Case Study: The Encore At Boca Raton Rehabilitation & Nursing Center (August 2019)

Patient’s Age: 82-years-old
Admission Date: 07/14/19
Admitted From: Northwest Medical Center
Discharge Date: TBD
Discharged To: Home
Length of Stay: TBD
Reason for Stay: Cerebral Infarction (stroke).
How did this patient hear about The Encore: Daughter Cheri searched resident’s health plan website, Encore was recommended.

Details of experience:
It was a seemingly pleasant Sunday morning as Mr. Frank Presto was relaxing on his bed watching TV. He suddenly started shaking out of control. Scared of what was happening, his wife Patricia immediately called 911. He was rushed to Northwest Medical Center and admitted on June 9th, 2019. The doctors informed Frank and Patricia that he had suffered a stroke. After receiving the appropriate treatment, they were informed that he was going to need extensive subacute rehabilitation services.

Frank was admitted to The Encore on July 14, 2019. Upon admission, he did not look good. He required maximum assistance to get out of bed, to stand and use the therapy bars. Overall, he required a lot of help to do everyday tasks. Frank stated, “I thought I was going to die.” Frank’s highly-trained therapy team knew they had to work hard with him for a speedy recovery.

Frank’s first week at The Encore was a tough one. Upon evaluation, he was only able to ambulate five feet while being assisted with the parallel bars. His daughter, Cheri, stated, “We hoped he’d pull through but we were uncertain. We didn’t even think he’d get out of the hospital. Hospice was talking to our family saying that we should be careful with what our hopes are in regard to him getting better.” Frank did not give up. By week 2, he was walking 3 feet using a walker and assistance from his encouraging therapists. The only struggle was that he still required maximum assistance with transferring.

Frank really started to impress everyone! A few weeks went by where he was able to sit up, walk more using a walker and able to transfer with only minimal assistance. By week 6, he was walking 90 feet with a rolling walker! When Michael Rubin, our Director of Concierge Services, spoke with his therapist about his progress, she stated, “This is huge progress. He will be going home soon! He required a Hoyer lift to get him out of bed and now he only requires standby assistance with a 4 wheel walker!”

The Encore has a beautiful outdoor area with benches, palm trees, a mini-golf course, a koi pond and a gazebo for everyone to enjoy! Besides participating in therapy, Frank’s favorite thing was to sit outside in the sun. He is also blessed with a very supportive family. Michael also spoke with Frank’s wife, Patricia. She stated, “We were very hopeful when we found the Encore. We were very pleased with everything. Frank’s story is just a miracle! We are overall very happy. The biggest challenge was having to choose the second floor where his nurse Kerline was or to be downstairs closer to outside!”

Nearing his discharge date, Frank was now able to function again and Team Encore could not be more proud of him! He stated, “the staff here are like my family. They really get to know you and are interested. I never felt like a stranger during my stay. I’ve come a long way. My therapists were extremely encouraging, the nurses were extremely accommodating and I loved the chicken salad! Everything was good.”

Congratulations to Frank for all his progress here and continued progress at home!

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Case Study: The Encore At Boca Raton Rehabilitation & Nursing Center (July 2019)

Patient’s Age: 74-years-old
Admission Date: 06/13/18
Discharge Date: TBD
Discharged To: TBD
Length of Stay: TBD
Reason for Stay: Husband was resident’s caregiver until needing skilled nursing so resident joined.
How did this patient hear about The Encore: Husband is a resident at The Encore.

Details of experience:
Mrs. Eileen Sheinmel was peacefully visiting her husband (who is a resident at The Encore) one day and then the unfortunate happened. In June of 2019, Eileen tried to get out of her wheelchair and had a fall. She did not sustain any serious injuries; however, this caused fear and frustration for her based on the realization that she was significantly more immobile than she had imagined, which motivated her to want physical therapy.

When starting therapy with her therapist, Jillian Lerner, Eileen was completely wheelchair-bound and could not walk at all without an employee supporting her. This frustrated her and she would often say that she wishes she could do more. She wasn’t sure whether she would succeed or not.

