Pennie

Just an FYI for all of you: Surprise: CMS announces the arrival of two new F-tags Source: Contemporary Long-term Care By Fall 2007, CMS announced that it will unveil two new F-tags after previously stating that fiscal year 2007 will not see anything new. The announcement came during the American Association of Homes and Services for the Aging (AAHSA) conference in Washington, DC this week. In June, skilled nursing facilities should expect to see new survey guidance on how to handle feeding assistants. Then by late summer, early fall, an accidents and supervision F-tag will emerge. A CMS official said the agency is anxious to release the accidents F-tag because of the concern about the ongoing prevalence of resident elopement. These will be the only tags released in the upcoming fiscal year, according to CMS officials. Does anyone know anything about these? Interested in the feeding assistants & how it will effect us the AD's. Later Pennie

WHO: Activity Directors, Therapeutic Recreation Specialists, Activity Staff & other interested parties WHAT: 8 hours of continuing education, NCCAP pre- approval #27059-08 Instructor: Pamela Sander, TRS/TXC, ACC WHEN: Wednesday, April 25, 2007; 8:30-5:30 WHERE: St. Dominic Retreat Ctr., 2401 E. Holcombe, Houston, TX If you need directions, call Maria, Cleo or Dorothia at 713-741-8701, at St. Dominic Village Nursing Home. WHY: explore person-focused assessment & care planning, learn at least twelve new activity ideas network with some of the finest activity professionals in Texas. HOW MUCH: $50.00 per person in advance of April 20, 2007. You must be pre-registered; no one will be admitted without registration. Registration is limited to the first 50 people. Lunch is included in the registration fee. TO REGISTER: Complete this registration form and mail with check or money order made payable to: Pamela Sander, TRS/TXC 6809 Duquesne Dr. Austin, Texas 78723  Name:_____________________________________________________________  Facility:____________________________________________________________  Address:_________________________________________ Zip:_______________  Check enclosed:____ Number of people attending:______  Amount of check/MO:____ Email:________________________________ (If you have questions, call Maria at 713-741-8701 or Pam at 512-926-8713) See Attachement for full details of workshop CP_Focus_Workshop.doc

Full time position Activity Director in Assisted Living At The Heritage, in Tomball, TX. Contact Chuck Lalonde, clalonde@tomballhospital.org. The Heritage is located on Graham in Tomball.

Do you use act calendars at your facility? If yes, why? Have you been asked/told not to use a calendar at your facility? Do residents prefer to do their own activities, will they? Is this a facility P&P, State or Fed requirement? Where does it state that in the regs. that there must be a calendar. Is this a practice that we have been taught to do or use to just to cover ourselves? Have we taught State about our calendars & made it easier for them to do their job by using our calendar as evidence against the facility or us? My answer: I have always been asked by state for my calendars, 3 months back & prior one. They have used the Res. CP, act calendar & participation records for part of their survey process. The job description for an AD usually has something in it about the monthly calendar. I have seen it mentioned under the Survey Procedures & Probes 483.15 (f)(1) to review the act. cal. But am interested on how all of you feel about this topic & any input you can add to this discussion

All of May is National Hamburger Month. Some resident's miss eating hamburgers, the All-American food. So why not get with your dietary manger & see about having a different hamburger every Friday in May. Some of the burgers you might offer are: cheese burger, swiss & mushroom, turkey burger, have a bar with different toppings & let res. fix it their way, BBQ burger the list is endless. You can make an activity out of this by discussing w/ res. how they use to fix burgers, why do they think this is the all time favorite food for young people now a day's etc. Turn this into a fundraiser for activities. Set-up a serving line & have the res. fix the burger's for staff who can purchase a burger, bag of chips, & drink for $5.00. What are some of you AD's doing with this month long event, if anything?

