good vibrations NEWS FOR THE VIBRA HEALTHCARE FAMILY Issue 3 • 2014 In this issue we hear from Vibra’s executive team on its 10-year path to success and the challenges ahead. A message from our CEO Brad Hollinger T en years ago a significant shift in the post acute healthcare arena was underway. Hospitals were encouraged to discharge patients sooner and sicker than ever before. The first of the baby boomers were hitting 60 and beyond. And, several major players were struggling to successfully operate their long term acute care (LTAC) and acute medical rehabilitation hospitals. Seeing an opportunity for a new company to make the most of this evolving environment, I founded Vibra Healthcare in the spring of 2004 with the acquisition of six specialty hospitals. Since that time, our experienced management team has continued to grow the company through the acquisition of underperforming critical care and medical rehabilitation hospitals. This growth strategy has served us well and established Vibra as true “turnaround specialists,” intensely focused on optimizing key operating metrics and developing strong referral relationships. While typically acquiring two to three hospitals a year, last year the acquisition of 16 Kindred hospitals was a unique exception. While Kindred was looking to divest hospitals that did not fit their strategic plan, this acquisition expanded our geographic footprint, generated greater economics of scale and advanced our strategy of expanding our post acute continuum model. Additionally the latest changes in the healthcare industry seek to integrate delivery from hospital to home, providing Vibra the opportunity to further establish itself as a leader in the post acute arena by effectively owning and/or managing the post acute continuum. The Kindred assets are integral to this strategy. We intend to lead the development of the continuum evolution in each of our markets, through efforts such as the Vibra Virtual Post Acute Continuum of Care (VPACC). Focused on ensuring patients are placed in the appropriate care setting, the VPACC creates savings through innovative treatments, protocols, continuous care coordination, and optimal patient outcomes. Our strategy is to establish Vibra not only as a postacute hospital company, but also as a post-acute continuum operator: delivering a comprehensive “episode of care” model that optimizes patient outcomes while delivering a value added service to its payers. This major initiative is an evolutionary process moving from a siloed, standalone provider mindset to one of coordinated care and collaboration. A model that requires Vibra to be flexible, visionary, and creative in our approach to healthcare delivery. I am confident we are poised to prosper in this evolving healthcare arena. Hospital NEWS Vibra Hospital Of Mahoning Valley Earns Quality Respiratory Recognition Good Vibrations is published quarterly for the staff and friends of Vibra Healthcare. Executive Editor Roger Breed, Vice President Corporate Communications Editorial Jean Waverka, APR waverkacommunications@ comcast.net Design Thom Aubrey The River Studio [email protected] Pictured on the cover are (front row, left to right) Brad Hollinger, founder and chief executive officer; and Donald Yoder, chief development officer and chief compliance officer; (back row, left to right) Mike Thomas, executive vice president, strategy & organization development; Clint Fegan, chief financial officer; and Stephen Marcus, chief operating officer. Scan this code to learn more about Vibra Healthcare. Published by: Vibra Healthcare, LLC 4550 Lena Drive Mechanicsburg, PA 17055 717.591.5700 Fax 717.591.5710 Vibra Hospital of Amarillo University recognizes doctor’s research efforts Texas Tech University Health Sciences Center (TTUHSC) School of Medicine recently presented Faisal Khasawneh, MD, with a Dean’s Scholarship/Research Award. Dr. Khasawneh, who works with Vibra Hospital of Amarillo as a critical care specialist in the ICU, also serves as an assistant professor of internal medicine for the university. Dean Steven L. Berk, MD, presented the award to Dr. Khasawneh saying, “Despite his busy clinical responsibilities as an infectious disease-critical care physician and administrative duties on hospital committees, Dr. Faisal Khasawneh has found the time to work on numerous research projects. Since 2009, when he joined the School of Medicine, he has authored or co-authored 25 manuscripts. “Many medical Faisal Khasawneh, MD students and residents seek him out for assistance with projects they are interested in. During his time with TTUHSC, Dr. Khasawneh has coauthored papers with six medical students and 12 residents, giving them their first experience with clinical research.” The award is well deserved, according to Kay Peck, chief executive officer, Vibra Hospital of Amarillo. “Dr. Khasawneh’s intensivist expertise and service on the Patient Care and Safety Committee have made him a valuable asset to the Vibra Hospital of Amarillo’s Critical Care Program,” she says. Chief Clinical Officer Melany McCarty, RN, agrees. “We