EARH Rehab Center an important resource in Ritzville community

The East Adams Rural Healthcare Rehabilitation Center lies, nearly unnoticed, on the southwest corner of 10th and Adams.

It hasn’t always been that way; for a time, the trim single-story building housed a dental practice. Today, it’s the home of the Rehab Center. Let go of your presumptions over “rehabilitation;” this place brings more benefits to Ritzville and the surrounding communities than many realize. And the reason is best begun with a summary of its history.

In the past, rehabilitation therapy in Ritzville was done by service contractors, including, Tami Heider, a physical therapist assistant (PTA) who for 25 years handled rehabilitation work herself. While a PTA can be quite helpful, her training did not allow diagnostic work. As time passed, Dr. Erin Ribic, a trained physical therapist working at St. Luke’s in Spokane, traveled to Ritzville to support the work and cover care that fell outside the parameters of a PTA.

Meanwhile, demand for locally provided rehabilitation therapy was growing. Time and cost to travel miles into Spokane for treatment restricted some patients. Some residents were also restricted by their work schedule. Local patient needs expanded into demand for additional local providers.

Then, into the development of the Rehab Center stepped Dale Nelson, whose tenure in Ritzville overlapped Heider and Dr. Erin Ribic. Nelson grew up in Rexburg, Idaho, earned his degree in Physical Therapy from University of Utah in 1981 and settled in Ephrata for 32 years doing independent work in private practice. The small-town location reminded him of where he grew up; and his goal was always to “do the best therapy in a rural setting.”

However, over time, single-payer insurance providers reduced their payments for patient care and Dale, foreseeing future reduction in income, began evaluating alternatives.

He passionately believes that care in a rural setting can be better than in a big-city big facility, expressing his desire that there is “no reason to go to Spokane or elsewhere to receive good quality (rehabilitative) care.” He works continuously to dispel the myth of lesser care in a rural setting; in fact he believes that care in a rural setting allows therapists to spend more unencumbered time with patients, and benefits from the healing effects of nearby family and friends.

Nelson and his wife became aware of an opportunity in Ritzville. They liked the small-town ambiance; but he says the tipping point came when he met the new CEO, Gary Bostrom. The two shared a philosophy regarding patient care, as well as goals and a willingness to work to achieve them. Nelson and his wife moved to Ritzville in July, 2014.

At the time, the rehab clinic was operating in a downtown space, which had been a dental facility. When Nelson began his work there, he focused on using exercise, heat and ice, electrical stimulation and ultra-sound, all of which are still in use and still available to his work.

However, Nelson has focused on myo-fascia release therapeutic methods after having had a back injury that was helped with standard methods, but didn’t help when working hard. After taking a course in myo-fascia release, his back injury was relieved and he has been focusing on that technique ever since. Through training under guidance of John Barnes, one of the few experts in the technique, Dale has become one of the few early practitioners of the therapeutic art that is now growing in use. He stated that he will use whichever physical therapy method which best fits a successful outcome for a patient.

When Dale became full-time at the rehab center, the volume of physical therapy patients increased dramatically. Patient access to providers improved, and patients filled available appointments during the day. And so again the need for more help increased. And the types of therapeutic help increased with the addition of specialists in distinct disciplines.

Occupational therapist Darcy Hunt was born in Dillon, Montana. Her degree in Exercise Physiology came from Gonzaga, and occupational therapist training from Eastern Washington University. She interned at Sacred Heart in 2003, where she met Dr. Ribic, which led to work at the Ritzville Rehab Center with Nelson.

Hunt “married into Ritzville”. At the clinic, Hunt says her role is “to return a patient to be able to do whatever they need to be able to do.” That could involve therapeutic work after severe illness or addressing physical disabilities.

Within that explanation, she defined “occupation” as “whatever one is doing…” and gave examples as diverse as sleeping or woodworking. If you’re thinking that physical therapy and occupational therapy appear to overlap, that’s right, and Hunt says it’s “kind of nice to be able to work in either niche.”

Hunt tends to work with shoulder and hand injuries, and helps with many neural injuries. She pointed out that this community is “hard on bodies,” which makes sense in light of a high population of farm workers. She also observes that residents of this community are “passionate about improvement” and that recovery rate of those she works with is very high.

Physical therapist Dr. Ribic hails from Kalamazoo, Michigan and attended Western Michigan University, which she pointed out has the same logo—the Broncos—as the Lind-Ritzville schools. Her interest in physical therapy was stirred by the recovery time spent in physical therapy clinics after having competed in cross-country, and power lifting. Dr. Ribic got her physical therapy training at Grand Valley State, lives in Spokane and has been on staff at Holy Family Hospital and Sacred Heart (trauma) for 10 years.

Dr. Ribic sees her role to “help people living lives” through pain management, strength, and mobility. She says she is here to improve function and the quality of life of her patients. Her therapeutic style involves work with soft tissue and functional mobility. She spends some of her time working with hospital patients, for either illness or injury.

PTA Dustin Killian is locally grown, having competed on the high school football and track teams. Killian was sent to school to become a certified athletic trainer. He became a PTA through an online course from Kent State. As a PTA, he is limited from doing initial evaluations, but Nelson was clear that Killian is fully capable to use the same therapy tools as himself.

Killian returned to school for a master’s degree in Athletic Training from the University of Idaho. While there he listened to a presentation of what an athletic trainer does, which sparked his interest in pursuing a career in the field. He was exposed to multiple treatment options during his schooling, and understands that determining what is effective for different people is learned with experience.

Killian appreciates his options, saying “people are different” and he applies whatever techniques he believes best fit the patient. He notes that the highest percentage of success depends on whether or not his patient “buys in to the treatment” being used. Killian says the hardest patients to treat are those who have lived with injuries for a long time, and that a huge part of the process is changing the brain’s patterns.

This year is Killian’s fifth season working as the physical trainer at LRS. Not surprisingly, he particularly enjoys treating athletes. He works at learning the physical “baseline” history of the kids so he can be most helpful in injury situations. He notes that athletes are most concerned with returning to the playing field and are therefore among the most motivated of patients. Plus, as generally younger patients, they heal faster.

Despite his desire to help athletes return quickly, he is very concerned and conservative with concussion events, which tends to complicate the relationship with both the athlete as well as coaches who want the patient to return to action. Some injuries can be nursed along, but he remains very strict with concussions.

Deborah Reynolds is not the type of speech therapist some people may have visited in grade school. She is a medical speech pathologist, earning her master’s degree in Communication Disorders from EWU, who works with the full range of human communication and its disorders. The brochure she hands out explains “speech-language pathologists evaluate, diagnose, and treat speech, language, cognitive communication, and swallowing disorders in individuals of all ages, from birth to geriatrics.” If that isn’t clear, she said that she “works from the brain down.” That includes a bevy of disorders; swallowing, brain injuries, neurological disorders such as Parkinson’s disease, strokes and more.

The Rehab Clinic obtained Reynolds’ services through her friendship in working with Hunt; she now commutes from Spokane. Among other activities, she has instituted mental fitness classes such as “Gray Matters” on Thursdays at 2 p.m. in the EARH basement conference room. The classes are “designed to exercise and animate the minds of older adults.” At first she was only mildly excited about joining the Clinic, but now loves it when people say “I’m glad you’re here.”

When you walk in to the remodeled Rehab Center today, an outside sign says: “Physical Therapy.” However the doorway sign says “Rehabilitation Center,” which more accurately describes the variety of quality care options covering all types of rehabilitative needs in order to successfully and efficiently serve the residents of Adams County: to help make us all that we can be.