Way to go!! Nice to hear from everyone on what the surveyors are doing when they come in. I noticed that you said you had a CP for EVERY resident. I get a lot of questions on this. AD's asking if every res. needs a CP written on them even if they have no concerns. I have been told "yes" every res. needs this done. If no concerns then you write one using their strengths. I get the arguement that this is not written any where. But better safe than sorry. Anyone else state survey, CP's being commented on when they are there? CONGRATS Miguel!! Of course I know that you do nothing less that 150% for your res. & your job

Hello All of you that are members on the website http://members.activitydirector.com we have a new Live Help. this Live Help is for Care Plans. After you log on go to the Care Plans & if you don't see a CP that will work for you use the Live Help. We have a new consultant working with us now, well not new but new to this area for us, Big Chris. He is an expert in this area of Activities. We are so glad to have him on our team. Be sure to check out the CP area & welcome him by asking him all of those hard questions we seem to have Thank you pennie PS Welcome BC

There are so many DVD's out there for us to choose from. We don't have the time to preview them all before showing them to our residents. So this topic is for us to write a review about any DVD's that we have seen & if we think it is appropriate for to show our residents. I will begin with one that I just watched. It was released on 2/27/07. The movie was Boyton - Beach - Club. This movie is rated R. It is a romantic comedy about "active adults" who celebrates life, love & finding happiness again after age of 60. I liked the movie & thought that the resident's men & women would enjoy it. There were two scenes in it that I thought might have caused the rating to be R, but I do not think they would offend most of our residents as it was done in good a humorous way. No nude or cursing scenes. Has anyone else seen this movie? What was your take on it?

Has anyone heard about this: CMS issued guidelines for state survey agencies to follow in regard to the use of photographic evidence to support noncompliance during the survey process. Photographs can enhance findings of non-compliance and ensure accurate observation records are being created by providing visual evidence of injury, scene, or other relevant components of a deficient practice. How is your facility going to defend your residents’ dignity when photographic evidence is used to document deficiencies. This should make for an intersting topic.

It is time to start planning for this annual event: National Nursing Home Week will begin on Mother's Day, May 13 and continue through May 19, 2007. Treasure Our Elders is the 2007 theme for National Nursing Home Week. If you go to http://nnhw.org/ you will find media kits, activities, products & planning guide. Pennie

hello bonnie cathy seems to have it down pretty good. You do not have to visit your res. 1:1 daily, make a calendar where you visit Ms Smith on Tues & Thur @ 1 pm Mr Smith Mon & Wed @ 1 pm etc. Start your activity program @ 9 am & end @ 3 pm everyday. You get to work @ 8 am use that hour for charting & meetings. Stop activities @ 10:30 & start them back up at 2 or 2:30 pm use that time for paperwork, 1:1' etc. Again same thing from 3 pm til 5 pm (or whenever you go home) If you know that every moning you have a meeting @ 8:30, CP's on tues plan you calendar & 1:1's around these. I also chart during the movie time & other activities that I only need to over see. There will be those days however no planning in the world will work stuff happens. One of the companies I worked for had us do monthly time anaylsis, it helped to see where I was losing so much of my time but I hated doing these as I felt it was time I could be using doing something else. I never read the book Big Chris is speaking of but I do know he had several facilities & over 400 res to deal with daily. So if he could make it work mine should have been a breeze with only 250! Don't take the work home with you. Because in the end you will get really burned out. Occ. you may have to but avoid it as much as poss. you need to spend time with your family or friends taking care of yourself in order to be all you can be for your res. trust me I speak from 1st hand expreniece. Take care pennie

welcome AJ lots of sharing & info can be gotten here

Hey All, March Events a few for you to take note of: (Be sure to Google these to be sure that they dates are correct, since some of the vary from year to year) National Doctor's Day celebrated 26th since 1990 website: www.sma.org LTC Administrators Week 19-23 website: www.achca.org National Pulmonary Rehabilitation Week 11-17 (check dates) website www.aacvpr.org National Social Workers Month website www.socialworkers.org Employee Appreciation Day 3 Human Resources Week 6-12 Pennie

Hi Julie, Welcome to the site. Sounds like you have your hands full. Have you been working in the field for very long? It sounds like you know what your doing. Anyway welcome & we are here if you need anything. Have a good one. Pennnie & the Activity Directors Network Team says "Welcome"

I got mine from the dietary dept. I also a second 1 from them & used as my cart for Bingo prizes. They are metal & 3 tier not the best ones out there but they were free & are easy to disinfect.

