1-2 Day Stand-Alone Intensives


Click on each Topic below to reveal more information.

The Interdisciplinary Approach to Care Planning

"Care Plans." Those two words alone can cause fear and frustration to most long term care professionals. Are we supposed to have separate, individual-discipline plans for every resident; or are we required to have one comprehensive care plan for each resident? And which care model do we use - medical or social; problem-based or needs-based? The debate goes on, the confusion grows, and professionals are now becoming so concerned overwriting a care plan that they have no time to actually implement a realistic, workable care plan.


Care planning is an essential part of healthcare, but is often misunderstood or regarded as a waste of time. Without a specific document delineating the plan of care, important issues are likely to be neglected. Care planning provides guidance to every care team member who is responsible for a resident's care. Many people believe that the care plan is the sole domain of nurses. This view is damaging to all members of the interdisciplinary team, as it shortchanges the non-nursing contributors while overloading the nursing staff. This practice can also lead to citations, poor care, and even litigation. To be effective and comprehensive, the care planning process must involve all disciplines that are involved in the care of the resident.

 

This educational offering will give participants an overview of the comprehensive care plan process, as well as specific details regarding:

  • CMS Requirements and Guidance
  • Person-centered care
  • Individualizing each resident's plan of care
  • Interdisciplinary assessment
  • The "total team" concept
  • Plans that promote psychosocial well-being
  • Pain, behavior, depression and end-of-life issues
  • Legal aspects of the care plan

 

Participants will be able to identify federal requirements, surveyors' expectations, and specific care issues as they relate to the care plan process. Care team members will learn how each discipline can truly assist in the development of a "resident-centered" care plan that is designed to meet specific care/medical issues, as well as help the resident "attain or maintain their highest practicable psychosocial well-being."

 

Session Length: 5-6 hours

 

Intended Audience: All disciplines; Long-Term Care


The Surveyor's Approach to Care Planning

So...just how do we write the care plan? Which method should we use? What do surveyors actually look for when evaluating care plans? Are there any "red flags" that will draw their attention? And shouldn't we be writing care plans that actually "make sense" to the professionals providing the care? Seminar participants will learn the answers to all of these questions and much more! They will also be able to identify federal requirements, surveyors' expectations, and specific care issues as they relate to the care plan process. Care team members will learn how each discipline can truly assist in the development of a "resident-centered" care plan that is designed to meet specific care/medical issues, as well as help the resident "attain or maintain their highest practicable psychosocial well-being." Areas addressed during training:

 

  • Federal regulations regarding the comprehensive care plan, quality of care, quality of life
  • What the Centers for Medicare and Medicaid Services (CMS) has to say about care planning
  • The survey components of care plan compliance
  • Areas of survey focus:
  • Quality of Care-physical/medical
  • Pain
  • Palliative Care/End of Life/Hospice
  • Behavior
  • Cognitive Losses/impairment
  • Resident Choices
  • Psychosocial Well-being
  • Communication
  • Activities
  • Symptoms of Depression
  • Risks and potential concerns
  • State-specific deficiencies in care planning, process, and outcomes
  • Examples of "problematic" care plans
  • "Do's and Don'ts of care planning
  • Care Plan "red flags" for surveyors
  • Care Plan Process
  • Basis/documentation for the plan
  • Anticipated outcomes
  • Delivery of services
  • Staff communication
  • How to write/develop a realistic, common-sense care plan that staff feel they can actually implement
  • How to convert a traditional, computerized, "generic" care plan into an individualized, person-centered, and/or "I" Format care plan

 

The last two hours of this session will consist of group work - your care team will convert a traditional care plan (an elder's plan from your own home) into either a realistic, "person-centered" care plan, or an "I" Format care plan. This format is being highly recommended and encouraged by the Centers for Medicare and Medicaid Services (CMS). Come and learn this new concept for addressing and meeting elders' needs.


Special Note: All participants will be asked to bring a completed care plan on an elder from their facility. Staff should make certain to remove all personal identifying information as mandated by HIPAA.


Of special interest: Cat Selman has over 30 years' experience and expertise in this specific area of care. She has trained both federal and state surveyors in the care plan process. In numerous states, she has trained entire state survey agencies on this topic! If you want to learn the accurate, most progressive and up to date information - THIS IS THE SEMINAR TO ATTEND!!