The good news was that her doubt and frustration did not last very long. Only a week later she started contact guard assist and was walking 125 feet with a walker. Then, within 3 days, she had progressed to standby assist and 200 feet with a walker! The progress started happening quicker and better than Eileen could have ever imagined!

Additionally, one of the things that made the experience for Eileen even better was some of the amenities that The Encore had to offer, such as their back patio. She shared “I love the back patio; I love sitting around the fishpond. It’s just so pretty out there.” Another thing that really helped her experience was the relationships that she had built with some of The Encore’s exceptional employees, as she emotionally stated, “The people here are very nice. My therapist Jillian [Lerner] gave me flowers for my birthday and Dana Nicolls (recreation assistant) got me a birthday gift (a nightgown and jewelry). I haven’t had a birthday this nice in years! My CNA, Viola, even bought me a scarf! Everyone has been so nice to me. Everyone is just so friendly!”

With only a little time after, Eileen had made even more progress! Only a week later she had made it to supervision and 300 feet with a walker! As time moved along, so did Eileen. Within the same week, she had the ability to walk on her own with a walker! She went from being wheelchair-bound to being modified independently in less than a month! With tremendous gratitude, she shared the director of concierge services “I wasn’t able to walk. Because of the therapy here [at The Encore] I’m walking again.”

We look forward to having Eileen celebrate with us for many more years!

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Case Study: The Encore At Boca Raton Rehabilitation & Nursing Center (June 2019)

Patient’s Age: 76-years-old
Admission Date: 06/08/19
Admitted From: West Boca Medical Center
Discharge Date: Currently Outpatient
Discharged To: Home
Length of Stay: TBD
Reason for Stay: Left Knee Amputation.
How did this patient hear about The Encore: Online research by the patient’s daughter.

Details of experience:
On a pleasant day, as Mrs. Rosemary Fraschilla was making her bed, her life quickly changed. Mrs. Fraschilla hit her leg on the bed frame. A seemingly small injury rapidly escalated, as an infection began leading to gangrene. This severe infection prevented blood flow to her leg and unfortunately, the result was a left knee amputation.

Rosemary and her daughter chose The Encore for her rehabilitation and worked diligently to learn to walk once again. Upon arrival, Rosemary status was maximum assist for transferring, ambulating, and bed mobility. Nonetheless, Rosemary stayed motivated and chose to start pushing through to achieve success…being able to walk again!

In the first weeks of Rosemary’s stay, she worked with her physical therapist, Michael Jordan, to progress to walking (hopping) 15 feet and becoming a moderate assist for transfers. A short time after with focused efforts and exercises with her therapists, she progressed to minimum assist and was walking (hopping) 20 feet.

On her last week as an inpatient, Rosemary had progressed to contact guard assist. She left knowing that she will return as an outpatient as soon as her prosthesis arrived. Upon inpatient discharge, she shared with our team “The staff [at The Encore] are very nice and kind. They were always reassuring me.”

When her prosthesis arrived, Rosemary returned to The Encore, as an outpatient, to learn how to walk with the device and become independent. Mrs. Fraschilla spoke in glowing terms of her therapist, Jillian Lerner. She shared with our staff that “Jillian is fabulous! She is very, very good!” At the beginning of her outpatient therapy, the patient needed minimal help for transfers, 15 feet on the walking gate and standby assist for bed mobility.

With a bit more time, she accomplished standby transfers and was walking 60 feet standby assist with a walker. Rosemary continues to stay determined and never gave up. She also had lots of help from The Encore’s Amputee Walking Program. This phenomenal program is managed with a hands-on approach by two Paralympic Gold Medalists, Todd Schaffhauser, and Dennis Oehler, who have mentored over 20,000 amputees worldwide. Rosemary stated, “Todd and Dennis from the Amputee Program are fabulous. They’re the reason that I came to The Encore. They have given me lots of encouragement. It’s because of them that I am walking today!”

