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Care Plans for Everyone!!!


bigchris

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Hello all,

 

I have been spending some time on the CMS website and I wanted to address a common question that I hear....

 

Are careplans required for every resident in the facility????

 

As all of my information has exceptions to your particular facility,corporation, administrator, etc. The answer is yes.

 

Straight from CMS- I am going to paraphrase here.... F248 will be cited if the facility(you) does not provide an ongoing program of activities designed to meet the needs of each resident with a comprehensive assesment.......

 

Remember the Careplan is part of the ASSESMENT and needs to be present for every resident....

 

Now, does that happen? Nope, not every day. Do you have admissions? Discharges? Sig.changes?

 

But our ultimate goal, is to have a working "living" careplan for every resident.

 

 

 

Questions?

 

 

BC

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Hi Big Chris

Over the years I was always told that every resident has to have a CP -- This was hard for me to grasp as not every resident had a concern -- Now they say to use a residents strengths to write a CP -- This has made it easier for most of us -- Maybe a sample of 1 CP for a resdeint who is OOR, active, engaged, content but not over doing it something along these lines you fill in the rest of what type of resident it might be Many thanks for all you input & help to us. :o

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Penkay,

 

It is interesting that you mentioned that as I am writing several for the CarePlan area of this site. I will write a Culture change/ "I" care plan for a resident, but I would like to do one that would help someone on the site.

 

Any takers?? I will recheck and whomever submits a problem before noon on March 6th will be the winner! If there are more than 1 I will continue....

 

Chris

 

 

Hi Big Chris

Over the years I was always told that every resident has to have a CP -- This was hard for me to grasp as not every resident had a concern -- Now they say to use a residents strengths to write a CP -- This has made it easier for most of us -- Maybe a sample of 1 CP for a resdeint who is OOR, active, engaged, content but not over doing it something along these lines you fill in the rest of what type of resident it might be Many thanks for all you input & help to us. :o

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Penkay,

 

It is interesting that you mentioned that as I am writing several for the CarePlan area of this site. I will write a Culture change/ "I" care plan for a resident, but I would like to do one that would help someone on the site.

 

Any takers?? I will recheck and whomever submits a problem before noon on March 6th will be the winner! If there are more than 1 I will continue....

 

Chris

Didn't make the deadline but, lets see what you do for this one: Spanish speaking only, male, smoker, refuses to eat facility 99% of the time except when family is there. Refuses activities except with a family member. In a wheel chair, in rehab/therapy-PT, OT, & ST. :rolleyes:

485jeanie

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The views that are expressed and the links that are provided by contributors on our comment pages are the views of the general public and/or organizations and are not necessarily the views of Press TV or its associates.

===========================

kingsnuche

workout plans

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OK, so I got busted for missing the deadline!!!!

 

Not a problem, it shows you are paying attention!

 

Here is the answer for your non englisk speaking resident.....

 

 

the first thing that I would say is to create several different methods to eliminate any of the issues before you careplan any of the other stuff.....

 

So what does that mean Chris?!?!?!

 

I am glad that you asked....

 

If you have a resident where English is a second language, the first thing a surveyor will ask you is what "ADAPTATIONS" have you made for this resident???? Did you see the big word? It means learn it!!!

 

 

I will ask some typical surveyor questions then give you a reason, I would like a response from you as I have had this happen to me and I was able to avoid a tag from what my assistant (who is from Africa) had told me....

 

1) How do you know the resident refuses activities and eating if he is Spanish speaking?

They will want to see extensive documentation from you and every other department on how YOU KNOW he refuses if he doesn't speak English.

 

2) What have you done to ADAPT to his CULTURE/PREFERENCES/upbringing/religion???/Etc. How did you know how to adapt if he doesn't speak English??? Notice a pattern??

 

3) How do you and the other departments communicate with him IF HE DOESN'T speak ENGLISH???

Definite pattern here folks.....

 

 

I am trying to drive home a valid point....This is not a Care Planning issue as it stands, with the information that I was given, which is exactly what the surveyor will use by the way....

 

WE HAVE AN Issue that needs to be addressed first. This is, what have WE DONE for the resident, that helps him understand what we are trying to do for him?

 

Does he refuse because he cannot understand? Because we don't communicate well for him? Will he benefit from using pictures versus words?? We don't really know....

 

 

So we go back to the beginning and put some ADAPTATIONS in place that we hope will help the resident participate in daily life. We tweak those interventions as needed and THEN we care plan about the interventions!

 

Does that make sense? Sometimes we need to look at the main obstacle and the other obstacles will fall down.

 

 

Until we chat again....

 

 

Chris

 

 

Didn't make the deadline but, lets see what you do for this one: Spanish speaking only, male, smoker, refuses to eat facility 99% of the time except when family is there. Refuses activities except with a family member. In a wheel chair, in rehab/therapy-PT, OT, & ST. :rolleyes:

485jeanie

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  • 5 years later...

So, in the guidance to surveyors 43 CFR 483.20 9(k)(1), F249 Comprehension Care Plan it states:

"Determine if the facility developed specific and individualized activities goals and approaches as part of the comprehensive care plan, unless the resident is independent in providing for her/his activities without facility intervention."

 

Does this mean that we don't need a care plan for those residents.  How do we define facility intervention?

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