Description:
PER DIEM, 8 HOUR SHIFTS
Position Title: Speech Therapist
Department: Rehabilitation Department
Reports To: Rehabilitation Supervisor
FLSA Status: Non-Exempt
About Us:
Sonoma Specialty Hospital, as the county’s only Long-Term Acute Care Hospital, is dedicated to caring for patients that require an extended acute care stay due to severe illness or catastrophic injury. We accept patients from the ICU, Step-Down and Telemetry units of partner hospitals and continue their care for as long as 45 days. This care focuses on the challenges of getting patients off of ventilator support, healing severe wounds, aiding their recovery following surgical procedures, and providing rehabilitation to speed their return to daily life. Our Hospital provides ICU, Surgical, and Step-Down care with dialysis, multi-specialty therapies and ongoing planning for the patient’s transition back home or into a lower level of care. Please contact us with any questions, and welcome to Sonoma Specialty Hospital.
Job Summary:
The Speech Therapist evaluates, provides and administers a rehabilitative program to patients with communicative and swallow disorders under a plan of care signed by a physician and in conjunction with other disciplines. The speech pathologist participates in in-service and quality assurance programs as well as other duties and administrative tasks as directed by supervisors.
Job Duties:
- Swallowing and Feeding (Dysphagia Management)
o This is often the primary role in an LTACH, as nutrition and pulmonary health are critical.
o Conducts clinical bedside swallow evaluations to assess safety and efficiency of oral intake.
o Recommends and trains staff on appropriate diet textures (e.g., mechanical soft, puree) and liquid consistencies (e.g., nectar thick, honey thick) based on assessment findings.
o Develops and implements compensatory strategies (e.g., chin tuck, head turn) and rehabilitative exercises (e.g., effortful swallow, Masako maneuver) to improve swallow function.
o Manages patients with Alternate Nutrition/Hydration (PEG tubes, NG tubes), determining readiness for oral trials and progressing oral intake as tolerated.
o Monitors for signs of aspiration, silent aspiration, and respiratory distress during meals.
- Tracheostomy and Ventilator Management
o Assesses and treats patients with tracheostomies, particularly focusing on Passy-Muir Speaking Valve (PMV) placement and tolerance.
o Collaborates with Respiratory Therapy (RT) to determine appropriate cuff management (deflation) to facilitate phonation and improve secretion management.
o Works with patients to wean from ventilator support by improving respiratory strength and coordination for speech and swallow.
o Assesses and manages oral secretion control (drooling) in patients with poor oral motor control.
- Cognitive-Communication Rehabilitation
o LTACH patients often have anoxic brain injuries, CVA/strokes, or post-surgical delirium.
o Evaluates cognitive-communication deficits including attention, memory, problem-solving, executive functioning, and orientation.
o Treats deficits affecting safety awareness (e.g., recognizing illness symptoms, understanding medication management, fall prevention).
o Works on functional communication for patient needs, including pain expression and basic wants/needs.
o Assesses capacity for medical decision-making and discharge planning readiness.
- Communication and Speech Disorders
o Treats motor speech disorders (Dysarthria, Apraxia) resulting from stroke or neurological decline.
o Develops and implements augmentative and alternative communication (AAC) strategies, ranging from low-tech communication boards to high-tech speech-generating devices for patients who are non-verbal or severely impaired.
o Provides voice therapy for patients with vocal fold paralysis or weakness (often iatrogenic or from prolonged intubation).
- Interdisciplinary Collaboration
o Participates in daily or weekly interdisciplinary team rounds with physicians, nurses, physical therapists (PT), occupational therapists (OT), respiratory therapists (RT), and case managers to coordinate care and discharge planning.
o Consults with the medical team regarding changes in patient status, readiness for procedures, or suspected silent aspiration.
o Trains nursing staff and Certified Nursing Assistants (CNAs) on safe feeding protocols, proper positioning during meals, and signs of swallowing difficulty.
o Coordinates with dietitians to ensure nutritional needs are met while maintaining swallowing safety.
- Documentation and Compliance
o Conducts comprehensive initial evaluations and writes detailed reports within regulatory timelines (Medicare, CMS guidelines).
o Develops measurable, functional, and patient-centered short-term and long-term goals.
o Documents daily treatment sessions, progress toward goals, and any changes in patient condition in the electronic medical record (EMR).
o Completes discharge summaries with specific recommendations for the next level of care (e.g., SNF, home, outpatient).
- Discharge Planning and Patient/Family Education
o Educates patients and their families/caregivers on home swallowing programs, compensatory strategies, and cognitive exercises for carryover after discharge.
o Makes recommendations for durable medical equipment (DME) needed post-discharge (e.g., thickening powders, suction machines, communication devices).
o Determines if the patient is safe to return home regarding their ability to manage meals, medications, and emergency communication.
o Communicates with outpatient providers or home health agencies to ensure a smooth transition of care.
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
Requirements:
Education, Training and Licenses Required:
Completion of an educational program focused on speech therapy acceptable for licensure. Valid license as a Speech Pathologist issued by the Board of Quality Assurance, Department of Consumer Affairs for the State of California. BLS required.
Experience Required:
Two years of experience as a Speech Pathologist in one of the following settings: acute hospital, skilled nursing facility and/or outpatient clinic. Two years’ experience with swallowing disorders: evaluation and treatment.
Knowledge/Skills/Abilities Required:
Thorough command of accepted Speech Pathology evaluation and treatment techniques; good documentation, communication, organizational and problem-solving skills. Ability to interact effectively with patients of all ages and developmental stages. See age-based competency form.
Equipment Knowledge Required:
The Speech Pathologist will demonstrate competency in theory and practical use of diagnostic evaluation tools to assess communication and swallow disorders and to plan appropriate treatment.
Working Conditions (Noise, Environmental, Demands, Shift, Setting, Human Interface, etc.):
Hospital and clinic setting with public address system. Patient care equipment noises; day shift, Monday through Friday with weekend rotation. Teamwork with other professionals.
Safety Requirements:
Employees are responsible for all aspects of the hospital safety and health program including compliance with safety rules and regulations, remedying unsafe working conditions, and for continuously practicing safety while performing duties. SSH’s policy prohibits employees with patient contact or those who prepare products for patient use from wearing artificial nails.
Supervisory Requirements: None.