It is such a pleasure to see Rosemary at The Encore. We love watching her continue her progress every day!

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Case Study: The Encore At Boca Raton Rehabilitation & Nursing Center (May 2019)

Patient’s Age: 80-years-old
Admission Date: 01/08/19
Admitted From: Jackson Memorial Hospital
Discharge Date: 03/28/19
Discharged To: Home
Length of Stay: 79 Days
Reason for Stay: Paraplegia.
How did this patient hear about The Encore: Resident’s wife found through networking nearby Skilled Nursing Facilities.

Details of experience:
In December of 2018, Dr. Kenneth Kunzman suffered from thoracic spinal cord ischemia. On January 8th, 2019, he was brought to The Encore at Boca Raton from Jackson Memorial Hospital. He entered our community with the hopes of becoming independent enough to perform a full-tilt on a powerchair!

Upon arrival, Dr. Kunzman was evaluated by his therapists, Norma Guerrero, and Eric Kalina. He was unable to ambulate at all, unable to function a wheelchair, and had poor sitting balance (total assist). Nonetheless, Dr. Kunzman had a very positive attitude and was extremely motivated, although he shared with Michael Rubin (director of concierge services), “There was an area of uncertainty. I hoped that the OT and PT would be intense enough to get me going. They did not fail me.”

The first thing that Dr. Kunzman focused on with his therapists was his wheelchair positioning. He primarily focused on upper body ADL’s (Activities of Daily Living) and sitting balance. As soon as he was able to position himself on his wheelchair, he was focusing on propelling a wheelchair and participation in lower body dressing. A few weeks after, Dr. Kunzman focused on laying down and sitting up.

Towards the end of his stay, Dr. Kunzman had progressed to being able to transfer from his wheelchair- to his bed, as well as transferring into cars. He was also able to do pressure releases on an electric wheelchair (which was his goal coming to The Encore!)

Aside from the therapy, Dr. Kunzman’s tremendous progress came from his determination to make his life work and accept the circumstances, he had never given up. He was discharged home from The Encore on 03/28/19 going from max assist to being to transfer!

Dr. Kunzman has stayed in touch with us at The Encore and shared “I’m doing well, The Encore was very good. Eric and Norma gave me terrific encouragement. The therapy was excellent!

Dr. Kunzman also shared that he has been asked to return to Cleveland Clinic (where he was employed before hospitalization)! We wish Dr. Kunzman the best from The Encore and we’re looking forward to having him come visit soon!

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Case Study: The Encore At Boca Raton Rehabilitation & Nursing Center (April 2019)

Patient’s Age: 67-years-old
Admission Date: 02/14/2019
Admitted From: West Boca Medical Center
Discharge Date: 03/29/2019
Discharged To: Home
Length of Stay: 43 Days
Reason for Stay: Compression Fracture
How did this patient hear about The Encore: Patients Surgeon, Dr. Sahai.

Details of experience:

Mrs. Pilar Angel had been suffering from multiple sclerosis for years. In January of 2019, she had found herself falling more than usual. Then, unfortunately, she had a fall that had a worse effect than the others, which led to a compression fracture in which she went to receive surgery.

She arrived at The Encore to receive physical therapy as she had hoped to regain her normal health and independence. Upon arrival, Pilar was greeted by the director of concierge services who assured her excellent customer service throughout her stay and let her know that he would be there if she needed anything. She was then greeted by her physical therapist who came to evaluate her. The results were moderate assist, inability to stand for longer than 10 seconds, and ambulation that was not very coordinated nor the ability to walk long distances.

Quickly after the evaluation, Pilar got to work with her therapist, J.R. Durity. Although in the early weeks she was making slow progress, Pilar didn’t see it and she became discouraged. She felt she would never get back to her previous state and stated, “I’m too young for these limitations.” She started to get depressed; however, she always tried to be social with the staff and residents and stay positive in order to remain motivated.

