On August 2nd 2023, DIH presented the executive team at Ignite Medical Resorts with the DIH Center of Excellence award. DIH recognized Ignite as the first skilled nursing group in the United States to offer Andago therapy.
Ignite Medical Resorts are a cutting-edge group of skilled nursing facilities that offer a unique “LuxeRehab” approach to care. They are sparking a change within the industry with their dedication to innovative treatment and the integration of multiple advanced technologies. Mat Thengil is Chief Therapy Officer and a partner at Ignite. He has over 21 years of experience in the field and is an occupational therapist by trade. In this interview, Mat describes Ignite’s business model, the role of rehabilitation technology at Ignite, the business case for advanced rehabilitation technologies, and the changing landscape in skilled rehabilitation.
Ignite Medical Resorts has a unique business model. What differentiates your therapy program from those at other facilities?
It’s a very complex industry, but if you want to simplify it, skilled nursing facilities can be split into two groups. You have those like Ignite, that focus on short-term rehab or the rehab-to-home model, and then you have the long-term care facilities. If you were to talk to a non-healthcare professional on the street and ask them what they thought of a nursing home, they would probably tell you it’s a place where people live and [receive] long term care. Our model is very different. Our patients are here as an inpatient for short-term rehab. They come in and get their rehab, and then they go home. That’s one of the biggest differentiators between us and the other skilled nursing operators.
What is Ignite’s philosophy for patient care?
When you look at our website, what you see right away are the words “uncompromising luxury and rapid rehabilitation.” What that means is a beautiful building with all the amenities that are included in a boutique hotel, such as a Starbucks, a cafe, and lots of seating areas, and outdoor areas. We also have therapy courtyards that have seating, fire pits, beautiful lighting, and water features. We have beautiful private suites for the patients. Everyone that comes in gets their own in-room showers, large flat screen televisions and in room hospitality tablets. In addition, we have a director of hospitality in every single one of our buildings. That’s the luxury side of it.
Then we have the rehab, and that’s the rapid rehab portion. Another thing that differentiates us, is that we don’t subcontract our therapy out. All of our PTs, OTs, and speech therapists are Ignite employees. Our focus is getting our patients back on their feet to reach their goals and to get them back home.
What role does rehabilitation technology play in helping Ignite achieve its mission?
I think it plays a huge role. We’re focusing on rapid rehab, rehab-to-home and we must have the technology to be able to support that. Having pieces like the Andago really helps us to meet not only our goals, but the goals of our patients. Sometimes their goals are to exceed their prior level of function. We’re able to do that with the tools that we have at our disposal. Rehabilitation technology plays a large role at Ignite.
You are Chief Therapy Officer and a partner at Ignite — and you are an occupational therapist. How would you describe your role, and how does your experience help you fulfill that role?
As the Chief Therapy Officer, my role is to oversee the operations of all of our rehab departments. We have 19 separate buildings and we continue to grow. My job is to look at efficiencies, staffing, and technology.
I’ve been in OT longer than I’ve been in management, so I understand the challenges that therapists face. I know their struggles. I know their needs and their wants. A lot of time and research goes into everything that I do, and I use my experience as a clinician first and foremost when making decisions. The reason we think the Andago is so great is the ability to quickly get someone in and out of it. I know the benefit of that because I was a treating therapist for most of my professional career.
In skilled nursing it is uncommon to see the use of advanced rehabilitation technologies. Ignite is changing this. Why do you see advanced rehabilitation technologies like Andago as important in skilled rehabilitation?
Our patient type changes all the time. I started my career in 2001 and I’ll tell you that the patients I treated at that time, we don’t see any more in our settings. The patients that we used to see were much younger, much healthier. We used to see a lot of elective surgeries like total knees, total hips.
Now the model across the country is to save money. That’s a CMS and a national focus. How can we as a country save money in healthcare? Part of that [focus] is decreasing the time that patients spend in the hospital. It’s moving them from a hospital, bypassing our industry, and sending them home. … That is really effective in saving a lot of money.
If those patients are all going home, who are we seeing? We’re seeing the very sick. We’re seeing the very frail, and the very medically complex patient. Patients that you know should be in the hospital, now we’re finding in our setting, and the patients that used to come to our setting are now going to home health. So, we need to have different types of equipment. If 20 years ago, we were seeing a certain patient, it’s not fair to think that we can keep the same equipment, the same technology and see a vastly different population of patients. As our patients change, we need to change too.
That’s always been our mindset and we’re not satisfied with where we are now. We know that the future of rehab in the next 10 to 20 years is going to be robotics and virtual reality. If we were to say, “Hey, we’ve climbed to the top of the mountain and we’re done!” We’d be left behind in 10 years. So, we have to continue to do our research and continue to adapt and change as our patient population does.
