A Medical Professional’s Guide to
Cardiovascular Health & Rehabilitation Programs
at Rice Memorial Hospital

Phase 2 Cardiac Rehab • Exercise Classes • Pulmonary Rehab Program
Stress Testing • Peripheral Arterial Disease Rehab
Cardiac Rehab Center and Staff
The Cardiovascular Health and
Rehabilitation Center, also known
as Cardiac Rehab, is located on
the second floor of the Lakeland
Health Center. Lakeland Health
Center is across the street from
Rice Hospital and the two
buildings are connected by a
tunnel below Trott Avenue.
Rice Cardiac Rehab
502 2nd Street SW
Willmar, MN 56201
320.231.8770
www.ricehospital.com
Program Coordinator
Kellie Prentice, RNC, CDE
Program Assistant
Darci Mohr
Nursing Staff
Jeanne Boller, RN
Roxanne Covert, RNC
Carol Hauge, RN
Lori Roelofs, RN
Exercise Physiologist
Randy Kobienia, MS, EP, CES, RCEP
Behavioral Health
Angela Zwart, MSW, LGSW
Dietitian
Jacinta Krych, RD, LD
Pharmacist
Kris Cervin, PharmD
Cardiac Rehab staff (left to right): Randy Kobienia, Darci Mohr, Lori Roelofs, Carol
Hauge, Jacinta Krych, Kellie Prentice, Roxie Covert, Angela Zwart, Jeanne Boller.
Respiratory Therapists
Jenny Bjork, RT
Keri Ohren, RT
Advisory Board (includes program staff listed above right)
Medical Staff
Dr. Alan Roiseland
Dr. Michael Nicklawsky
Dr. B.J. Mellema
Dr. Steve Shelver
Dr. R. Boyd
Dr. Y. Sonbol
Nursing
Administration
Wendy Ulferts, CNO
Department Director
Lynn Stier, MS
Physical/Occupational
Karyn Loos, OT
Members of the Advisory Board welcome
your questions and comments. Resources
are available in the Cardiac Rehab Center,
including all program descriptions, policies,
and procedures.
Cardiac Rehab Programs: General Information
Who can benefit from Cardiac
Rehab and Pulmonary Rehab?
Each of our unique programs has
guidelines that match patients to the
program that best meets their current
needs. Please refer to individual
program descriptions for information.
What’s included in a Cardiac
Rehab program?
Exercise, education, and support are
the three main stays of each rehab
program. In addition to their individual
exercise plan, patients have access to
education and support sessions which
address the following topics:
 Cardiovascular function and
recovery process;
 Lipid management;
 Smoking cessation;
 Nutrition and weight control;
 Medications;
 Stress management and relaxation;
 Sexuality and family concerns;
 Individual exercise choices; and,
 Vocational concerns.
Who supervises the exercise
sessions?
Registered nurses and/or an exercise
physiologist are present when patients
exercise. Staff are coronary trained
and ACLS certified. They have been
specially trained in Cardiac and
Vascular Rehab at state-of-the-art
educational facilities. They have access
to ongoing education from the State
Cardiac Rehabilitation Association, and
the American Association of
Cardiovascular and Pulmonary
Rehabilitation.
How does someone get into a
Cardiac Rehab program?
The patient’s physician communicates
the referral to the rehab staff by
sending a written order, or by calling
320.231.8770, and following with the
written order.
What information does the
physician need to provide?
1.) A written order.
2.) A graded exercise test is
recommended:
 resting EKG tracings,
 summary sheet showing maximum
points attained including METS,
B/P, and heart rate,
 the physician’s interpretation.
exercise is progressed according to
these targets as well as the rate
pressure product, heart rhythm and
patient’s rating of perceived exertion
(Borg 6-20 scale).
Patients participate in EKG
monitored exercise for one hour, two
or three times weekly, using equipment
such as the treadmill, arm ergometer,
Schwinn Air dyne, Schwinn Bio dyne,
bench steps, stair master, Concept
Rower, Nu-Step, Recumbent bike, and
light hand-held weights.
Why are exercise intensities
measured in METS?
The MET (metabolic equivalent) is
recommended as the unit of energy
cost related to work load since it is
3.) A brief summary of the patient’s
easily understood by both patients and
history:
professionals and can be applied to
 discharge summary if patient has
various tasks.
recently been hospitalized,
Integration of: a) individual physical
 consultation summary from the
work capacity; b) the energy cost of a
cardiologist if patient has been seen given physical task; and, c) an exercise
and tested by a consulting
program; is facilitated by using the MET.
physician,
It represents a rate of energy cost and
 results of a recent lipid profile and can be used to measure individual
diabetes labs as indicated.
physical work capacity and the
metabolic requirement of a task. One
What follow-up communication is MET is the approximate energy
provided by the Rehab Team?
expenditure while sitting in a chair
1. An initial report, explaining the
quietly.
patient’s exercise prescription and
Although some variation is seen
plan.
among subjects, the MET is defined as a
2. A follow-up report periodically
rate of energy expenditure requiring an
throughout the program, explaining oxygen consumption of 3.5 ml 02/min/
the patient’s progress.
kg body weight. This unit, which
3. A discharge summary upon the
corresponds essentially to the basal
patient’s program completion.
metabolic rate while sitting, may be
4. Immediate notification of any signs used for all patients since it is
or symptoms which would be
expressed in terms of the individual’s
contraindications for continuing to body weight.
exercise.
