OT Across America: Kansas City, MO with Maria Lindbergh OTR/L

I’m so excited to share our first “OT Across America” Kansas City, MO edition, with home modifications occupational therapist Maria Lindbergh from Kansas City, Missouri.

It was so informative learning Maria’s perspective about starting a business in her city and what working in other settings in Kansas City has been like for her.

For more about Maria and her home modifications business, be sure to also check out her website, Toilet Talk, which offers lots of helpful bathroom tips to share with your clients.

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Tell us a bit about your background. What drew you to occupational therapy?

I graduated with my Bachelor’s degree in Anthropology right at the start of the recession in 2008 and was having a hard time finding a job. I was working full time as a pharmacy tech and heard a story on NPR about a need for male occupational therapists for male clients and I thought, “Oh how interesting, what an interesting job.” While I was job searching and taking a career profiling test to help find a job best suited for your personality, I saw the results and lo and behold, occupational therapist was on there. That’s when I decided to pursue it, take the pre-reqs and get into OT school at the University of Kansas Medical Center.

When I was in OT school, I knew I wanted to work with older adults. After I graduated, I worked in skilled long term care. I did that for four years and now am pursuing home modifications because of the high rate of patients completing rehab, going home, and then needing to come back because their home environment was not suited for them.

What does your typical day look like?

When working in home modifications, it’s pretty flexible day by day.

I do evaluations in patient’s homes so I can see them and how they’re performing in their own environment. I’ll talk to them about some interventions they can do but I really get an idea of what they’re looking for. I’ll ask people if they want to continue living in their home or if they’re thinking about moving to a different place, like a senior living community, for example.

If they want to stay at home, I’ll talk to them about bringing a contractor back with my write up of list of recommendations. When I do give recommendations, I’m happy to give easy and inexpensive modifications to sometimes some long term modifications that involve remodeling.

Part of my day also consists of is talking to contractors and doing billing with Missouri Medicare. I use a billing service now and am also working on becoming credentialed with the Kansas Medicaid Managed Care companies.

I also spend time networking, working on my home modifications blog and video content. My day is so flexible, so I really go week by week and schedule things that way. Every day is so different.

Do you make your own productivity standard?

For the most part I don’t have to worry about productivity standards, so that’s really nice, but I do have to stop myself and think about personal productivity if I’m doing an evaluation and thinking about the documentation.

It’s so easy for me to want to be incredibly detailed and spend lots of time documenting, but I have to really step back and look at it and go, “Is it really worthwhile and does this person really need a second picture of this type of grab bar?” I’ve also had worker’s comp evaluations that uses a different evaluation form that the company wants me to use. With these I do take a lot of pictures and want to be incredibly detailed showing these workers comp companies the exact environment. These do take a lot more time so I need to be mindful of the time I’m putting in.

When I was working in skilled nursing, my productivity standard was 85%. I currently work PRN in Independent Living and Assisted Living buildings with no in-house therapy (no Med A, just Med B) and their productivity is 73%, with a lot of walking from building to building.

With your home modifications business, how many patients do you see in a week?

It can be so variable. The other week I had 3 evaluations in a week and the past two weeks I’ve had zero. My current goal is two a month consistently and I’m hoping to grow that.

What are the most common diagnoses you see?

So far, I’ve been working with mostly orthopedic and stroke diagnoses, and I recently had one person with a spinal cord injury.

What do you like most about your job?

Working in home modifications is SO rewarding. I love, love, love going into people’s homes where I can be way more client-centered than some other settings. I get to address what the client wants to address, using interventions that they feel comfortable with at the price-point they are able to afford. I can give practical options with that practical education that OT gives to people in their homes. Touching on those practi things makes being an OT so rewarding.

What are the biggest challenges in your job?

The biggest is educating people on what occupational therapy is as well as finding clients.

When I network and talk to people, I say “Do you know someone who has a hard time getting out of the shower?” And when they say yes, I tell them that I help people figure that out. Then I’ll have a more in-depth conversation with them.

Sometimes I’ve found people still aren’t quite certain what I do, so I created a one-page flier with what I do along with my contact information. Coming up with those strategies has been more effective.

What is the job market like in your area?

I’ve heard that pediatric OT in Kansas City is competitive since so many pediatric OTs love and stick with their jobs. As far as the adult-based OT job market, it’s hard for COTAs to get full-time jobs since it’s more saturated in the metro area. COTAs can get PRN jobs and work for three PRN companies, but for some reason they’re not offered full-time jobs as much.

I think it has to do with funding like Medicare and companies not wanting to pay for quality workers, unfortunately. I feel like the need is certainly there but companies are fulfilling positions according to what they’re being reimbursed, which is really sad.

As far as with OTRs, I feel like it is a little trickier to get a full-time job as an OTR, but not as hard as for COTAs. The thing here is the turnover is incredibly high. It’s hard not to get burned out by all these different factors. I don’t know a single OTR who hasn’t had a short stint somewhere. It’s really rare to find someone who’s been working somewhere for even 5 years. I’ve met maybe one or two OTRs who have maybe worked for a home health company for a longer amount of years but it seems like the turnover is just so high.

Is OT appropriately represented in your setting? Do you feel like you really need to advocate for it?

I definitely do. There are some home modification OTs that don’t even talk about occupational therapy whatsoever. They’ll say they’re “Home Safety Assessors” or use those types of terms, but they don’t talk about OT at all which bums me out.

I’m here to promote the profession of occupational therapy as well and not be so ambiguous to the public. That’s one of my personal lifetime goals.

How would you rate the compensation in your area?

For the most part I feel like the compensation in my area is good. Personally, I was satisfied with what I was making full time working in skilled nursing. Kansas City is a lower cost of living city so it’s easy to live comfortably on a OTR or OTA salary.

What are your future plans for your career?

I would love to do the AOTA’s Specialty Certification in Environmental Modification. I would also like to go through a certification through the Center for Universal Design. It’s a certification that they have specifically for Universal Design more so for future building projects in residential and commercial spaces to make those places better for a wider array of people.

Universal design isn’t always going to be perfect for every single person, but I think it’s a good goal to make it more generalized than how it is today with design, especially with building new homes.

As far as my business goals go, I’m hoping to continue building my home modifications business full time. I would love to be busy enough to hire a COTA and grow it even more, as well as hire another OTR with a background and interest in pediatrics so that my services can be more comprehensive for that population.

I also want to continue to do more community outreach and raising awareness on the definite need for home modifications for people who stay at home.

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We’re so thankful to Maria for talking to us for this interview series. It was a pleasure getting to know her and really see her passion for helping her clients. Don’t forget to check out more about her business via her website.