asandlin 0 Report Share Posted October 12, 2006 I need some clarification can someone help!! Does every resident need a careplan even if there is no problem or trigger from the MDS. Here at my center each department is responsible for writing there own. Thanks asandlin hvlactivity@ahcthm.com Quote Link to comment Share on other sites More sharing options...
mashonda 0 Report Share Posted October 12, 2006 Hey Asandlin, What type of facility do you work at? I work at a long term care facility and there was some confusion a while back about the same thing you are asking. We had some people in corporate office that thought everyone should have a CP, but luckily my administrator and i was able to explain to them that each resident did not need a careplan unless there was a problem. the CP afterall is used to address PROBLEMS and then has goals as to how you plan to assist in eliminating or diminishing the stated problem. Also be sure to review the printed out CP when everyone is completed, b/c I'm not sure what software program your facility uses for CP, but some problems that the Social Worker may have careplanned, will have that the act. dept. will assist in the goals. I always look at the resident's careplan even if i did not write an activity one b/c some of the social problems overlap with activities. I want to be sure that social services didn't write that "in room visits will be provided by social services and activities staff two to three times per week and will consist of...)" Hope this helps. Quote Link to comment Share on other sites More sharing options...
Guest Mel Report Share Posted October 13, 2006 New regulations state that everyone must have a care plan. Quote Link to comment Share on other sites More sharing options...
mashonda 0 Report Share Posted October 13, 2006 Mel, what state are you in and can you point me to where the new regs say that everyone has to have an activity careplan. in the new regs that i have, i did not read that every resident has to have an activity careplan. we just finished our annual survey last week under the new guidelines and my dept. was deficiency free and all of my residents do not have an activity careplan b/c every resident doesn't have an activity problem. Quote Link to comment Share on other sites More sharing options...
Guest Guest_Miguel Report Share Posted October 13, 2006 Careplanning... Care planning involves identification of the resident's interests, preferences and abilities; and any issues, concerns, problems, or needs affecting the resident's involvement /engagement in activities. IN addition to the Activities component of the comprehensive careplan, information may also be found in a seperate activiyt plan, on a CNA flow sheet, in a progress note, etc. Activity goals related to the comprehensive care plan should be based on measurable objectives and focused on desired outcomes. NOT MERELY ON ATTENDANCE AT A CERTAIN NUMBER OF ACTIVITIES PER WEEK! Note: For resdients with no dicernable response, service provision is still expected and may include one-to-one activities such as talking to the resident, reading to the resident about prior interests, or applying lotion while storking the residents hands or feet. TAKE FROM THE CENTERS FOR MEDICARE AND MEDICAID FEDERAL TAG. So.. 1. It does'nt matter what state you are from as this is the Federal government which has set this standard for state surveyors to us in the "Guidance Process" 2. Activities, as stated above are not just about PROBLEMS... Care planning involves identification of the resident's interests, preferences and abilities; and any issues, concerns, problems, or needs affecting the resident's involvement /engagement in activities. 3. Careplan's can be written on Resident Strenghts, which from what I gather is kinda looked down upon as it does require "more" work from the whole interdiscplinary team. MAahonda, I suggest you and your admin. re-review the new guidance's as they clearly state a careplan is needed for EVERY Resident. These guidances are set for our profession to clarify that what we do has a purpose and that Activities needs to meet the needs of each and every resident (hence a plan of care for Activities) -Miguel Quote Link to comment Share on other sites More sharing options...
Guest Guest_Miguel Report Share Posted October 13, 2006 Additionally! If you have the opportunity anyone with questions on how to write careplans should purchase Beth Hall and Michele Nolta's Careplanning Cook Book! -Miguel Quote Link to comment Share on other sites More sharing options...
Guest Guest_Miguel Report Share Posted October 13, 2006 Again.. as I can really relate to the fustration of careplans as at one time I was under the impression if its not a problem dont bother.. How many of you have those residents that really dont actively participate in group programs that they are at...... YEAP JUST AT.. NOT DOING.... How many times have you sat back and thought.. gosch how can I get Mr. So and So to actually benefit from what everyone else is doing even if they cant really complete the full tasks. Well, thats a problem and their is also a need... the Problem is that the resident attends group program, however usually just watches from the sidelines with little or no actual participation. or the need Resident needs one-to one encouragement within programs to promote actual participation. What's the goal for this resident? What are they going to do that will show the Activity Professional that this resident is responding and growing and benefiting from a programs being offered. Anyone can attend a program, whether it be in room or in a group setting. The new guiedances dont want to see that Mr. So and So will come to Bingo 2-3X per week. They want to see that the activity department has clear goals for that resident to strive for. take a really good look at all of your residents and review their activity plan of care. Some other department careplans can include an Activity Intervention, however that does not Negate the fact that an individualized activity plan of care is needed. Correct me if I am wrong guys as this is an open forum for all of us to learn from, discuss and grow as professionals! -Miguel Quote Link to comment Share on other sites More sharing options...