can always count on Dr. Khasawneh,” she says. “He is attentive to his patients and is an excellent physician who treats complex medical conditions and infectious diseases.” Vibra Hospital of Mahoning Valley has earned Quality Respiratory Care Recognition (QRCR) under a national program aimed at helping patients and families make informed decisions about the quality of respiratory care services available in hospitals. The American Association for Respiratory Care started the QRCR program in 2003 to help consumers identify those facilities using qualified respiratory therapists to provide respiratory care. It grew out of growing concerns among healthcare leaders and the general public regarding the safety and quality of health care services provided to patients. Hospitals earning the QRCR designation ensure patient safety by agreeing to adhere to a strict set of criteria governing their respiratory care services. About 700 hospitals, or approximately 15 percent of hospitals in the United States, have applied for and received this award. The association maintains a list of QRCR hospitals on its website, www.YourLungHealth.org. Vibra Hospital of Northern California wins public health award The Shasta County Public Health Advisory Board presented Vibra Hospital of Northern California with an Excellence in Public Health Award 2014 for its efforts in protecting patients, staff and the community from infectious disease. Presented during an awards luncheon in May, the award recognizes and honors those who go above and beyond to improve the public’s health and quality of life. Specifically, the award recognized Vibra Hospital’s success with the influenza vaccination process, according to Debbie Wiechman, RN, CIC, infection preventionist. “Our public health officer made the vaccine mandatory for all healthcare workers in the county, but it was up to us to come up with a plan for how to implement the mandate,” Wiechman says. Knowing that many staff and physicians worked in three area hospitals, including Vibra Hospital, it was important that they develop a consistent record of vaccination. “We all ordered the same sticker so that by sight, we all knew that someone had their shot,” she says, adding that the hospital’s vaccination rate improved by 45 percent. “The whole premise was to protect the patients from ourselves.” In addition to the hospital’s impressive gains, Wiechman was thrilled with the public recognition of achievements in the local healthcare community that came out of the award presentation. “You don’t realize all the unsung heroes in your community until you [attend the award luncheon] and see what they are doing to elevate the public health in Shasta County,” she says. “It was a great honor to be a part of that.” n www.VibraHealthcare.com © Vibra Healthcare, LLC 2 www.vibrahealthcare.com Issue 3 Issue 3 good vibrations 3 Health&Wellness A CLOSER LOOK From Springfield to Spain One (extra)ordinary woman’s Team USA journey Telehealth takes several forms at Vibra hospitals A s part of its explains. “For example, commitment a gastroenterologist to providing could evaluate a patient the same high quality prior to undergoing patient care in each of endoscopy, answer their its hospitals, including questions, and obtain those that may lack easy their consent for the access to certain speprocedure.” cialists, Vibra HealthBefore telehealth, care is actively pursuing it was necessary to opportunities to use transport a patient to electronic information and from the LTAC and telecommunicahospital to a short-term tions technologies to acute care (STAC) hossupport long-distance pital by ambulance for clinical healthcare. evaluation. The patient Known as “telehealth” then had to return to or “telemedicine,” this the STAC hospital at a Photo of an eICU monitoring station provided by Phillips Hospital to Home. technology provides later date for the actual new approaches for working through as a video camera, monitor and telemeprocedure. challenges at the bedside, according to try feed of vital signs, heart rates, etc., to “Telehealth eliminates the interruption, Dana Kellis, MD, MBA, PhD, chief mediobserve patients’ conditions, communirisk and inconvenience of transferring cal officer. cate with them and their care providers, a patient across town for evaluation,” he “Telehealth could play a significant and to make treatment decisions. Vibra says. “Although the endoscopy may still role in meeting patient care needs in Hospital of Boise is currently developing need to be done at the STAC hospital, every Vibra facility,” says Dr. Kellis. “It an eICU partnership with the nearby St. the number of trips is cut in half.” allows us to increase availability of qualiLuke’s Health System. Adding to the attraction of telehealth fied specialists that may not otherwise be “The idea is to enable physicians in is the fact that the cost has been draavailable to help our patients.” the intensive care unit at St. Luke’s to matically reduced thanks to advancing Currently, Vibra has three levels of provide coverage for critically ill patients technology, according