Who Is Qualified To Signoff On Doc's

[Pennie 26]

... from my Email, thought it would be useful information....

 

 

The heated question that was brought up about a year ago re: Activity

Assistants signing off on the MDS. If you remember, we were discussing that

there was somewhere ( I can't remember, in a regulation or what) it said

that you needed to be a Qualified Health Professional. Now, when I refer to

the MDS 2.0 book it of course is making me look like a liar b/c it is saying

that anyone can sign it; however, highly recommended that a qualified

professional does the scoring for accuracy. I hope you recall and can lead

me in the right direction as to where I should look. I do recall looking at

something (one of my books, I think) and located something. This is really

important to me b/c I consult for this Nursing Home and somehow in a

conversation I mentioned that it should be the AD's job to sign and score

these. Well, somehow this recommendation went to the Adm. and phoned my

Boss. This Adm. is not too happy w/ my work and it seems that the harder I

try w/ her the more I screw up. I consult for 37 Nursing Homes and the

majority of the places are great. I work well w/; this place is a real

struggle for me. Contradict everything I say questioning my knowledge. I

thank you so much for you assistance.

 

The F-tag you would be looking for would be one that relates to the MDS, F-272, the area that refers to who is qualified to complete portions of the MDS. Your second reference would be the current, Jan. 2003, MDS Users Manual. It refers to "qualified professional." This "Qualified Professional" would be those people who are licensed and/are considered qualified by regulations, which then returns you to F-248 & 249, the people who are qualified to serve as AD. Nice runaround, huh? As far as other documentation, anyone designated by the facility can do the facility activity specific assessment, the care plan, the progress notes, etc.

 

************ F248

Activities

Residents should not sit idle for long periods of time without being invited to an activity or offered individual activity supplies. This is the responsibility of all staff.

All staff must take an active role in inviting and assisting residents to activities. Activity staff must make an effort to actively engage residents into the group, especially if each resident will be recorded in the participation record as attending. Programming needs to reflect the interests and needs of all resident. Special groups should be designed for the lower functioning residents, men, residents with similar issues, etc. Documentation must be timely, complete, accurate and organized. Overall care plans must be specific, measurable and individualized. If a resident expresses an interest, it is the activity staffs responsibility to provide the resident with the opportunity to enjoy that interest. Interests are identified on the MDS, Activity History and Interest Survey, planned for in the care plan and/or Overall Activity Plan, and followed through with, as evidenced in the participation records, 1-1 documentation forms and progress note. If you say you are going to do it, do it! Quarterly progress notes must reflect how the resident responded to the previously identified activity problems, goals and/or approaches from the care plan. (F514)

Participation records and 1-1 documentation must be accurate and current. Falsification of records is not permissible!

Spiritual activities need to be offered each Sunday and as needed. Every resident must be given the opportunity to practice his or her religion. Facilitate special needs when necessary.

Activities must be offered throughout the day, evenings, weekends and holidays. Residents who are unable to leave their room, ie.. roombound &/or bedbound, at risk for isolation, must be on a 1:1 program. Documentation of 1:1 programs must reflect date, the type of activity provided, approaches, length of program & response of resident.

Residents who choose to primarily stay in their rooms &/ or prefer independent activities should be on a visitation schedule (In-Room). Documentation of the In-Rooms must reflect date, what the visit consisted of, type of activities &/or supplies offered & response of the resident. Sufficient funds must be available to the Activity department. Transportation must be available for taking residents out of the facility. Supplies need to be appropriate and as adult-like as possible. A change of condition may warrant a change in the activity plan. Post activity calendars around the facility in conspicuous locations. i.e. wheelchair level, large, dark ink lettering for optimal visibilty. Avoid canceling groups. In the event of a cancellation, change the activity calendar. Volunteers require proper training to perform required duties. Volunteer files must be current and include an application, orientation checklist and job description. Volunteers must sign in and out.

 

********* F249

Qualifications :

Activity program must be directed by a qualified:

CTRS or person eligible for certification or

Activity professional certified or eligible for certification, (see course information below) or Qualified OT or OT Assistan.

