Years ago, I began working at a large nursing facility that also had an assistive living complex attached to it. The place was immaculate in every detail (except one), had a large library and two fancy dining rooms. There were multiple levels with stairs and elevators located at the end of the halls. To get to the therapy room with patients we had to take them in a wheelchair to the elevator and descend into a subterranean level. I felt like a level-three cleric from the game "Dungeon and Dragons." I wanted to cast a light spell to illuminate the whole area.
The therapy room was very hot in the summer with poor air circulation available. To achieve privacy, we put up portable dividers around the patients and tried not to talk too loud because of the faint echo emanating from the chamber. On my first day there, I was locked out and no one seemed to have a key, including the nursing staff, because nobody else went down to that level except the therapists. One lone housekeeper who spoke very little English gestured for me to follow her to the stairwell. Hidden behind a step was the key to unlock the therapy gym. The walls were bare, the ceiling low and the ugly berber carpet didn't add to the décor.
Later in the morning, I went to another facility that was straight out of the early 1960s. It didn't have a gym. The therapy space was the hallway or if I needed the parallel bars, I had to unhinge them from the wall in the dining area. Next to the parallel bars was one of those big steel wheel things attached to the wall for shoulder ROM. I had never seen one up close before and I stared in awe of it for a brief moment. I felt like I was part of history when I touched it and heard it creak. The housekeepers weren't always there before me so I often had to step over spills and food items. When I forgot to attach the parallel bars back to the wall, I heard about it from everyone in the facility. I was thoughtless and thankless to leave the area such a mess for others to clean. Big sigh with rolling eyes as I wandered away.
Physical therapy services can bring in money to a facility to improve structures, hire more staff and fix items that require attention. Every once in a while, the therapy staff will require equipment to be able to serve the clients better. There should be no haggling about therapy equipment since we sometimes work in conditions that are no better than a shanty town.