wasn’t

during competitive play. I was playing just for fun and some guy decided that day I wasn’t a player anymore. The man hit the right side of my right knee with his knee bending my knee inwards.

Before my therapy, I was not just hurt physically, but mentally as well. Tearing your ACL is really hard to deal with mentally. I couldn’t do anything like walk, run, or use my leg. Since coming to therapy, I have seen extreme improvement with my knee. The first day I came in I couldn’t even walk. Now because of therapy I can walk, run, jump, and squat. I want to a give special thanks to Crystal, Jared, and Bet. They have been such amazing

people at helping me through this whole recovery experience.

The clinic has helped me in a way I’ve never been helped before. One of the biggest things I love about this clinic is the people. Everyone here doesn’t just want you to get better and then move on. They want to make sure you are doing great and that you leave therapy knowing you will be good on your own. Therapy has been one of the toughest things I have ever had to do. But being at the clinic with everyone’s support really helped push me through it with happiness. Being discharged from the clinic has been a bitter sweet experience.

Norma Month of June

Before coming to the CRC my arm ached, I felt bad, and couldn’t exercise or do things around the house because of the pain. I didn’t have much movement in my arm and was very sad because I couldn’t fend for myself. I always had to ask my family for help and I felt frustrated. I couldn’t even pick up my grandchildren or play with them.

The care in the clinic was excellent. From the very first day, I had undivided attention and they were very kind. The most wonderful thing was being able to speak in my own language and communicate my pain and problems. The exercises that the doctor gave me helped me a lot and I did them at home every day. Now I feel pretty good and can do everything froom cooking, cleaning, and playing with my grandchildren. I am free.

CLINICIAN OF THE MONTH

Dr. Will Sykes Part-Time CRC Physical Therapist

Will Sykes, DPT was born and raised in the Bay Area just south of Oakland in California. He moved to Arizona when he was 12 and did as many sports as he could throughout his teenage years (this is what got him into physical therapy).

Will went to BYU and graduated in 2008 with a BS in Exercises Science with a minor in Coaching and Physical Education. While at BYU, he met and married his wife, Bri, and together they have 3 kids: Emerson, Ensley, and Beckett.

Will was in the first cohort for the DPT program at Rocky Mountain University (RMU) and graduated in

2012. He now spends most of his time working at RMU as the Director of Clinical Education and also teaches professionalism and kinesiology. He also works at the Community Rehab Center (CRC) pro bono clinic run by RMU. Previously, he worked in a skilled nursing facility, IP rehab, and at Utah Valley Hospital in their Outpatient Sports/Orthopedic clinic. Dr. Sykes started working full-time at Rocky Mountain University in August 2017, after being an adjunct professor starting in 2015.

1 2

Increasing Patient Treatments

The CRC provided rehabilitation treatments for 233 patients and did 1,486 patient treatments this quarter. Both of these totals are higher than the previous quarter.

ACCOMPLISHMENTS & GOALS 3

Impactful Visits

The CRC’s outcome measures continue to surpass national averages in most categories.

Providing Service

The CRC had 45 volunteers, including RMU students and faculty, that provided 1,540 hours of service.

Financially Impacting the Community

Provided savings of $224,112 for the 2nd Quarter to patients and their communities.

Quarter 3 Goals

1. Continue to excel above national outcome averages for the 3rd Quarter of 2022.

2. Prepare budget and narrative for additional public support for the CRC including ARPA.

3. Improve upon Functional Scores in FOTO assessments to above national averages in every category.

ACKNOWLEDGMENTS

Private foundations, municipalities, corporations, and individuals’ contributions are key to the success of CRC operations. Their support allows the Clinic to operate as a major healthcare resource for the underserved and uninsured citizens of Utah County.

Special thanks to The Kahlert Foundation, Rocky Mountain

University of Health Professions, and Provo City who have provided substantial support for the CRC.

Additionally, Rocky Mountain University Foundation wishes to thank the following additional individuals, foundations, corporations, and municipalities for their financial support of the Community Rehabilitation Clinic:

• Utah County Commissioners

• Utah County Mountainland Association of Governments

• Orem City CDBG

• Provo City CDBG

• Rocky Mountain Power Foundation

• United Way of Utah County

• State of Utah

CRC Advisory Board

Chair

Dr. Mark Horacek

RMUoHP Executive Vice President of Academic Affairs & Provost

Board Members

Vice Chair

Dr. Trevor Dorius

Intermountain Physical Therapy

Dr. Matthew F. Bushnell

Orem Sports Medicine Center

Dr. Coleby Clawson

RMUoHP DPT Assistant Professor & CRC Physical Therapist

Dr. Hina Garg

RMUoHP DPT Associate Professor & MS Physical Therapy & Wellness Center Director

Dr. Crystal Miskin

CRC Clinic Director & RMUoHP DPT Assistant Professor

Dr. Ulrike Mitchell

BYU Associate Professor Department of Exercise Sciences

Dr. Mark Walker

RMUoHP DPT Faculty

Vic Morris Senior Director RMUoHP Foundation

Rachel Lovejoy Mortenson Executive Director Community Health Connect

Dr. Joel Tenbrink

RMUoHP DPT Instructor & Assistant Director of Clinical Education

Dr. Crystal Miskin Clinic Director and Full-time Physical Therapist

Dr. Michael Bartholomew Part-time Physical Therapist

Joshua Jordan Part-time Physical Therapy Technician

Jessica Raymond Part-time Research Assistant

Emily Gard Part-time Research Assistant

Cade Mooney Part-time Research Assistant

Ellie Casas Receptionist

Dr. Hina Garg MS Center Director and Part-time Physical Therapist

Jared Labrum

Part-time Physical Therapist Assistant

Dr. Coleby Clawson Part-time Physical Therapist and EMG Specialist

Yvette (Bet) Hawley Part-time Physical Therapist Assistant

Dr. Will Sykes Part-time Physical Therapist

Emily Flake

Part-time Physical Therapy Technician

CONCLUDING SUMMARY

The Community Rehabilitation Clinic continues to provide proficient healthcare services to the underserved citizens of Utah County in face of the ongoing pandemic. The CRC is near total operational capacity and continues to provide Health & Wellness and post-COVID treatment programs to assist post- COVID-19 patients in their on-going rehabilitation to fully regain their health and function. The CRC is an excellent educational tool for Rocky Mountain University DPT Students and Brigham Young and Utah Valley University pre-PT students to gain key concepts in physical therapy education as they volunteer and serve in the Clinic.

Contact Us

For additional information or interest in volunteering or contributing to the Community Rehabilitation Clinic please contact us:

Email: admin.crc@rmucrc.org Phone: (801) 375-2041

If you wish to contribute to the CRC please contact:

Victor Morris, Senior Director

Rocky Mountain University of Health Professions Foundation Email: victor.morris@rm.edu Phone: (801) 885-8075 call or text

587 South State Street, Provo, UT 84606 · 801-375-2041 · rmucrc.org