Guest Guest_Pennie Report Share Posted October 14, 2006 Hi Yawl, I was like some of you, thinking that not every res. needs a CP written. After all if there is no problem.concern then no CP was needed. However I have spoken to a couple of consultants who teach, work hand in hand with the state & surveyors. They have told me the same thing as Miguel that EVERYONE needs a CP written on them. I was told that CMS says res. strenghts is 1 of the things to be CP'ed on. Also they are now looking beyond just activity attendance records. They are looking at behavior, social, restraints etc. They want to see what activites has CP'ed for res. in this. It is more than section N that we are involved in now. Did you know that the level of deficiency we can now get may actual go as high as a level 3? I think that if there is alot going on at the facility when they get there (state that is) that you may be able to get by w/o them looking to close at our dept. but if everything is OK or about normal you can expect them to be really looking at our depts. Read the CMS guidelines on what the surveyors are looking at now with the Ftags on 248. They are suppose to be asking all depts, CNA, Dietary, Maintienance, Laundry & us what are they doing with res. as far as activities go. Of course it is worded a little different but it still means the same thing! So to avoid any problems you should write a CP for all residents. My personal thinking is that by writting CP's for all & by having to be so speciifc that we will be hanging ourselves. I mean if I have 200 plus res. & only 1 or 2 staff people then we won't remember exactly what each res. CP is, and if I do, will I remember to document it everytime!? But what I think & what it is are 2 different things. Anyway this is what I was told from my sources & they have never led me wrong in over 20 plus years. This should make for a heated topic/discussion. Lets hear from all you good folks. P.S. Miguel can you email me over the weekend I need to speak with you please pbacon@activitydirector.com. Quote Link to comment Share on other sites More sharing options...
Guest Guest_Miguel Report Share Posted October 14, 2006 Thanks Pennie, You are absolutely RIGHT Pennie! This could be a catch 22 now with additional paperwork for those who have 200+ Residents. I am happy I only have 54. 8-) But this is also could be a good thing... More paperwork requires more time to complete it and that will make the whole facility team (and possibly more activity staff hiring) take more of a role in Activities. Activity Professional's calendars are going to change from the same stuff done at the same time every month to providing programs that will help residents meet their careplanned activity programs. Some state surveyors are surveying under the new guidances here in California and I was recently informed by my boss that two facilities were cited at a level J for Activities which is a major major thing! Something I believe that was un heard of at one time. But its here... time to wake up and show everyone that what we all do does matter and we are not just baby sitters.. We provide Quality of Life enhancing services to America's Geriatric Population. WE ARE ACTIVITY PROFESSIONALS! -Miguel Quote Link to comment Share on other sites More sharing options...
mashonda 0 Report Share Posted October 20, 2006 Well I guess that my facility, dept., admin., and i have a lot of work to do. Quote Link to comment Share on other sites More sharing options...
bigchris 1 Report Share Posted October 25, 2006 It should also be noted that the Care Plan serves many different uses. 1) It documents all progress and loss for backup and direction to those who may come in and not know the resident. 2)It can point out the good things that are happening for the resident, it doesn't need to be P/G/S all of the time, it can point out progress that your resident is making. 3) It is making a movement (especially in activities) toward a "person centered", less medical model. Bigchris Quote Link to comment Share on other sites More sharing options...
ActPro7 0 Report Share Posted October 28, 2006 We have spoken out so often about how important our role in our residents' lives are---now we are on center stage! Every resident in a facility must have a care plan----room for more errors......and opportunities to fine tune what we do for the residents. Make certain that you keep copies of the new care plans in your office, along with the progress notes, activity data collection forms, etc.--this will help with training your staff to read what was written on each resident/ getting them involved in activities they like. Make certain that you have a strong Resident Council President, a strong volunteer/family member around when survey rolls around. Please know your residents, always doing ongoing assessments. We as A.D.s have one of the hardest positions in the facility----it is getting harder---but guys this is what I was meant to do---I love this work and I make a difference in these folks' lives. You do too! Care Planning is just one more challenge---you and I are the pioneers of this----changes are coming--more changes! We are going to have to become more educated on our craft---hopefully the ones coming behind us will learn from our struggles. Meanhile, keep the faith. 8-) Quote Link to comment Share on other sites More sharing options...
Guest Guest_Karen Report Share Posted October 29, 2006 Did anyone participate in the Tele-conference last week in regards to the updates from the new guidelines. In response to Mashonda, it was stated that many of the states have not yet begun surveying fully under the new guidelines. So those of you who have passed your surveys since June 1st, beware. Different states are in the process of training core teams right now to be able to train the rest of the surveyors. They expect it to be more operational some time this spring. In regards to the careplans, I too believe you now need a careplan for each and every resident even if it is to describe their interests and leisure habits. Quote Link to comment Share on other sites More sharing options...
Guest Guest Report Share Posted November 21, 2006 Tele-conference? Updates to the new guidelines? I seem to have missed something. Was this a CMS tele-conference? Family health issues have kept me out of the loop over the last couple of months. Is there a way that I can access the info from the tele-conference? Any help would be greatly appreciated. Quote Link to comment Share on other sites More sharing options...
Guest Guest Report Share Posted November 21, 2006 I just went through survey last week and YES every Resident has to have a Care Plan. Thats a fact.................... Good Luck on your surveys ) Quote Link to comment Share on other sites More sharing options...
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