Hey Cathy, My heart goes out to you. I remember having worked with similar dept heads who thought like yours do. They are not giving you & the Ad Dept the respct that it deserves. When they treat you this way it reflects how other staff members treat you. Only you know what you to do but in case you need a little advise start looking for another job. You sound like you would make a great AD, we need all of the good ones we can keep in our profession. After all you are losing sleep over your job, your pride is at stake & it is really not fair to the res. but you can't take that on. I am speaking from expernice! As far as not being certified or qualitified as an AD there are a couple of things here. One the admin will get a deficiency even if you are registered to start the course, they only clear it up once you are finshed with the course. Also you can't sign off on the MDS's unless you are qualitified/certified. So don't do it let somone else do it & take the heat for it like the DON. The admin may be surprised at how state is looking at act. now. (Unless they find a really big problem with another dept, then you may slide by) I am also hearing alot about the FEDS coming in with or right behind state so he should beware. As far as the dog well you are being used it sounds like but I don't know if you speak with him that it would make any difference, sounds like it won't. Anyway don't worry about post being to long this is why we are here for advise, venting & siding up with you Keep us updated & take a step back, breath & take time for yourself, the job is not worth the health risk. The res yes the job no. Later pennie

Hi Don't know how many of you in Texas has heard about the program "DADS Texercise Program" It is a great program for our residents. A little info about it: TEXERCISE is a statewide fitness campaign, developed by the Texas Department of Aging and Disability Services (DADS) to educate and involve older Texans and their families in physical activities and proper nutrition. The TEXERCISE campaign promotes activity among individuals To read more about it & get info. go to http://www.texercise.com also try doing a search for it on google or whatever & you will get more info about it. thought I share this with you & if anyone is already about it can you share anything with us about the program?

Hi, The rules have changed as of lately. It use to be that you only write a CP for res. that had a concern/problem. Now that they the State/Feds are using the res. strengths, they are looking for a CP on every res. I like most of you was taught that you needed to CP a res. if they triggered &/or had a problem/concern. Now very, very reliable resources have told me that every res. should have a CP. Also activities should be included in the approaches on other (depts.) approaches. It is a hard to change the way that we (especially the old school professionals) are use to doing things. But now it time for the changes to take place. Every res. is to have a CP. I know that this is a very controversial subject, different views etc. but is it worth taking a chance on? As far as putting all res. into the "some" category, that will raise a red flag. Not every res. is going to fit into this category. Yes if you put a res. into other categories a trigger will cause a RAP, but it needs to be addressed. You know your res. in the activity area & they are different than the DON sees (deals) with them. So you should put what you know what applies to them. Backup your decision in your progress notes. Remember that you are the AD Professional, trained in this area & it is your name going on the MDS (a legal document) not his/hers. You will be the one to answer to state/feds. if a question was to arise about it. As far as who fills what out on the MDS, section "N" for most of us but I hear pretty soon we will responsible for other sections. Take note: The feds. do not care who fills out what section of the MDS as long as the information is completed by a "qualified professional." Therefore, facilities can assign whatever sections of the MDS they desire to whomever the facility thinks is best to complete that section. Surveyors are looking to see that the AD is included in completing areas of the MDS that relate in any way to quality of life, that would be all of those sections that you have mentioned. However, most facilities have the AD complete section N, with perhaps verbal input to the rest. It is up to the facility policy and procedure and the MDS/care plan team. Whatever section is completed by the AD, he/she should be aware of the rest of the information recorded on the MDS. It is vital that the AD utilize this information in formulating the input for activities into the overall plan of care. From Pam Sanders, TR/TXC, ACC Hope this will help you understand better.

Hi Cath, Translation Converter The above will also translate anyting into different languages. It is great for newsletters, calendars, word searches, & yes Res Rights & much more.

Hi Jcat, Sounds like you have a tough job with the age difference & the different types of units involved. I don't know that anything I can suggest will be of any use but I will put a few things here that pop into my head & hopefully you can use them &/or it will get those creative juices flowing. You just never know I know that thy are using a lot of the music from the 60's & 70's on TV now. So possible that can be something used in an activity or at a party. It would cover poss. cover some of the younger res to res in say their 50's. When having a party make a mixed CD to play that could hit all age groups but just don't put any Heavy Metal, RAP & twangy C&W. Ask res from differnt generations to help you by picking aut a couple of songs for the mix CD. Go for types of music that are easy listening, light rock, old classical etc. This way everyone would get a little of what they like & who knows you may cross the generation gap with some of them. How about sports for a discussion making trivia game or something like that using the older players & mixing it with the current players stats now. Ususally a good winner for all ages is to do somethng that they work together in aiding others. Making something for the childrens hospital, or any local charity groups needing things. The Alzheimer unit & Behavioral unit may need to be have there on seperate calendar & occ. mix the units/res together, when all your staff is on hand to b sure of a smooth act. program. I don't know whatelse to say right now, other than every activity planned on your calendar does not need to fit all of your res at the same time. Just be sure that everyone has an activity on it that she/he likes/might attend. Do a Facility Population Assessment & to make sure that your calendar is balanced for everyone. Best of luck. Any other suggestions from all of you AD's out there? Pennie