It’s been almost two years since Ignite installed Andago devices in seven of its rehabilitation centers. What has your experience been like?
Honestly, it’s all been good. It’s an absolute game changer. When you put yourself in it, it’s almost like it’s not even on you. I know that’s a weird concept because you can watch the videos and you see this frame around the patient and people might be thinking that the patient must be pulling it or dragging it along, but there’s zero effort. The only thing that patient has to do is focus on rehab: standing and walking. And the device: it’s effortless. The staff is really happy and excited and I think that’s key. You have to have their buy in. The buildings that don’t have it are always asking, “when can we get one?”
So you have to have the engagement from the team and then you have to have easy patient set up. I mentioned to you that we have some devices where the setup is a bit of a challenge and when you have that your staff is going to shy away from utilizing it. We have found that the [Andago] setup is super easy.
Also, there’s lots of excitement around it when family members are coming in to see their loved ones. They ask a ton of questions. …What is that? …Can my mom use it? That’s been our experience. We’ve invited our community partners, hospital partners into our buildings to see it. We’ve done technology fairs and everyone is blown away by it.
We did a presentation at the LTC conference and showed a video of a patient walking with a rolling walker and we had two therapists, one on either side, and another therapist behind following very closely with the wheelchair. The video showed the patient kind of swaying left to right and you can see the demand, the physical demand, on the therapists that were keeping the patient up upright. And then we showed a video with the same patient, the same day, ambulating with the Andago and it was awesome. The therapists weren’t physically doing anything. They were providing the patient with verbal cues and the patient was upright and safe in ambulating a nice straight path. That video tells the story of what this device is able to do, not only for the patient, but for the therapist. … It takes a tremendous physical load off of them.
The only thing that patient has to do is focus on rehab: standing and walking. And the device: it’s effortless. The staff is really happy and excited. We have found that the [Andago] setup is super easy.
What populations have you used it with? Have you seen improvements in patient outcomes?
We don’t tie this device, the Andago, with a certain patient type or diagnosis. What’s beautiful about it is that any one of our patients are able to use it. If the goal is to be able to stand and walk, which it is for almost every single guest that comes into our buildings, this is a perfect device for them. It has full fall protection and it’s our go to when it comes to these patients. Now you know outcomes, I think we’re able to get our patients better quicker. We haven’t done any actual studies. That’s something that I’d like to focus on in the future … to see if there is a length of stay impact here. The biggest thing that we can do to help our patients get home faster is to get them walking sooner in their rehab stay. Early ambulation is so important, because most of our patients are with us for about three weeks on average. And if they are with us through private insurance, they’re probably with us for about two weeks.
So our time is very limited to get these patients up and walking. If we are waiting till day five, day six before we can get them up right because we need to get them stronger and they’re sitting balance better, that’s a lot of time. They’re losing about 1/2 to 1/3 of their time before they can stand, but with the Andago we could get someone standing on day one. Everyone always thinks about the ambulation part, but you need to be able to stand before you can walk. So we do that a lot. We’re like, OK, let’s get this patient up!…let’s get them standing! Many of our patients haven’t stood in months, so getting them upright is a huge morale boost for them, their family, and for our staff. And then it’s just kind of snowballs from there.
So do you take it into the patient rooms too and have them stand up in the room and things like that?
Yeah, we have. It’s one of the cool things about the device that it’s not stationary. We’re able to have them walk throughout our gym. Our gyms are very, very large. We’re able to have them walk throughout the gym, exit the gym, go through the hallways.
What advice would you give to your peers who might be interested in investing in rehabilitation technologies such as the Andago?
it’s a really good question. I would say very simply: do your research. It took me about five years of doing research on robotic technology before we were able to make the purchase of the Andago, and that’s because our industry doesn’t have equipment like this.
You have to start by reaching out to people that do. I started my research at Saint Lukes Rehab Hospital in Kansas City. I met the director over there and he actually showed me all the different types of equipment that he had. If there’s anyone who’s interested and they reach out to you, they can absolutely call me. They can ask me what my experience was like and how I started. I’d be happy to share that with them. They can come into our building and look at what we offer and they can take a look at the Andago.
One of the biggest things for me is also the company that we do business with, and I can’t say enough about everyone that I have met at the DIH. Every single person, from the therapists that come in and train our staff, to Paul and Rob. These guys have been super helpful. Getting the equipment is one thing, but then having the ability to reach out and get answers to questions that we have, or refresher training, which is something that you guys are helping us with now, is awesome. We have new staff that keep getting added to our team, so we want them to be able to get that refresher. It’s been a great partnership.