The Essential Role of Therapy in Long Term Care Facilities: A Call to Compassionate Care

By JR Burnett, BBA, DPT, RCD Mid South

I am honored to get the opportunity to write these articles twice a year to share things the Lord has put on my heart. In a recent trip to a nursing home partner, I was able to evaluate 5 patients that needed therapy services. I saw tears of joy and appreciation in several of the patients and their families, and it made me truly think deeply about the essential nature of what we do for long-term care residents. Physical, occupational, and speech therapy services stand as vital pillars of dignified, holistic care for all ages. For elderly residents in long term care facilities facing mobility limitations, cognitive decline, or communication barriers, our services are not mere luxuries but essential services that restore function, foster independence, and honor the God-given value of every human life.

“A resident who regains partial mobility after physical therapy may never run a marathon, but that small victory sparks hope, dignity, and renewed purpose.” - JR Burnett

As followers of the Lord Jesus Christ, who heals the sick and comforts the afflicted, we recognize that providing such care reflects His command to love our neighbors as ourselves and to walk as He walked while on this Earth.

For patients, the benefits are profound. Physical therapy strengthens muscles, restores joint function and health, reduces pain, encourages healthier gait patterns, regains postural deficits, improves balance, reduces fall risks, and establishes appropriate assistive devices enabling residents to move with greater confidence and less pain. Occupational therapy helps individuals relearn daily tasks—dressing, eating, or using adaptive tools—preserving independence and dignity. Speech therapy addresses swallowing difficulties and communication challenges, preventing isolation and malnutrition, as well as helping patients with memory and cognitive challenges. And this is just scratching the surface. Together, these interventions yield physical improvements, but they extend far deeper and wider than that. Emotionally, successful therapy sessions combat depression and anxiety by celebrating small victories and rebuilding self-worth. Spiritually, they create opportunities for prayerful encouragement and remind residents of God’s sustaining presence in their lives. In the name of the Lord Jesus Christ, therapists and caregivers can fill sessions with hope, motivation, encouragement, and human touch that the residents and their families are all craving deep down to their core.

When we work with their loved ones, families experience tremendous relief and renewed connections. Witnessing a loved one regain the ability to dance in their room, feed themselves or converse clearly eases their emotional burdens and sometimes feelings of helplessness that can come when we see our loved ones age. One of the reasons I became a therapist was seeing my own grandmother, Frannie, be motivated to participate in care after she had several strokes while suffering from small vessel disease. Therapy made her and our family feel as if it was not the end—that we had a fighting chance for recovery even while still on this earth that helped us look forward to the final recovery we as followers of Christ will receive when we see Jesus face to face.

For long-term care facility workers, effective therapy programs reduce injury risks from lifting or managing dependent patients, lower burnout, and create a more rewarding workplace culture centered on progress rather than giving over to a slow decline. We can be a part of fostering a culture of living instead of a culture of slow death. When therapy succeeds, staff get re-infused with purpose and compassion.

On the flip side, withholding therapy services from those who need them constitutes a serious disservice. It condemns residents to unnecessary decline, robs them of potential joy, and contradicts the Biblical call to care for the vulnerable. Denying therapy accelerates dependency, increases medical complications, fall risks, fractures, contractures, loss of freedom, surgeries, rehospitalizations, and diminishes quality of life for residents. It also causes families and staff to shoulder heavier loads. In a society that sometimes prioritizes ease and cost over compassion, this neglect dishonors the image of God in every elderly person.

I truly believe it is better to have loved and lost than never to have loved at all. Just as opening one’s heart to love carries the risk of loss but also holds the opportunity for immeasurable richness, it is better to have tried therapy and achieved even minimum improvements than not to have tried at all. A resident who regains partial mobility after physical therapy may never run a marathon, but that small victory sparks hope, dignity, and renewed purpose. The emotional lift from speaking a few clearer words or completing a simple task can bring a feeling of joy to a life shrouded in frustration. To withhold therapy out of fear of limited results is cowardice, the lazy way out, and it rejects the risk of love entirely. In Christ’s name, we are called to try, to persist, and to trust God with the outcomes. And let us not grow weary of doing good, for in due season we will reap, if we do not give up (Gal 6:9). God determines the due season, the fruit, the outcomes, and our call is not to grow weary in doing good. Therapists, DO NOT GROW WEARY!! You have a mighty call to perform self-sacrificial love day in and day out to all of these patients.

Improving patients physically, emotionally, and spiritually can be greatly helped by the intentional integration of therapy services, and for the believer who has the opportunity to work with us at Mid South Rehab, we also get the honor and privilege to pour ourselves out in this way with faith-centered care. Facilities should prioritize consistent therapy access, train staff in compassionate techniques, and partner with us to change the lives of their residents, residents’ families, and all other interdisciplinary teams. By embracing this approach, we fulfill Jesus’ ministry of reconciliation one patient encounter at a time.

Ultimately, therapy in long-term care facilities embodies love in action. It declares that every life holds sacred worth and is worthy of the investment of our time, our skills, our compassion, our efforts, and our care. May we be good stewards of God’s mercies and various gifts, and may we commit to pour ourselves out so that residents, families, and our facility partners may flourish in body, mind, and spirit—to the glory of the Lord Jesus Christ. For from Him and through Him and to Him are all things. To Him be glory forever. Amen. Romans 11:36

Highlighting the Tiffany Turney Scholarship

By Paul Evans, DPT, RCD Tennessee Region

At Mid South Rehab, we pride ourselves on being a people first, purpose driven company. This ideal is a guiding principle to the support we provide to not only our patients and employees, but also to the families. I have spoken before in this space about how intentional Mid South Rehab is as a company when it comes to supporting the career growth, education, and work life balance of our employee partners and the varied ways which we offer that support. I wanted to use this time to talk about a specific program that Mid South Rehab provides to support the families of our employee partners while also highlighting the legacy of our former employee and friend, Tiffany Turney.