Hi Be sure to check this out. A great way to have your volunteers &/or staff folks recognized by ALFA Awards Rules & Info For more information contact Nikki Crevey at 703-894-1805 ext. 221 or by email ncrevey@alfa.org

Hey Stacy & Bartman, I could not even imagine how stressful it was/is. It could be enough to drive you to drinking, if only you find the to do that (lol). So can you share with us what did they seem to be watching as far as activities. How about the charts, could you tell if they were looking at any particular documenations? How did you come on deficinicies? I have been told that they are really keying in on peoples certifications. We have been getting alot of phone calls from Admins last couple of weeks saying thought that the AD's were certified but come to find out they aren't. They all seem to have this kind of panic in their voices. After all w/ new regs it can be a Level 3 or 4 deficiency now, depending on the State's mood that day. So all of you AD's be sure that you look at your certificates to be sure you are either qualitied or certified by your state or NCCAP, which ever applies to you area. Check the expiriation dates, may be time to get those CEU's done & your renewal's sent it. Bartman & Stacy keep us informed we are hungry for all the details Later & thanks so much for the input pennie

I also have never been through a survey with the Feds. It is nerve racking enough just with State, everyone's tension level had to have been raised a level or 2. Do the Feds come in random or is there some specif things that could possible make them show up to? I do agree with Bartman that the survey's are getting a bit harder. Expecially with the new F-tags, they are being trained to look into things more throughly that in the past. I mean tears ago most survery's didn't even really know what we are about (Activities that is). Also you read alot more about the negative things happening in LTC facilities (well not just LTC but AL, retirement etc) So this has to be adding to the presurre for state to be more alert as to what is going on in homes. This is my preceitive anyway. Pennie

Hi Mary, Are the Dept Heads in charge on week-ends? Most of the facilities I have worked at the Dept. Heads rotated the week-end. The Dept head who was working that week-end was the person in charge, responsible for what goes on. Usually there is a person who is in charge for nursing staff on the week-end, she/he worked directly under the dept head in charge. Like Bartman said the person in charge had the power to write up/fire staff, not matter which dept they work in. I found that by working with the week-end person in charge of nursing staff usually was up against the same problem as you are. She/he is dealing with the same rude employees & finds the DON had to deal with. The thing I learned is the she/he (week-end person) has alot of power with the Admin. So I would speak with her/him & we worked together. Once we did this I saw a change in the week-end attuitudes & got more support from the DON. The admin I beleive had a talk with the DON & backed us up. Also like Bartman said have the family members speak up to. If they are only complaining to you then how does the Admin & other Dept heads know there really is a problem? e sure you ask them to fill out a complaint form that goes to the Admin &/or speak to them. If all of you stick together you will see a change which is so much better for the over all facility. You know the res. also have to see & hear this. They have a say about this problem as well. So encourtage them to speak out too. Hopefully this will be helpful to you. Pennie

Hi I think that the oxgen problem has been resolved for you in all of the helpful replies that you have gotten from the others. But what about the ladies attitude? You have discovered some of the underlying cause for it. But my question is how unfair she is making the outing as well as your activities fo rthe other res. They have voiced a concern about the lenght of time it takes to load/unload the bus. You said it effects the mood of everyone. This problem seems to me that it is a concern of the other res rights to have an enjoyable outing & activity. Maybe this lady should speak to Social Services about learning how to deal with her health issuses &/or speaking to her about her her negative comments is effecting others. She should be made aware of this (I am sure she already knows this) and how this needs to be resolved or addressed. Is this part of your question? A problem that you are asking for advise as well? Just a thought that went through my head as I read your posting & the replies. I personnel have a hard time, as I am sure most of do, with behavioral problem res. Let know how it is going what is working & not working. Maybe other AD's have been here before & can share the experinces with us.