As a therapist for people in long-term care facilities, Rita Kelley noticed that patients who needed specialized wound care seemed to slip through the cracks.
“It wasn’t the fault of the facilities,” Kelley explains. “There just wasn’t anyone there who could provide what the wound care patients needed.” The doctors who rounded in the facilities were there to address other concerns and didn’t have time to check for and address developing wound issues, much less evaluate how particular support surfaces or footwear might create or exacerbate wounds.
The facilities Kelley worked in were simply not equipped for complete wound care. Patients languished. When someone finally recognized a need for treatment, the patient was taken to another location to receive it. “I hated seeing these elderly people, for whom the slightest change was often traumatic, lying in the hallway on gurneys waiting for someone to take them away in an ambulance or van, to a hospital where they would wait some more.”
Wound care was outside Kelley’s scope of practice. Many professionals might have surrendered to their apparent lack of power to make a difference. Not Rita Kelley. She knew there had to be a better way.
Kelley began researching in her off-hours to find out what medical professionals might be able to provide specialized wound care on site at clinics, homes and hospitals, as well as rehabilitation and long-term care facilities. She found out that Certified Nurse Practitioners could not only perform specialized would care, but they could also obtain provider numbers to direct bill Medicare and Medicaid for their services. “That was a huge discovery.” says Kelley. “Long term care administrators are dealing with high costs and loads of paperwork. Now I knew I could offer nursing homes and other facilities a way to improve patient care without any additional costs or administrative headaches.”
Kelley had a great idea, but she needed revenue to bring her vision to life. She approached a St. Louis family with experience in the long-term care business and they gave her the revenue she needed to get started. Specialized Wound Management (“SWM”) began operating in 2003 and the company has offered superior, innovative wound treatment to patients in myriad settings ever since.
SWM’s Nurse Practitioners go where the patients are, whether at home, a clinic or an intermediate to long-term care facility. Patients benefit from a holistic approach; their care encompasses head to toe assessment, treatment and follow up as well as consultation with family members and other care providers to create optimal outcomes. What has set SWM apart since its inception is that the Nurse Practitioners can recommend and perform procedures ranging from debridement to enzymatic therapies at bedside, obviating the costs and risks associated with transferring a patient to another location to receive care.
In 2006 Dr. Jeffrey Niezgoda, President of Hyperbaric and Wound Care Associates, began acting as Medical Director for SWM. While the partnership seems natural considering their professional interests, Kelley’s initial meeting with Dr. Niezgoda was accidental. Dr. Niezgoda had pulled Kelley’s business card off of a bulletin board at a conference, assuming that SWM was a staffing agency for wound care clinics. “I’m looking for Nurse Practitioners,” he told Kelley. “So am I,” Kelley replied, “do you have any?” The confusion was quickly dispelled and when the two realized they had a common passion for wound care they developed a collegial relationship. Eventually, Dr. Neizgoda proposed that he join SWM as its Medical Director. Kelley was delighted that Dr. Neizgoda saw the potential of her business model. She knew that working directly with a recognized expert in the field would lend credibility to her business and also ensure that SWM would always have access to cutting edge, evidence-based practices in wound care. “Dr. Neizgoda’s clinical and research expertise is unparalleled,” Kelley explains. “The medical specialty group he supervises provides over 50,000 wound patient visits a year and he has served as the Principle Investigator on several wound research trials. He worked on the consensus panels whose recommendations were utilized in establishing the standards in this field. We are thrilled to have him as part of our team.”
Specialized Wound Management’s innovative approach has allowed the business to provide cutting edge wound care in over 300 facilities, employing over 40 Nurse Practitioners and completing over 25,000 patient visits a year—and the business continues to grow. SWM is expanding to new regions and hiring new staff to service those areas.
Wherever they go, each Nurse Practitioner who works for SWM will share Rita Kelley’s vision of advocating for both the wound care patients they treat and the facilities where those patients receive care. “It’s not a question of choosing whom to serve,” says Kelley. “Ultimately, when you provide the best patient care while also educating families and facility staff, several things happen: You catch wounds early so they don’t become as severe. You are providing the best treatment at bedside, so patients experience better overall outcomes. The facilities reduce their costs while also cutting their risk of legal and regulatory liability. Everybody wins.”