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kevinm

New 248-249 Inspections?

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Now that as of June 1st, Surveyors are using the "new" Guidelines, anyone out there been surveyed? We are in our "window", I'll be sure to post any new areas/sites etc. for Activities. after they exit, what real changes have you seen re: Surveyors since new regs are in place?

 

Kevin

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Guest Guest_Karen

Good question!

 

Definately anyone who gets a survey please give us some insite on what is expected!

 

Thank you,

 

Karen

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Hi everyone,

The state has been in our facility. New guidelines in effect. They ask nurses, CNA's, all staff, on what activities they do with residents. What all the residents do during the day.

They ask me, AD, what I did with my resident's that did not attend activities.

They were watching activities alot.

Seeing who was coming into activities, and who was escorting resident's into the activity.

Hope this helps.

actpro in Texas

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Diana,

I am in a little place called Ballinger, Tx.

Do you have any insight, on the culture change.

I would like to know how to get the rest of the staff to do activities.

What is the name of your facility.

Actpro

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Diana,

I am in a little place called Ballinger, Tx.

Do you have any insight, on the culture change.

I would like to know how to get the rest of the staff to do activities.

What is the name of your facility.

Actpro

Hello,

 

I am in Brownwood, Tx. I am an activity director at an assisted living facility. We are in our window also. Was wondering how they are surveying assisted living facilities. Anyone could give me an insight it would be appreciated.

 

 

Thanks,

Sonia

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I actually just typed up and passed out a little one page questionaire to my staff inquiring what they believe they do activitywise with the residents on any given day. I am still waiting to hear their response. Then I am planning on leading the facilitywide inservice on payday, touching on the new regs and implementing specific activity carts for each of my 4 units - so that it is fully accessible for all staff when I am not available.

 

I hope this helps!

 

Getting staff aware of the fact that State will ask them what THEY do to help will be so important! One of my questions specifically asked if a member of the floor staff had in the past 3 months provided an activity to a resident who had a recent behavior (needing redirection), stated they were "bored," or were up late at night (unable to sleep). And then I asked what it was that they provided. Realizing they cannot rely on the activity director to be everything to everyone will be so important!!!

 

Diana

OH, for ACTPRO, I am at Memorial Medical Nursing Center in San Antonio - been here for 5 years and still feel like I don't do enough!

Edited by Diana

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Guest Guest

i am finding it very hard to retrain the staff to the idea that the phrase ( its not my job) does not alppy anymore and never should have.... the CNA's are saying " why do we have to do our job and yours" .......i am going to have a inservice on this the first of aug. if anyone has any thing the can send me that could help me out it would be great.....i have only been the director there for 6 months .....well i have only been an activity dir for 6 months.......so i really dont know enough yet....if you have any thing that can help my e-mail is magictiger2004@sbcglobal.net tank you in advance

 

KIM

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Guest Guest

Honestly, I think it is important that any inservices/education/workshop regarding the new tags be generated and led either by the administrator or Nursing Inservice Coordinator. THESE NEW GUIDELINES ARE NOT RECREATION INITIATED. They are to be implemented by the FACILITY. If the job of inservicing and educating staff falls into our lap, the new guidelines will be confused with something "the Recreation Dept has to deal with". THIS SHOULD NOT BE THE PERCEPTION

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I used the inservice and the forms I received from taking the FTAg course on this site, We used BigChris idea of making a floating multi dept documentation for all the facility to note any and all self set goals, interests, off hour activities and I took it upon myself to do the inservice. I need my facilty to rally behind this in order to get staff moving in this direction.. the Admin and Nursing in our facility dont have the friend factor that activitys has, Our Activity Dept, works with dietary, nursing, janitorial.. everyone to get residents moved, get meeting rooms setup, lunches perpared.. we have a good working relationship with everyone. We started non scheduled activities with several residents, teaming them up with staff, we supplied staff with materials to better equip them when talking to or helping out with certain residents, we are developing friendships as well as a good community.. it works for me... my facility wide activities are being noted, my assessements are being updated and I know I will be ready for state.. good luck....