Certification requirements: Activity professionals must completed the BEC- 90 hour course and the 90 hours of practicum, and the AMC-90 hour course and 90 hours of practicum.(The BEC and AMC have a new named, the Modular Education Program for Activity Professionals, BEC is Part 1 & AMC is Part 2) Both of these courses must be taught by a certified NCCAP pre-approved instructor, effective July 1, 2001 and approved by the state. Sit for the state exam. See www.nccap.org for more information on certification requirements. The two year experience clause was only used during the grandfather period. After June 1999 all of this was null and void. All Activity Professionals must be certified by 2004 per HCFA request. No excuses will be accepted after this. The regs. that came out in April 2001 discuss certification issues.

Facilities may consider using a consultant and putting the consultant name on the staffing record.

 

 

 

Here is a Texas link

Angela Chisholm, RN

512/490-0415

angela.chisholm@hhsc.state.tx.us

State website for MDS 20 & Relates ?'s

Texas

www.dhs.tx.us/about/initiatives/assessment/index.html

http://www.dhs.state.tx.us/about/initiativ...ment/index.html

[gina 2]

Hi Pennie,

Thanks for the great info!

Are the f-tags the same on the MDS in Texas as they are in Calif.,Or do they vary from state to state?

Just wondering.....

:-D gina

[Cassidy 0]

Thanks Pennie for the insight. I learned that a number of years ago; however, don't see it practiced to much. What's the link to the F Tag and how can I search for the definition of the Qualified Professional. :-D

[Pennie 26]

The discussion has always been a back and forth volley trying to identify who is qualified to sign. The MDS and the Users Manual describe Qualified as a person who is State Certified or is eligiable for State Certification, ftag 249, which I take as anyone who has completed the Certification Courses. I dont see it practiced much either, as a consultant I have always stressed, to a facility, the importance of having State Certified Directors. After all would a facility have just anybody sign off on a Nursing Chart...!@#$! I have run into all types of Administrators, those who understand the value of a good fun recreational enviroment and those who think the State makes them have an Activity Department, so they allocate them space and tell them to stay out of the way, they dont include AD in the family meetings or care planning, they just dont get it..

 

But you can always tell if you are in a great facility by the smiles and all the activity. ummm

 

Here is the MDS Section on the State of Texas Website.

 

http://www.dhs.state.tx.us/providers/ltc-p.../MDS/index.html

 

pennie :-)

[Guest sammy]

I do not understand the way you are descibing the education for activity professional.

I was certified by the Consortium for activity professionalin Austin ,nobody told us anything about this new Bec and Amc.

Please tell us if we need further education and update

Sammy Kessi

[Pennie 26]

Hi Sammy,

There are 2 types of cerfication: the first one is the one I believe you are certified thru: Consortium for Therapeutic Recreation/Activities Certification. This is a Texas Certification: which you would sign AD/TXC after your name.

The second one National Certification Council for Activity Professionals. This is as the name implies a National Certification: which you would sign after your name ADC.

The courses use to be called BEC & AMC Basic Management Course & Advance Management Course. Now the are called MEPAP 1 & 2 the Modular Education Program for Activity Professionals, BEC is Part 1 & AMC is Part 2

These courses are taught as 2 different courses each being 90 hrs. plus 90 hours of practicum (practicum may have been counted if you are holding down a full time job in activities).

Then after these courses are completed you sit for the State exam. This would be how you become certified for the State of Texas. AD/TXC

For NCCAP you would need to all of the above plus take a few more courses, see NAAP.org for full details. Once you have done all required by NCCAP then you are National Certified. ADC

Both of these do expire, so you are required to take so many hours of Continuing Education Hours/Units CEU's, before they expire. Each Certification renewal different number of hours for renewal.

Do you have a certificate from CTRAC? If you took the exam for Texas then you must have taken the courses you asked about. Your certificate will have your name, a number on it, as well as a date that it will expire. If you have the certificate mentioned then you are OK in the State of Texas but must renew it before it expires.

Same on the National certification, name, ADC number & a date it will expire.

In Texas either of these certifications will work. But if you are certified for NCCAP then you have already done the requirements for CTRAC, might as well get certified by both :idea:

I hope that I have answered your question without adding to much extra info. I know when I first read the stuff from NCCAP I was so totally confused :-o

If you have need for more info. or still don't quiet understand it all please feel free to write more or call NCCAP they are great people who are more than willing to help out.

See www.nccap.org for more information on certification requirements