to Dr. Kellis. telehealth programs in development. in our LTAC hospital, and allows them to “The communication links already The easiest and most common is basic give orders and review medicines in real exist through T1 lines or Internet cables,” telephone and Internet technology that time,” Dr. Kellis adds. “Telemedicine has he says. “Additionally, the sponsoring allow specialists to confidentially discuss become a valuable adjunct to the physiinstitution, like St. Luke’s in Boise or the patient care issues, even when they’re in cians at the bedside.” STAC hospitals in Massachusetts, have several different locations. Another example of Vibra’s use of telestaffed their physician departments with “While this may seem simplistic,” medicine is underway at Vibra Hospital an eye toward providing this service.” Dr. Kellis says, “a telephone or Internet of Western Massachusetts, where Vibra Several studies have shown that communication between physicians is close to completing an agreement to patients also are happy using the new and patients about medical issues often have a telemedicine cart—complete with technology. fulfills the telehealth needs of clinicians, a computer server, display screen and “They express satisfaction with the is readily available, and requires no addiinstruments, such as a stethoscope and high definition video,” Dr. Kellis says. tional resources.” examining scope—available for a nurse to “They feel like they are actually speaking On the other hand, one of the most roll into a patient’s room. to a physician and not doing some type advanced forms of telehealth is the eICU, “Through a video hook up, a physician of electronic robotic interaction.” n In the next issue of Good Vibrations, which includes an upgraded video and interacts with a patient and his or her we will take a look at the role of IT in the telemetry monitoring system. The central family, and gives them an informed conimplementation of telemedicine at one of eICU station uses information from sultative opinion as to what he or she recVibra’s hospitals. equipment in ICU patients’ rooms, such ommends for a patient’s care,” Dr. Kellis Twelve years ago, Ann Stahel was 50 years old, overweight and slightly depressed. An office worker, she had never run before but decided to give it a try when the hospital she worked for sponsored a 5k. “To prepare, I got out in the morning and did some walk/run things. I don’t know what I was thinking, but I was not prepared,” remembers Stahel, now an executive assistant at Vibra Hospital of Springfield. “I thought I was going to die.” Well she didn’t die, but she did continue to run. For the next 10 years she performed in the middle of the field, plagued by pain in her knees and back. At one point she threw out her back and was unable to run for a year. After going to physical therapy and learning to focus on her form, things began to change. “I also started reading and figured out how to eat better. That was a big deal,” she says. “I started sleeping more, and I got faster.” By the time she turned 60, Stahel was ready for a new challenge, so she bought a bike. But, having never learned to ride one, she left it in her garage for an entire year, terrified to give it a try. On her 61st birthday, her son convinced her to take a long bike ride together and just one month later, she successfully completed her first biathlon. “I did the running and biking,” Stahel says. “I was so happy.” Around the same time, she started to receive email from Team USA. Her running times had caught the team’s attention. Unaware she ranked among the top runners in her state, Stahel was elated when Team USA invited her to compete in the National Championships in Tucson, Ariz. The top six finishers would represent Team USA in the World Championships in Spain the following year. “What did I have to lose?” Stahel remembers thinking. “I wanted to go out there and see if I could make Team USA.” Stahel would run a 5k, bike a 20k and then run another 5k, beating her best time and running a seven-minute mile to ensure that she not only made the team, but also finished fourth in the nation. “I just wanted to pass the person in front of me,” she says of her motivation. “The books will tell you that as you get older, you will be slower. It hasn’t happened yet. I just get faster and faster.” Elated by her win, Stahel decided it was time to up her training regimen, adding spinning as a way to prepare for running through Spain’s hilly terrain. “I don’t have a lot of time to train,” she says, stressing that she is just a “regular” person. “I do get up and run every morning and bike every evening I can. I don’t train for six hours a day.” 4 www.vibrahealthcare.com Issue 3 Issue 3 Stahel headed to Spain in May of this year to compete alongside athletes from all over the world. Despite uneven ground and the steepest, most winding bike route she had ever ridden, she held on where others faltered and finished 14th in the Women’s event. “I am so proud! I couldn’t be happier,” she says. “Without a coach or special gear, I did it as a regular American