The Tiffany Turney Scholarship is a program that our company established to honor and remember Tiffany’s kindness and generosity. Since 2021, we have awarded deserving high school seniors and college students of full-time employee partners this scholarship to help support their academic pursuits. This annual scholarship program rewards applicants who excel academically in high school or college, participate in extracurricular activities, engage in community service, demonstrate leadership skills, and show scholastic aptitude and work experience. This scholarship has helped a number of young students reach their academic goals and it is truly remarkable when you get to see the fruits of all that hard work come to life in part through the support offered by this program.

I wanted to highlight one student who is the son of one of our employees in the Tennessee Region, Marcia Wadley. Marcia has been a phenomenal Rehab Office Manager who has been with Mid South Rehab since 2016 and is a key part of our success in Tennessee. Marcia’s son, Alaye’, was the recipient of the Tiffany Turney Scholarship in 2022.This support was instrumental in helping with the purchase of books, academic support, and offsetting the growing cost of tuition. Alaye’ completed his Bachelor of Science degree in Exercise Science in 2023 at Middle Tennessee State University. He then went on to recently complete his Master of Science degree in Exercise Physiology in 2025. Currently, Alaye’ works at Carda Health Cardiopulmonary Rehabilitation as a Clinical Exercise Physiologist in the Murfreesboro area. Marcia could not be more proud of the accomplishments of her son, and it is very rewarding to see him also excel in a health-related career where he is truly using a servant’s heart to help his patients and the community.

It is really inspiring to see the growth and development of young people as they mature through life and into their chosen careers. Knowing that this scholarship program played a part in that journey is very rewarding and a big reason for the intention that Mid South Rehab places on supporting our employee partners and their families. Alaye’s journey also serves as a great example of what the Tiffany Turney Scholarship Program is all about and why it was so important for us to annually highlight her legacy and make sure we remember her example that truly embodies the spirit of Mid South Rehab.

An SLP's Guide to Cognitive Rehabilitation

By Kim Rayburn, MS, CCC-SLP, Central MS Regional Clinical Director

I would like to share some pertinent information from a continuing education seminar I recently attended. The course focused on cognitive evaluation and treatment services, including appropriate CPT coding, diagnosis selection, documentation requirements, and establishing medical necessity for reimbursement.

Cognitive Evaluation (CPT 96125)

One of the key topics discussed was CPT Code 96125, which is used for standardized cognitive performance testing. This code applies to assessments of:

• Attention

• Memory

• Reasoning and problem-solving

• Safety judgment

• Executive functioning

The presentation emphasized that a standardized assessment tool must be utilized, and the total time spent administering the test, interpreting results, and completing documentation should be at least 31 minutes. Common assessment tools discussed included:

• Ross Information Processing Assessment (RIPA-2)

• Arizona Battery for Communication Disorders of Dementia (ABCD)

• Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES)

• Brief Cognitive Assessment Tool (BCAT)

• Cognitive Linguistic Quick Test (CLQT)

Cognitive Treatment (CPT 97129 & 97130)

The course also reviewed billing guidelines for cognitive treatment services:

• 97129 – First 15 minutes of cognitive treatment

• 97130 – Each additional 15 minutes

These treatment codes are intended for interventions focused on improving attention, memory, problem-solving, and compensatory cognitive strategies. Attendees were reminded that when treatment exceeds 15 minutes, both codes are typically reported according to time requirements.

Diagnosis Coding Considerations

Several commonly used ICD-10 coding categories were reviewed, including:

• I69 series – Cognitive deficits following stroke or other cerebrovascular conditions

• R41.84 series – Cognitive deficits following traumatic brain injury (used in conjunction with injury-specific diagnosis codes)

• R48.8 – Other symbolic dysfunctions associated with neurological or medical conditions such as epilepsy, brain tumors, neurodegenerative diseases, and other cognitive-linguistic impairments

A major takeaway was the importance of confirming diagnosis codes through the patient’s medical record and physician documentation to ensure accurate coding and reimbursement.

“The seminar reinforced the importance of accurate coding, proper diagnosis selection, clear documentation, and demonstrating skilled intervention when providing cognitive evaluation and treatment services.” - Kim Rayburn

Documentation and Medical Necessity

A significant portion of the presentation focused on documentation requirements. Speakers stressed that documentation must clearly demonstrate:

• The patient’s medical history and diagnosis

• Functional deficits and their impact on daily activities

• Prior level of function compared to current level of function

• Reason for referral

• Measurable and functional treatment goals

• Skilled interventions provided by the clinician

The recurring message throughout the session was simple: “If you didn’t document it, you didn’t do it.”

Skilled vs. Unskilled Services

Another important discussion centered around distinguishing skilled services from unskilled services.

Skilled services include:

• Training patients and caregivers in compensatory cognitive strategies

• Providing clinical analysis and feedback

• Modifying treatment approaches based on patient performance

• Developing maintenance programs and carryover strategies

Unskilled services include:

• Reporting task completion without describing clinical intervention

• Repeating activities without documenting modifications or progress

• Observing caregivers without providing education or instruction

Proper documentation of skilled clinical decision-making remains essential for demonstrating medical necessity and supporting reimbursement.

Key Takeaway

The seminar reinforced the importance of accurate coding, proper diagnosis selection, clear documentation, and demonstrating skilled intervention when providing cognitive evaluation and treatment services. These practices not only support compliance and reimbursement but also ensure high-quality patient care and clinical accountability. This educational session provided valuable guidance for therapists, clinicians, and healthcare organizations seeking to improve documentation practices and maintain compliance with current Medicare and payer requirements.