Her therapist then had an idea- he took Pilar to the parallel bars so she could see the progress in her balance and control. This was the first time Pilar witnessed how much she had actually been benefitting from the first few weeks of therapy and she was very excited and determined. J.R. decided that showing Pilar her progress will become the regular weekly routine to keep her motivated.

Due to the awareness of her progress, Pilar’s successful rehabilitation became a snowball effect and she started progressing at a high level. In her final weeks at The Encore, Pilar did a lot of community reintegration which included outdoor walking with steps, curbs, ramps, and gravel. This was her safety awareness training.

In her sixth week, Pilar was discharged from The Encore. She left walking around casually, almost completely back to her prior level. She stated to the director of concierge services, “when I came I was in a wheelchair, I couldn’t walk, I couldn’t do anything. Now I can walk! Everything about this place is amazing, it’s the best! And [my therapist] J.R. is the best!”

Pilar still joins us at The Encore a few times a week to maintain her progress. We look forward to watching her continue to grow stronger every day!

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Case Study: The Encore At Boca Raton Rehabilitation & Nursing Center (March 2019)

Patient’s Age: 89-years-old
Admission Date: 03/03/2019
Admitted From: West Boca Medical Center
Discharge Date: 03/28/2019
Discharged To: Home
Length of Stay: 25 Days
Reason for Stay: Muscle weakness
How did this patient hear about The Encore: Social worker from the hospital recommended it.

Details of experience:

Mr. Arthur Blander was having a pleasant walk near his house in Century Village when he suddenly had an unfortunate fall and injured his head and bruised his hip which sent him to the hospital. On March 3rd, Arthur was admitted to The Encore to rehabilitate and get back to independent living.

Upon arrival, Arthur was very confused. He was greeted by the director of concierge services to ensure excellent customer service throughout his stay, as well as his therapists who came to evaluate him and get him ready to do whatever it takes to get him back on his feet.

It wasn’t very encouraging for Arthur post evaluation since he was unable to dress by himself, bathe himself, and needed max assistance for ambulating. But despite being totally dependent, he was determined to make his stay at The Encore worth it and he was ready to get to work with our devoted therapists.

Despite Arthur’s motivation, he was nervous about not recovering. He would often check the locks on his wheelchair due to fear of falling. Luckily for Arthur, the determination outdid the discouragement as he would say “I want to get home, sleep in my own bed and swim in my own pool again!”

With a little time, Arthur progressed from max assist to contact guard assist. His therapist shared that “it just happened with everybody’s efforts”. This was when he and his therapist started to strongly believe that his projected goals of independence will likely be met.

Arthur particularly loved walking outside on the patio and would often share how beautiful it is and how it was his favorite place to walk. While enjoying the outdoors, Arthur progressed to standby assist. Then shortly after, he progressed to modified independent! He was able to upper body dress, use the bathroom, and get out of bed all on his own!

On the day that Arthur was discharged, he shared that he was sad to leave! He stated “The therapy was good, the help was good and the food was good. Everything was wonderful! I came in a serious condition and I’m okay now!”

We wish Arthur only the best going forward and hope he will come to visit us at The Encore soon! He shared with the director of concierge services on the phone that he goes walking with his aide daily. May Arthur, continue to walk for many more years!

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Case Study: The Encore At Boca Raton Rehabilitation & Nursing Center (February 2019)

Patient’s Age: 84-years-old
Admission Date: 01/04/2019
Admitted From: Boca Regional Hospital
Discharge Date: 02/28/2019
Discharged To: Home
Length of Stay: 55 Days
Reason for Stay: Left Hip Fracture
How did this patient hear about The Encore: The patient lives in area and witnessed the creation of the building!

Details of experience:
On a nice sunny day in December, Mrs. Olga Arrington went to a park near her home to relax by the lake. Suddenly out of the blue, Mrs. Arrington’s left hip gave out and she had an unfortunate collapse.

As some children were walking by, they happened to see her on the floor which led them to call 911. She was brought to the hospital where she was informed that she had a left hip fracture.

