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Indiana FSSA Division of Aging Issues Updates to e450B Process
'Why' I Originally Chose to Work in Long-Term Care
ISDH Publishes Update to Advance Directives Brochure
CMS QAPI Material Rollout for Nursing Homes
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SHC Blog

Behavioral Symptoms

October HP LTC (Indiana) Monthly Summary Released - Is Your NF Prepared?

IHCP (Indiana Health Coverage Programs) has just released the October statistics for HP LTC Case Mix audits.  Each monthly summary can be found on their website here.  Several items should be of interest to Social Service staff - 

  • One of the expanded audits was due in part to PASRR
  • For October, the Behavior category was only fully supported at a rate of 50%
  • For October, Impaired Cognition was only fully supported at a rate of 87%
  • 13 residents were referred for Level IIs

Although the BIMS is considered a source document, there must be evidence that the interview was completed during the assessment period.  Residents who do not participate in the BIMS interview must have specific documentation during the time frame to validate their cognition.  There also must be documentation within the assessment period of any behavioral symptoms with specific examples.  

Does your Social Service staff keep a current PASRR list?  Have you reviewed those residents' Level II recommendations to ensure the recommendations have been implemented?  Has Social Service made Level II referrals for residents with significant changes as appropriate?  Need assistance with preparation?  Contact SHC and we'll schedule a visit to help your facility continue improving Quality of Life services to your residents.

And the Antipsychotic Medication Studies Continue

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Another new study, summarized in today's McKnight's News, warns of the possible negative effects of 4 of the most common antipsychotic medications.  The need to have an involved and informed pharmacist onboard with your Behavior Management program remains of the upmost importance.  Is your mental health provider communicating with Social Service and nursing staff?  For those residents who continue on certain targeted medications, the value of thorough documentation is a must. The documentation must include specifics regarding why the benefits clearly outweigh any potential risks. All too often, I see facilities failing to document the numerous non-pharmacological interventions that have been attempted.  I know it's a cliché phrase, but take credit for all the wonderful approaches you've tried and the outcome. Passing along pertinent nursing facility guidelines to your residents' physicians, who might not be up-to-date on the current push to reduce/eliminate antipsychotic medication, can also be a valuable tool.  
Need assistance with your Behavior Management / Psych Med program?  Contact SHC and we'll schedule a visit to help your facility continue improving Quality of Life services.

Behavioral Interventions, AP Med Reductions via LTL Mag

Quick Post - Click here to read Long-Term Living Magazine's recent article, "Reducing Anti-Psychotic Medications?  Try These Behavioral Interventions".

Bathing and Behaviors

Those of us in long-term care know that bathing residents can be one of the most difficult aspects of the day.  Bathing cognitively-impaired residents is where we typically see the behavioral symptom of resisting care.  Unfortunately, these behavioral symptoms can then set a negative tone for the remainder of the day, not only with the resident, but also with the staff.  It doesn't have to be that way!  Do your newly-hired CNAs have the proper knowledge of why bathing time is so crucial and what interventions can be used to help it be successful?  Are your 'been-doing-this-forever' aides due for a refresher?  Even for the non-Dementia residents, there are numerous ways that the bathing routine can become more relaxing and less like an unwanted chore.  The following article has some interesting tips - "Dementia-friendly Bathing".  

Need assistance with training or simply an outside review of your system?  Contact SHC and we'll schedule a visit to help your facility continue improving Quality of Life services.

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