Susan J. Harris has spent more than three decades maneuvering through a system that has put many health care providers down for the count. But she and her company are still standing.
“We have gone through so many reimbursement changes and I have managed to stay in there,” said the founder and chief executive officer of Kearny Mesa-based Therapy Specialists. “I so love what we do that nothing will prevent me from staying in this field and figuring out ways to provide services no matter what the reimbursement is.”
Her grit was recognized this month by the Occupational Therapy Association of California, which bestowed on Harris its first Entrepreneur of the Year award at its annual conference in Santa Clara.
Founded by Harris in 1976, Therapy Specialists , among the earliest providers of physical, occupational and speech therapy services in San Diego County , contracts with skilled nursing, assisted and independent living facilities. The business recently expanded its services outside the region to Delano, a rural community in Kern County near Bakersfield.
“We have a customer in San Diego who moved to Delano and asked if we’d be willing to head up there,” said Vickie Harris-Brosnan, president of Therapy Specialists and Harris’ daughter. “We said, ‘sure.’ ”
It’s all part of the company’s slow but steady plans to expand beyond San Diego’s borders.
“There is so much consolidation in skilled nursing,” said Harris. “We have always been in San Diego, serving independent and small chains. But, over the last two to three years they have sold out to the big national chains and they have contracts with the big national rehabilitation companies. We want to maintain a hands-on, family-type business. Can we maintain that and grow outside of our county? We believe that we can. We have software now that allows us to manage, and we have enough area managers.”
It’s also easier to travel to rural areas these days, said Harris, which is where she wants to take her business.
“This is where they are under-served,” she said. “Recruiting therapists to go to Delano and Bakersfield is quite a trick. It’s a small, rural community, but a lot of people like that. We can get new grads who want to live cheaply for a while, and get training and oversight from experienced therapists.”
Eventually, Harris wants to expand the business into Arizona, Nevada and New Mexico. Meanwhile, within the county, Therapy Specialists recently hooked up with Country Villa La Mesa, Kearny Mesa Convalescent Hospital and Nursing Home, and LifeHouse Healthcare and Rehabilitation Service, a skilled nursing facility in Vista. Along with the new association in Delano, the company has racked up about $1 million in new contracts this year, said Harris.
Terry Quigley, administrator for Escondido-based Redwood Elderlink, a nonprofit agency that provides services to seniors and adults with disabilities, has worked with Therapy Specialists for about a year and a half.
“They are an extraordinary group to work with,” she said. “They are consummate professionals, know their business and are truly interested and invested in their customers.”
Therapy Specialists also maintains outpatient clinics in Chula Vista and Lemon Grove, catering primarily to injured workers, and has a contract with TRICARE, a health care system that serves the U.S. armed forces.
“We treat military dependents,” said Harris-Brosnan. “Because of the war in Iraq, there is an overflow from Balboa Hospital, and we are seeing more TRICARE families.”
Therapy Specialists provides its staff with continuing education, and mandates a “behavior of the week,” in keeping with its mission statement , respecting “the dignity of all patients and their right to the highest quality of life.”
Maria Loprete, administrative assistant to Dr. Lyle Rosenfield at Girard Orthopaedic Surgeons in Chula Vista, has been referring patients to Harris since 1994.
“I think they are a wonderful company,” she said. “I like their philosophy of how they treat their patients and employees.”
But the supply of professional therapists has been dwindling in recent years , something that Therapy Specialists has been trying to stem. The company sponsors a nationwide program for students as part of their course work, and supplies housing for them during their stay.
Harris-Brosnan also is in the process of hiring a full-time recruiter to attract both professionals and recent graduates.
Another ongoing frustration is the roller coaster nature of the U.S. health care system.
“Insurance plays a part in what we can and can’t do,” said Harris-Brosnan. “We believe in being patient advocates, and we will continue to treat them , and err on the side of patients.”
That often means treating patients at the outpatient clinics before reimbursement approval comes down from the insurance carrier, as long as there is a doctor’s authorization in place, she said.
“We will do three treatments if we haven’t heard back,” said Harris-Brosnan. “Then we try to make some kind of arrangements with the patient.”
“If worst comes to worst,” she said, they often continue the therapy at cost.
Therapy Specialists also does pro bono work for Medi-Cal patients at the skilled nursing facilities.
“We consider ourselves a partner to our facilities,” said Harris-Brosnan. “It goes back to Sue’s philosophy , looking at the quality of life for all people, not only for those with insurance. We feel strongly about the need to keep our seniors as healthy as we can.”
If the insurance carriers do say no, Therapy Specialists will go through the appeals process.
“We take it to the highest level,” said Harris-Brosnan.
The government cutbacks and caps that have been imposed on treatment for Medicare patients has had a significant impact on the industry as a whole, said Harris.
She makes annual treks to Washington, D.C., to meet with San Diego’s U.S. senators and representatives to discuss health care issues, pushing for exceptions to the caps on therapy services. She also regularly visits the lawmakers when they return to town.
In the long run, extending the number of therapy sessions saves money, said Harris, often by eliminating the need for surgery and the follow-up care that would be required. Senior care is only a part of it, she added.
“San Diego is a very big veterans and armed services town and there are lots of issues coming up regarding injured vets,” said Harris.
Occupational therapy has as much to do with a patient’s mental and emotional health as it does with physical problems, said Harris.
“Most people think about occupational therapy as it relates to physical functions,” she said. “But, it started in the 1800s with psychiatric problems.”
While the injured soldiers who returned from World War I and II spurred the need for occupational therapy, 19th century medical professionals discovered that occupational therapy helped those considered to be mentally disturbed.
“Those that were considered ‘crazy’ were sent to asylums, and the people who were in the moneyed class sat around and did nothing and never got better,” said Harris. “The working class were assigned jobs, got better and left. The whole notion of productive activity as being therapeutic was born then, with the focus of OT to help people return to or adopt skills for productive living.”
While medication can keep patients submissive, said Harris, “It doesn’t help them or the care-giving in a facility. OT is listening and gaining the trust of the patient, then using basic, repetitive activities that are calming, leading to activities that are meaningful. At the end, the patient is participating and family members are thrilled.”
Dr. John Berger, who serves as medical director to some of the facilities that Therapy Specialists serves, has known Harris personally and professionally for 35 years.
“She does a superb job, first-class,” he said.
And, as a pioneer in a field that tends to be dominated by women, Berger noted that Harris has always tried to provide flexible working conditions for her staff, so that they could balance work and family.
“She has kept everybody happy, and has kept a lot of dishes in the air over the years,” he said. “She is absolutely top-notch.”