After her stay in the hospital, Olga chose our community, The Encore, to rehabilitate her hip to get back to living independently. Upon admission, Olga was greeted immediately by the director of concierge services and the assistant administrator.

A short time after her arrival, her devoted therapists, Robinson and Sylvia, greeted Olga and began her initial evaluation. During her evaluation, Olga was unable to get out of bed, go to the bathroom, or dress. She had no strength and was in pain. Despite the pain, Olga really enjoyed the environment at The Encore as she shared that her first thought entering the community was, “It’s so nice here! How could I not want to be here?”

Olga’s progression was slow during the early stages of her rehabilitation journey. She was lacking motivation and did not have much hope. Her therapists would make a strong effort to motivate her through different avenues. Olga required a lot of help with almost everything involving everyday independent living.

As time went by, Olga began having more hope. She became more accepting of her situation, and as her hip began healing a bit more each day, her strength and tolerance skyrocketed- and her hopelessness turned into determination!

Her therapists got her locked in the mindset of “one day at a time.”With this mindset, Olga began to slowly see the light at the end of the tunnel.

This progress gradually continued and with time Olga needed less and less assistance. The more progress she would make the more confident she would become. She started to walk short distances with a walker and was able to dress on her own!

Olga’s progress gradually continued with time. Olga began to need less and less assistance, and the more progress she would make, the more confident she was becoming! She began walking short distances with a walker and was able to dress on her own. Keep in mind- she was unable to do these simple tasks upon arrival!

Aside from therapy, Olga also enjoyed many other things that The Encore had to offer as she stated “Everyone was wonderful, the nurses are fantastic, the aides are so pleasing and they work hard. It’s like one big family. I [also] loved the music, I would dance sitting down. The garden is [also] beautiful. I love it here.”

Olga was discharged on February 28th. She left as modified independent- she can go to the bathroom and can dress all by herself! She was correct when she stated to the director of concierge services, “I knew that I was going to get better!”

We wish Olga only happiness and health going forward. We welcome her to come visit us at any time that she would like and hope to see her real soon!

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Case Study: The Encore At Boca Raton Rehabilitation & Nursing Center (January 2019)

Patients Age: 71-years-old
Admission Date: 11/16/2018
Admitted From: Westside Regional
Discharge Date: TBD
Discharged To: TBD
Length of Stay: TBD
Reason for Stay: Intracerebral Hemorrhage
How did this patient hear about The Encore: A friend who knew about The Encore told patients sister.

Details of experience:
When Mrs. Irene Fiorella entered our community from Nursing Center from the Westside Regional Medical Center with a PEG (Percutaneous Endoscopic Gastrostomy), she was unable to eat anything, and speech she was barely responsive, completely non-vocal, unable to follow

simple directions such as being asked to blink and was only able to answer yes and no questions with a very minimal nod and headshake.

Her speech therapist decided to try a different method. She brought in a cold moist spoon and did cold oral sensory stimulation (placed the spoon on Irene’s tongue). This initiated Irene’s first real response. Her swallow was delayed and weak, but this became the primary focus as it was something to expand on due to it being her strongest response. When asked if she wanted to do it again, Irene suddenly had a much stronger nod.

As time moved along, the swallowing stayed more consistent although Irene had some difficulties staying awake and had trouble with single unit questions.

About a week later, she began talking. She was answering two-unit questions which shortly progressed to multiple unit questions! Everything began progressing for the better very quickly which led to Irene and her family telling people how grateful they are for her therapists and her.

Only a few days later, Irene was able to name objects in the environment, answer W.H. questions (who what when where), and count the days of the week and the months of the year. Her cold oral sensory stimulation also escalated to 100% on swallowing. This began a new journey… foods and liquids! At the end of the week, Irene was tolerating drops of water!

The next week Irene’s therapist started testing minimal amounts of thin water and was successful! This led to trials of mechanical soft food which was a success, leading her to regular food and that was successful as well! Her swallowing was strong! Irene can eat regular foods again, completely opposite of the conditions she was in upon arriving at The Encore!