What makes up an Exercise
Prescription and Plan?
Cardiac Rehab staff use information
from the exercise test to determine the
frequency, intensity, duration, and
mode of exercise. This also includes
determination of a target heart rate and
target exercise MET levels. Ongoing
Stress Testing
Phase 2 Cardiac Rehab
What types of stress testing is
offered at Rice?
 Plain GXT
 Stress Echo
 Dobutamine Stress Echo
 Cardiolite GXT
 Adenosine Cardiolite GXT
 Dobutamine Cardiolite GXT
Who can benefit from Phase 2
Cardiac Rehab?
Patients who have experienced:
 a heart attack or angina
episode,
 angioplasty, and/or stent,
 valve replacement or valve
repair surgery,
 coronary bypass surgery, or,
 heart and/or lung transplant.
Who performs the stress test?
Any active physician who does stress
tests, may do them at Rice. Also,
the primary physician may request
another physician test their patient.
Where is the test performed?
The Cardiac Rehab Center has
stress testing equipment and staff
have been trained to assist in stress
testing. The physician simply calls
Cardiac Rehab to make an
appointment. If an alternate testing
facility is used, we ask that the test
results be forwarded to us so that
exercise prescriptions and plans can
be customized for the
patient.
How does a functional exercise
test differ from the diagnostic
exercise test?
“Functional exercise tests
are usually submaximal or
symptom-limited. Prior
to testing, patients should
be ambulatory. Drugs
should not be withdrawn
for testing (so functional
capacity and THR can be
extrapolated). A sample
pre-discharge protocol
would take patients to
70% of predicted maximal
heart rate, 5 METS,
angina, a specified level of
exertion, or any of the
previously outlined
reasons for stopping an
exercise test, whichever occurs
first.” Taken from: ”Guidelines for
Exercise Testing and Prescription,”
American College of Sports Medicine.
Who should be referred?
Because each patient’s exercise prescription is highly individualized, almost all patients who are post-MI,
post-CABG, post-angioplasty, postStent placement, post-valve surgery,
post-heart/heart and lung transplant,
or who have stable angina or CAD
risk factors, may be considered for
referral.
What does the program include?
Phase 2 Cardiac Rehab includes education and support in addition to an
exercise prescription that is telemetry monitored, closely supervised,
and consists of multiple training
modes.
Happy Hour for Your Heart
Exercise Class
Our self-pay program, formerly
known as Phase 3, is called Happy
Hour for Your Heart.
Who can benefit from
Maintenance Exercise Classes?
Patients who are:
 at risk for heart disease
 overweight
 high blood pressure
 high cholesterol
 looking to improve their
overall health, and need a
supportive and educational
environment
And/or, who have:
 not exercised in a long time
 Diabetes
 a family member with heart
disease
Who should be considered for
referral?
All patients who could benefit from
this supportive, educational
environment for people who want
or need to start exercising and don’t
know how.
Registered Nurse Carol Hauge offers
encouragement and assistance to a
participant at the YMCA during the Annual
Cardiac Rehab Reunion Walk.
What does the program
include?
Happy Hour for Your Heart is a
medically supervised and selfmonitored exercise program with
monthly telemetry. Participants can
exercise up to five times per week,
following their own exercise
prescription.
Pulmonary Rehab
Who can benefit from
Pulmonary Rehab?
Patients who experience breathing
problems as a result of chronic lung
disease, chronic bronchitis, asthma,
emphysema or other lung condition.
Who should be considered for
referral?
Newly diagnosed patients with
asthma, COPD, or emphysema.
Patients with frequent hospitalization
for COPD or asthma. Patients who
would benefit from an increase in
strength and endurance to improve
their daily activities. Patients who
desire an increase in feelings of
control and self-esteem.
What does the program
include?
Pulmonary Rehab is a comprehensive
education and exercise program.
Patients are supervised closely and
monitored using O2Sat monitor and
heart rate monitor. The multidisciplinary team work together with
the patient and patient’s family to
provide education about lung disease,
breathing techniques, relaxation
techniques, medications, a healthy
nutritious diet plan, physical activities/
exercise, and emotional health.
Peripheral Arterial Disease
(PAD) Rehab
Who can benefit from PAD
Rehab?
Patients who have intermittent
claudication, and/or patients who
have undergone a procedure to treat
PAD (i.e. femorial bypass surgery or
stenting) , can benefit from this
program.
Who should be considered for
referral?
All patients with intermittent
claudication can benefit by learning
about PAD and ways to treat it.
What does the program
include?
Patients will receive exercise
therapy, education and support.
Participants have two exercise
sessions per week that consist of a
warm-up, 30-minutes of exercise,
followed by a cool down. Heart
rates are monitored, with weight,
exercise data and progress notes
recorded at each session.
Respiratory Therapists, Keri Ohren and
Jenny Bjork, offer encouragement and
assistance to a Pulmonary Rehab Program
participant.
What do the initials after
our names mean?
CDE
Certified Diabetes Educator
CES
Certified Exercise Specialist
CNO
Chief Nursing Officer
EP
Exercise Physiologist
LD
Licensed Dietitian
LGSW
Licensed Graduate Social Worker
MS
Masters of Science Degree
MSW
Masters in Social Work
OT
Occupational Therapist
RCEP
Registered Certified Exercise
Physiologist
RD
Registered Dietitian
RN
Registered Nurse
RNC
Board Certified Cardiac and
Vascular Registered Nurse
RT
Respiratory Therapist