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In the late 1980s, as a young occupational therapist working in an inpatient geriatric rehab facility, I saw firsthand that it was the nurse, not a nursing aide, who provided all the activities of daily living (ADL) care, and that patients remained in the rehab hospital for several weeks, not days. That’s right, I said “weeks.” I’m also old enough to remember when you went to the doctor and saw only the doctor—not a tech, nurse, or physician assistant. Healthcare has gone through many changes through the years in order to become more effective and efficient. Transitions in healthcare, as in life, are often necessary to survive and thrive; challenges exist and change may be required. As our nursing facility population has become far more acute and complex, facility leaders are being confronted with a big challenge—transitioning to more specialized quality care and specialized skilled-care teams.
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