allowed to compete alongside truly amazing athletes from all over the world.” What was important to her was showing people that it is possible to get up every day for work and still make time for health and fitness and dreaming big dreams. “This has all happened in such a short amount of time,” she says. “I was never chosen for any team when I was in high school, but I’m having the time of my life now and, hopefully, encouraging those around me.” n good vibrations 5 Vibra Healthcare: uniquely positioned for success 10 Ten years ago, Brad Hollinger recognized that a significant shift was underway in the post acute healthcare arena. Hospitals were encouraged to discharge patients sooner and sicker than ever before. The first of the baby boomers were hitting 60 and beyond. And, several major players were struggling to successfully operate their long term acute care (LTAC) and acute medical rehabilitation hospitals. Sensing the timing was right, Hollinger founded Vibra Healthcare with the initial acquisition of six specialty hospitals and set the company on a course to lead the field of LTAC and acute medical rehabilitation hospital providers. “We did our due diligence to determine whether we wanted to start the company with those hospitals or not, evaluating their existing operations and how we could impact each facility in a positive way,” explains Stephen Marcus, chief operating officer. “There were a number of different items we could improve, but it wasn’t the same thing at every location.” During the next 10 years, Vibra would selectively acquire two to three underperforming specialty hospitals each year and turn them around to create added value. The company was successful at operating in this manner because management recognized from the beginning that each hospital was situated in a different market, had different practice patterns, and different expectations, according to Marcus. “We decided we needed to be flexible; that we needed to modify our operating model to each community’s needs and demographics,” he says. “One of our strong suits is that we are not a cookie-cutter company. We have really tried as we have gotten larger to not ignore that fact, as it has helped us to be successful from the beginning.” At the same time that Vibra was expanding, the healthcare industry was changing in response to the Affordable Care Act and the government’s attempt to reduce costs within the overall healthcare system, according to Mike Thomas, executive vice president, strategy & organization development. “Our key to success as a healthcare provider is our ability to be flexible,” Thomas says. “Given our structure and how the company has developed, we have the ability to move quickly in whatever direction this changing healthcare world goes.” Part of what is happening in healthcare reform is the need to have a much larger scope of operations making it possible for a provider to operate more efficiently and have less administrative cost, Thomas believes. Vibra moved in that direction last year when it added significant assets with the acquisition of 16 hospitals formerly operated by Kindred Healthcare. Unlike earlier acquisitions, it almost doubled the size of the company from a hospital standpoint. “We’re very opportunistic,” says Thomas. “If we can find assets that are underperforming and make sense for us, we will do that.” With the Kindred acquisition, Vibra’s portfolio became heavily weighted toward LTAC hospitals. As a result, Vibra intends to focus on the strategic acquisition or ground up development of rehabilitation hospitals in the immediate future. “Another focus will be our virtual post acute care contin- uum, which allows us to really be flexible in certain markets and work with other providers to help coordinate or manage the overall delivery of post acute care in that market,” Thomas says. “Our approach is that we don’t necessarily want to own everything, but we can help create referral patterns with other providers in that market to create a network of care.” Despite the changes that have taken place in the healthcare industry since Vibra got its start a decade ago, tre- “We embrace a culture that promotes creativity while rewarding for results. Management is encouraged to foster these attributes thus ensuring the flexibility and resourcefulness needed to navigate the evolving healthcare landscape.” —Brad Hollinger, Founder and CEO mendous need exists and continues to grow for post acute services thanks to the graying of America and the development of chronic disease epidemics, according to Don Yoder, chief development officer and chief compliance officer. continued on page 10 6 www.vibrahealthcare.com Issue 3 Issue 3 7 nationwide hospital operations reach coast to coast Inpatient Rehabilitation Facility (IRF) Long Term Acute Care (LTAC) MICHIGAN ● Vibra Hospital of Southeastern Michigan (LTAC) - Lincoln Park ● Vibra Hospital of Southeastern Michigan-Taylor Campus (LTAC/HIH) - Taylor NEW JERSEY n Marlton Rehabilitation Hospital (IRF) - Marlton NORTH DAKOTA ● Vibra Hospital of Central Dakotas (LTAC) - Mandan ● Vibra Hospital of Fargo (LTAC) - Fargo OHIO n Summa Rehab Hospital (IRF) - Akron ● Vibra Hospital of Mahoning Valley (LTAC) - Boardman CALIFORNIA ● Vibra Hospital of Mahoning Valley-Trumbull Campus (LTAC/HIH) - Warren n Ballard Rehabilitation Hospital (IRF) - San Bernardino OREGON ● Vibra Specialty Hospital of Portland (LTAC) - Portland ● Kentfield Rehabilitation & Specialty Hospital (LTAC) - Kentfield PENNSYLVANIA ★ Vibra Healthcare, LLC - Mechanicsburg n San Joaquin Valley Rehabilitation Hospital (IRF) - Fresno SOUTH CAROLINA ● Vibra Hospital of Northern California (LTAC/TCU) - Redding ● Vibra Hospital of Sacramento (LTAC) - Folsom INDIANA ● Vibra Hospital of San Diego (LTAC) - San Diego ● Vibra Hospital of Fort Wayne (LTAC/HIH) - Fort Wayne COLORADO ● Vibra Hospital of Denver (LTAC/TCU) - Thornton ● Vibra Hospital of Charleston (LTAC/TCU) - Mt. Pleasant TEXAS MASSACHUSETTS IDAHO ● Vibra Hospital of Northwestern Indiana (LTAC) - Crown Point ● Vibra Hospital of Boise (LTAC) - Meridian KENTUCKY ILLINOIS n Gateway Rehabilitation Hospital at Florence (IRF) Florence ● Vibra Hospital of Springfield (LTAC) - Springfield 8 www.vibrahealthcare.com ● New Bedford Rehabilitation Hospital (LTAC) - New Bedford ♦ The Meadows of Central Massachusetts (Freestanding SNF) - Rochdale ● Vibra Hospital of Western Massachusetts (LTAC) Springfield n Southern Kentucky Rehabilitation Hospital (IRF) - Bowling Green Issue 3 ● Vibra Hospital of Western Massachusetts-Central Campus (LTAC) - Rochdale Issue 3 ● Atrium Medical Center (LTAC) - Corinth n Highlands Regional Rehabilitation Hospital (IRF) - El Paso ● Vibra Hospital of Amarillo (LTAC) - Amarillo n Vibra Rehabilitation Hospital of Amarillo (IRF) - Amarillo ● Vibra Specialty Hospital at DeSoto (LTAC) - DeSoto VIRGINIA ● Vibra Hospital of Richmond (LTAC) - Richmond good vibrations 9 REIT financing was key to early growth It is often said that timing is everything. In 2004 when Brad Hollinger was looking to purchase the six hospitals that would become Vibra Healthcare, a colleague with a brand new real estate investment trust (REIT) was looking for hospitals to finance for his company’s jump start. “They needed a big deal, and Brad had this big opportunity,” remembers Clint Fegan, chief financial officer. “A purchase was negotiated for the six hospitals, with Medical Properties Trust (MPT) providing the funds. It was a transaction that launched both companies.” It was also a relationship that would serve both companies well as they continued to work together in subsequent years—Vibra strategically purchasing underperforming hospitals and MPT financing the acquisitions. “It worked out great for both companies,” Fegan says, explaining that MPT provided financing for Vibra’s first 10 hospitals. “We’ve since refinanced all but four of those hospitals.” The REIT structure allowed Vibra to finance the purchase of the hospitals and provided enough working capital to fund its start-up losses from 2004 to 2009. It also allowed senior management to own 100 percent of the company, which is unusual for companies HEALTHCARE HERO Vibra Healthcare: uniquely positioned for success . . . continued from page 7 Clinical lab manager earns national recognition “We’re in a good space to provide a very valuable service,” Yoder says. “At the same time, we’re right at the tip of the spear in relationship to change and how we get more value out of healthcare.” Historically, post acute providers have acted individually with little coordination of care along the continuum. That is beginning to change as government and payers look for ways to expand the number of people receiving healthcare while minimizing the cost to deliver that care. “In addition to a growing need for services, there also is tremendous need for leadership on our part to make change related to expanding regulations, as well as moving toward an organized, integrated post acute continuum,” he says. “Our strategy is to affiliate with other providers and be the post acute solution in our existing markets rather than getting into additional markets.” Vibra will integrate services with the short term acute care (STAC) hospitals and Accountable Care Organizations and move with them as change occurs on a community level, Yoder believes. “The opportunity we have as a company comes from the fact that we are private, very hands on, experienced and have done some of this before,” he says. “We are able to go in, move fast to make changes, and integrate us with the STAC systems and begin to show them we can reinvent care in such a fashion that there can be savings.” The challenge will be in finding ways to treat more patients in a more cost effective approach. “We have a road map to do that through our strategy of joint ventures and the virtual post acute continuum of care,” Yoder says, “but, we have to do it within the rational framework of what we control and what influence we can create.” n Citing her achievement in the medical laboratory field, the American Society for Clinical Pathology (ASCP) named Michelle Spinosa, CLS, MLS, clinical laboratory manager, Kentfield