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Guest Guest_magictiger

i work in a 176 bed snf 1/2 of the facility is a lock down alzhiemer unit. so i have a regular unit and alzhiemer unit.......i am going crazy trying to come up with an inservice that will benifit the hole facility ......if any one have a copy of an inservice please HELP>>>>>>>>>>>>>>>>>>..kim magictiger2004

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Hi Guy's!

State survey last week... All just fine with Activities, tough though.

With the new way surveyors are looking at Act I was looking forward to it actually.. Much more observation in halls, and not the numbers actually attending, but how they got there. No one left behind.. Facility wide involvement. Aides were asked about activities, "which activity does Mr Jones enjoy?" Do they encourage attendance, participate in activities themselves? (wow). And believe it or not, all had the right answers!

 

Every under 55 resident was assessed and activity preferences reviewed

 

1:1's/in room activities of course, the documentation the key

 

Some things just kinda related to activities but pushed on to nursing, was communication with non english speaking residents, and the smoking policy. Activities I know will be called on to assist. I will start a different thread with those issues.

 

Anyway, unfortunately there were bigger fish to fry in my facility, so Activities I think really did not get the full brunt of an informed surveyor really doing some digging... But my facility is on alert! they know now what surveyors are looking for now.. I've been telling them, glad to see some change..

 

Kevin

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Hey Kevin & everyone,

Thanks for taking the time to tell us about the survey. I think we are all curious about how these go, even before the change. I was wondering did you change up how you keep you participations records&/ or how you keep any of your records? I guess what I'm asking is how are you showing that the staff members of other depts. are getting involved, especially when your not there. If so how & what did state look at? CONGRATS on a good survey. Pennie

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Guest Guest

We are putting a partial REC. care plan next to care card closets. Because we are on an Electronic Charting System we are able to pull and separate, Copy and paste the ACTIVITY/INTERVENTIONS for each individual resident. As we update our careplans now, we are very specific interms of "what , where and when" the residents leisure individual preferences are. WE are not that "big " on how often, for example 2x 3x etc etc. This enlarged card is is for all of the "facility" to see.

 

In September we are forming a "QUALITY OF LIFE" committe comprized of assigned staff from all dept's and all levels, who we think will "get it". Durring those meetings we hope to brain storm and come up with interventions that the facility as a whole can improve and OWN quality of life directives (MANY THINGS THEY ARE DOING ALREADY) The difference is we will have written minutes to show the state. This committe WILL NOT BE LED BY RECREATION. REC dept will have a representative attend

 

What won't be on the activities calendar will be small monthly clubs that will meet 1x per month and be facilitated for 1 hour by volunteering staff who share those similar interests. These "clubs" will be small and targeted. They may have 2-3 residents only. Our administrator is already setting an example by having a Men's Club Luncheon! This is very popular and well attended.

 

Lastly, at the end of CNA's FLOW SHEET, we will have an optional button for aides to write a very short narrative as to what she had done in terms of elevating QUALITY OF LIFE from a leisure preference point of view. Again, this could be as simple as stating " I brought, Mrs. T. a gourmet magazine to page through ( because hopefully, as it reads on the care card the CNA will KNOW this ) OR it could be, " I put a small group together to have tea and turned on the preferred music '" OR " I told MrB. the YANKEES were on and found the right channel, OR NOTHING AT ALL . The point is: It is not mandatory. The point is: we are giving the CNA the opportunity to document on the "total PERSON" not just a CHECK MARK about what type/form their stool was today or what level of ADL assist was performed, or what quantity of food intake or weights.......etc etc. We hope that it will empower them. We hope that we will gain useful information. We want to value their efforts and opinion. We want to give them the opportunity to TAKE CREDIT for the many things that they are DOING ALREADY, that the REC dept. knows nothing about!!!!!!!!!!!!!!

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Guest Guest_Melissa

Our admin is asking us to make sure we are doing everything we need to do for the new survey requirements. Wea are getting close to time for a visit and she is getting nervous. We are in Ohio .. Long term care 248 beds.. we have been doing the updates on our assessemtnets and would like any suggestions from anyone.

 

what is everyone else doing to be in compliance.?

