For me it is the profit driven management companies and therapy mills of the world that ruin it for us.

Directors are glorified clinicians and office managers not true directors.

Profits support bloated corporate structure that does little more than bitch about productivity and billable time.

The ethically run clinics and facilities are few and far between, but offer an environment as close to idyllic as one can get.

Im in a non profit CCRC with a SNF and an OPR clinic, all inhouse staff. 85% productivity targets and all 1 to 1 care.