Irene shared her whole story with the concierge director while enjoying a tuna fish sandwich that The Encore had served for lunch that day! We wish Irene many more years of health and hope she enjoys all the delicious foods out there that she now can continue to experience.

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Professional Of The Quarter, Dave Smith

Congratulations to our Professional of the Quarter, Dave Smith, Director of Environmental Services at The Encore at Boca Raton Rehabilitation and Nursing Center!

Dave Smith has been working in healthcare for 46 years, 36 of those years at The Encore; Smith was brought on as the community was being built.

“We have a good team here, I have a good crew; it’s the best part of the day. All of the people here are nice, it’s a good structure. The job itself is challenging, but we want to make sure that everyone gets done what they [our patients] need.”

Nominated by Smith’s colleagues, he has a strong presence in The Encore community. When he learned that he had won Professional of the Quarter, he began, “I was kind of shocked! It felt good!” He continued, “We work hard here; I was thankful. I was very surprised, and I’m humbled.”

Dave Smith is a finalist for the Professional of the Year contest; the winner will be announced during Nursing Home Week 2019!

Congratulations Dave Smith! You are #TheCareRiteDifference!

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Case Study: The Encore At Boca Raton Rehabilitation & Nursing Center (December 2018)

Patients Age: 91-years-old
Admission Date: 09/04/2018
Admitted From: West Boca Medical Center
Discharge Date: 12/04/2018
Discharged To: Daughter’s House
Length of Stay: 3 Months
Reason for Stay: Kidney Infection
How did this patient hear about The Encore: Case Manager at West Boca Medical Center

Details of experience:

Mr. Paul Kachmarik arrived to The Encore at Boca Raton from West Boca Medical Center for a weak lower body and severity levels of unstable medical conditions. He was highly discouraged and was not sure if he was going to succeed.

As Paul stated to our director of concierge services, “I didn’t feel well, I didn’t want to eat. I was scared I would never recover. I had no strength, could not walk or get out of bed.”

Paul was unable to get out of bed, was on max assist of two, and was unable to propel a wheelchair on his own. After being evaluated by his therapist, he immediately got to work.

For the first few weeks, the therapists worked hard with him, but Paul was unable to do too much exercise due to a weak heart. Nonetheless, Paul remained motivated. He reached a level of moderate assist and walked 30 feet altogether!

Despite Paul’s frustration about his inability to exercise, he was pleased at the other things that The Encore had to offer. He shared with the director of concierge services, “I was amazed how nice it was. I had my thoughts on nursing homes… I was amazed by the [service of the] aides and nurses, [the housekeepers] always kept my room neat, and the food was always on time. It was different than a regular nursing home.”

A few weeks later something clicked. Suddenly, Paul had a burst of inspiration and hope based on his results in therapy, along with his appetite coming back! Paul stated, “after I started eating, I started having hope, my appetite was coming back. Progressively every day, I started looking forward to my meal. The tilapia was very good.”

Paul had also remained determined based on all the encouragement that his therapists gave him, as he shared with his therapist, Debra, “Debra, if not for your encouragement, I would not have this confidence in me do to it.”

Paul’s progression really took off throughout the weeks. He progressed to contact guard assist, walked 100 feet, wheeled himself to therapy, was able to get out of bed, and dress his upper body all on his own! Within a week, he progressed to 200 feet standby assist, was able to walk to therapy, able to car transfer with a rolling walker, which very soon led to supervision!

Paul was discharged on December 4th to his daughter’s home. He left walking 250 feet modified independent with a walker. He went from 25 feet max mobility to 250 feet modified! Paul was very grateful upon discharging as he shared, “I was on a low number when I came. I had no appetite and I was just weak. Now I can get out of bed and walk with a walker! I just walked on my own yesterday! I’m able to go to the bathroom without assistance and OH, DO I HAVE AN APPETITE!”

We are always proud of our residents, patients, and staff, but hearing the kind words from Paul was a pleasant reminder that we always strive for the best for everyone that walks through the doors at The Encore. We wish Paul the best of luck!

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