Rehabilitation and Specialty Hospital, to its inaugural “40 Under 40” Program. The program recognizes 40 pathologists, pathology residents and laboratory professionals under age 40 who have made significant contributions to the profession and stand out as the future of laboratory leadership. “We are inspired by these young professionals who are passionate about the profession, driven to improve healthcare delivery and doing amazing work for their institutions and beyond,” said Dr. E. Blair Holladay, executive vice president of ASCP. The 34-year-old Spinosa earned the recognition for building Kentfield’s new clinical laboratory in just two months after she was hired in 2010. “At the time, there was no other lab within Vibra. Everything had to be made from scratch,” Spinosa remembers. “There wasn’t a Quality Assurance manual, there were no policies or standard operating procedures. It was a lot of work.” Previously, the hospital had contracted with a nearby hospital for all its services, but the cost and delays caused by transporting specimens were major barriers to efficient patient care, according to Ann Gors, Kentfield’s chief executive officer. “Because we wanted to reduce costs and improve our quality of services, we embarked on the new lab project and hired Michelle to start the lab,” Gors says. “She got it up and running, initiated all the policies, received the equipment, did the initial testing and successfully passed the COLA accreditation survey.” In fact, COLA presented its highest commendation to Spinosa, The Laboratory Excellence Award, due to the outstanding survey results. Although the timeline was aggressive, Spinosa believes her professional network contributed to her success. “It was helpful to be young and able to work a lot,” she says. “I also made a lot of technical calls to colleagues I could ask what needs to be done, and I read and reread all the regulations.” Today the lab is staffed by a solid team and runs smoothly and efficiently, according to Spinosa. “It took a while to get there, but everybody loves working here,” she says. “It is a great lab.” n of Vibra’s size. “By buying underperforming hospitals and then paying attention to every operating detail, we’ve been able to generate financial improvements in the operations of our hospitals and create our own working capital,” Fegan says. “We’re certainly a much different company than we were 10 years ago.” n Photo by Capturing Grace Photography. 10 www.vibrahealthcare.com Issue 3 Issue 3 good vibrations 11 Hospital/Community IN ACTION Marlton Rehabilitation Hospital hosts amputee golf clinic E very year the Marlton Rehab Annual National Amputee Golf Association First Swing/Learn to Golf Clinic welcomes new participants looking to reclaim their golf swing or just interact with peers who share similar disabilities. “Some of the attendees are current patients, some are past patients and some have never been to [Marlton Rehabilitation Hospital],” says Ken Turley, manager, outpatient rehabilitation. “The clinic’s main goal is education and community support.” Working along side the hospital’s therapists at the clinic is Lou Namm, a double amputee who has served as a clinic instructor for 20 years. In the morning session, Namm educates therapists on the proper techniques for using adaptive equipment to help someone golf. “The afternoon session is when it opens to the community for participants to come out and work with the therapists and Lou,” explains Turley. “Basically Lou is educating them and the therapists at the same time.” Andrea Varone, a physical therapist who works with the majority of amputees who come through Marlton Rehabil- itation Hospital, says the event is an excellent activity for anyone with limitations in balance or walking. “They take turns on the equipment or get up and try swinging. If someone needs assistance, one of the therapists is there to assist,” Varone says. “One of the big benefits is that people realize they can do more than they could do before. Improved self confidence is a huge advantage.” The clinic is just one way that Marlton Rehabilitation Hospital is helping amputees. With one of the longest running amputee support groups in New Jersey, the hospital also does its part to show amputees that life does not end when they lose a limb, according to Dennis O’Donnell, an amputee since 2004. “Beside the golf outing, we’ve gotten people to go rock climbing, play tennis and other crazy things,” says O’Donnell, who co-facilitates the amputee support group with Varone. “Lately we have been trying to get people into kayaks.” O’Donnell, who believes everything happens for a reason, firmly believes the reason he is an amputee is so he can provide support to the amputee community. “That is part of what we share with the group: You have two choices. You can accept it and go with it or sit at home and feel sorry for yourself,” he says, adding that the people who are in the middle eventually fall their way after they attend a few meetings. “They realize it is a lot of fun.” n
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