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)

oThis is often the primary role in an LTACH, as nutrition and pulmonary health are critical.

oConducts clinical bedside swallow evaluations to assess safety and efficiency of oral intake.

oRecommends 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.

oDevelops and implements compensatory strategies (e.g., chin tuck, head turn) and rehabilitative exercises (e.g., effortful swallow, Masako maneuver) to improve swallow function.

oManages patients with Alternate Nutrition/Hydration (PEG tubes, NG tubes), determining readiness for oral trials and progressing oral intake as tolerated.

oMonitors for signs of aspiration, silent aspiration, and respiratory distress during meals.

•Tracheostomy and Ventilator Management

oAssesses and treats patients with tracheostomies, particularly focusing on Passy-Muir Speaking Valve (PMV) placement and tolerance.

oCollaborates with Respiratory Therapy (RT) to determine appropriate cuff management (deflation) to facilitate phonation and improve secretion management.

oWorks with patients to wean from ventilator support by improving respiratory strength and coordination for speech and swallow.

oAssesses and manages oral secretion control (drooling) in patients with poor oral motor control.

•Cognitive-Communication Rehabilitation

oLTACH patients often have anoxic brain injuries, CVA/strokes, or post-surgical delirium.

oEvaluates cognitive-communication deficits including attention, memory, problem-solving, executive functioning, and orientation.

oTreats deficits affecting safety awareness (e.g., recognizing illness symptoms, understanding medication management, fall prevention).

oWorks on functional communication for patient needs, including pain expression and basic wants/needs.

oAssesses capacity for medical decision-making and discharge planning readiness.

•Communication and Speech Disorders

oTreats motor speech disorders (Dysarthria, Apraxia) resulting from stroke or neurological decline.

oDevelops 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.

oProvides voice therapy for patients with vocal fold paralysis or weakness (often iatrogenic or from prolonged intubation).

•Interdisciplinary Collaboration

oParticipates 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.

oConsults with the medical team regarding changes in patient status, readiness for procedures, or suspected silent aspiration.

oTrains nursing staff and Certified Nursing Assistants (CNAs) on safe feeding protocols, proper positioning during meals, and signs of swallowing difficulty.

oCoordinates with dietitians to ensure nutritio