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Guest Bingo

Several things that our facility was sided on

1. No mail delivery on Saturday

2. F242 One Foreign resident did not have a communication board.

3. Lost clothing

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Guest Guest

are ya all workin for profit, or non-profit? If it's for profit, I'm thinkin that every last one of you are bamboozled. activities is the last concern that any corporation has in mind, other than the bare minimum to meet regs; and then, it's more of the paperwork issue than whether the residents are really happy or not! So sad, I was glad they asked me to leave!

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Guest Guest_Kara

:-( Hi everyone, State Surveyors were here last week and ouch...They were tough and looked at all the activities. I work in a 142 bed facility that includes our Alzheimers Unit of 42 beds and they gave me a sitation on two residents in our Alzheimers unit, never talked to me about them or anyone but I guess their act's did not meet their needs and were not individulized. I wish I could have talked to the surveyors about them because I believe we were meeting their needs knowing their past history. My first sitation ever, been her for 10yrs. They also looked at 3 of our residents on isolation. Glad we had good activity documentation on what we were doing for them one on one in room. They were going to get us for abuse:social isolation but thank goodness for documention on our part.

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Guest Guest_KAREN

HI

How much documentation is enough on Residents that are in isolation?

In our facility we provide supplies geared toward that Residents interests

to make sure that they have something to do . But we do not spend much time with them during their isolation. This comes from our DON.

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State just left our facility on Thursday. I was a little disappionted. They observed two activity groups and that was it. I questioned staff (i.e., CNAs and nurses), but they were not asked about their roles in activities at all. When asked if they wanted to see the activity calendars, the surveyors said that they did not use them to evaluate anymore - the new interpretive guidelines instructs them to be more focused on individuals - not groups. I'm afraid all of my work inservicing staff on how activities are the responsibility of all is going to go down the drain now! I was hoping the surveyors would reinforce what I've been preaching.

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Guest happy
Diana,

I am in a little place called Ballinger, Tx.

Do you have any insight, on the culture change.

I would like to know how to get the rest of the staff to do activities.

What is the name of your facility.

Actpro

:lol: I gave activity bucks for every resident the staff member brought to activities. At he end of the month the staff member with the most activity bucks got a gift. Try this I'm in a small town also, but this worked for me.

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Guest happy
Several things that our facility was sided on

1. No mail delivery on Saturday

2. F242 One Foreign resident did not have a communication board.

3. Lost clothing

:lol: Bingo, I got the same tag for no mail on saturdays last year. I got with the DON and the Week-end RN's and they pick up the mail and hand it out to the residents that got main for that day. The RNs write down the # of residents they give mail to in a spril notebook and sign it. I check it every Monday morning and put my name & date next to the RNs name. I hope this helps you out.

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We had our annual survey and the exit was done on my birthday---July 21st! It is going to be interesting to see how well our department does next year. The survey team were curious as to how Social Service and Activity Department work together mjeeting the needs of certain residents. They were looking at the space available for activities---WAS THERE ENOUGH LIGHT, etc. Impressed to see upper management assisting residents to activities. We got a tag---it seemed to appear after the meeting with Resident Council. This was on dignity----staff not waiting for resident's response before entering. The Resident Council can be our best friends------or our downfall. Continue to educate the CNAs-----this will be my future downfall----our CNAs have not grasped the importance of assisting residents to programs. Good luck---the facility got 4 tags......Activities none. Care Planning was a hot spot---I suspect that it will become an open sore that may hurt activity programs everywhere. Karen 8-)

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Guest Tara

We had our survey the week of June 20 by our Texas Survey team. I've worked in activities for over 5 years, serving as assistant director the last two....but have been activity director for just 6 months. I must admit I was nervous, but my predecessor had been a great mentor, and had already taught me how to set up our activity care plan system to include interdepartmental cooperation and activity documentation to reflect the "personal" preferences of our residents. I also found it helpful to watch the same training videos on activity tags on the internet that the CMS required surveyors to watch prior to June 1.

 

I was interviewed just once, and the only comment made to me was "I've noticed that the CNA's assist residents to activities" I'm so glad they do!! I was able to brag to the CNA's that the surveyors noticed the good job they were doing (out of hopes they will CONTINUE their good habit of bringing residents to our activity times.)

 

Resident Council has always been a toss up, because you just never know what kinds of complaints can come out of the blue!! I'm just glad we got through this year, with only 3 fairly minor deficiencies

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