Session Length: 6 hours


Intended Audience: All disciplines; Long-Term Care


Advanced Activity Training - Moving Beyond the Basics

This session takes the activity and recreation professional beyond the "elementary" and moves into more specific issues: going beyond the basic activity assessment; individualized care planning that "makes sense;" problems vs. needs; CMS requirements/guidance for the activity care plan; resident choices; 1-1 programming; responding to challenging behavior - care planning - surveyor focus - activity interventions; most cited deficiencies; professionalism; and "how to talk" with administration, management, and surveyors. This training was requested by professionals who wanted more than "just the basics" in an educational offering. Seasoned participants comment: "Always learn a great deal to carry back to my facility. This is my 25th year. Wow - you held my attention all day." And "I feel more passionate, energized, and more informed after your workshop." If you have a choice of educational opportunities, this is the one you want to make certain to attend!


Session Length: 6 hours


Intended Audience: Activity/Recreation Professionals; Long-Term Care


Social Work Practice in Long-Term Care - Part 1 and 2

These two training courses were developed in response to a need voiced by practicing Social Workers and Social Work Designees in nursing homes. Part I is designed to cover the function of social services from "A to Z": to identify the role, function, and value of social work in nursing homes; to provide material that can be the basis for social work practice in nursing homes; and to comprehensively cover the psychosocial needs of residents and how to meet them. Part II takes professionals a step further in social work practice for the elderly in nursing facilities, and goes beyond the "basics." Dealing with families; case-mix reimbursement issues; ethical dilemmas & decisions affecting resident care & social work practice; quality indicators/quality measures; management, staffing and budgetary constraints; & defensive documentation/legal aspects are just a few of the areas that will be addressed in the advanced course.

 

Special Note: The courses should be offered at least one month apart so that learned techniques and principles may be implemented by participants during the interim time period. Both courses would cover a 4-day time period.


Session Length: 4 days (6 hours each day); Part I: 2 days; Part II: 2 days


Intended Audience: Social Workers, Social Service Designees; Long-Term Care


Survey Process for Psychosocial Outcomes

Federal and state surveyors are actively utilizing guidance to determine the severity level of psychosocial outcomes for residents. Surveyors have been instructed to assess facility practice as it relates to a resident's psychosocial well-being. Although the assessment of a resident's ability to maintain or attain their "highest practicable level of psychosocial well-being" has always been a requirement of OBRA, more emphasis was placed on negative outcomes involving potential or actual physical harm, injury, danger, or death to the resident, rather than psychosocial harm. Surveyors have been instructed to focus on facility practice that results in negative outcomes such as apathy, anger, depressed mood, dehumanization, humiliation, and boredom. Facilities may need to reevaluate the manner in which they provide care and services to their residents. This session provides instruction in this area for the long term care staff and Social Worker/Designee.


Session Length: 6 hours


Intended Audience: Social Workers, Social Service Designees, Nursing, Activity/ Recreation Professionals; Long-Term Care


Survey Process for Activity Requirements in Nursing Homes

Tougher surveys...more cited activity deficiencies than ever before...changes in the survey process...more focus on quality of life issues... It seems that the healthcare industry is inundated with major change on a daily basis, so it comes as no surprise that the Centers for Medicare & Medicaid Services (CMS) is paying more attention to quality of life and activities in nursing homes. Will your facility be prepared for the interdisciplinary focus? Will your activity department be able to stand the scrutiny? If you want to learn how the surveyors are being instructed to evaluate activities in nursing homes, presented by a speaker who served on the CMS panel of experts responsible for the revision of the guidelines, this is the one session to attend!


Session Length: 6 hours


Intended Audience: Activity/Recreation Professionals, Nursing, Social Services; Long-Term Care


Defensive Documentation for Long-Term Care Professionals

Documentation is important not only to validate the care that we are providing, but it now supports the reimbursement that we are receiving. In today's world, where everyone seems to be "sue happy," documentation becomes even more important when it is utilized to defend the actions taken by a health care facility. When involved in a lawsuit, the facility's documentation becomes a major source for the facility's defense - and not just nurses notes! Supporting documentation is necessary from all disciplines. Most seminars dealing with this topic are on such a level that only attorneys can understand the content. Your team needs to know how to document defensively! This seminar will provide simple, common-sense techniques and documentation strategies for all disciplines: nursing, dietary, social services, and activity/recreation.

Session Length: 6 hours (Session can converted to a 3-hour session to accommodate conference break-outs, if desired.)

Intended Audience: All disciplines; Long Term Care

The Common Sense Approach to the MDS 3.0

"They" said it would be easier..."They" said it would take less time... Did that happen? Help! While most would agree that the MDS 3.0 is a much better document than the MDS 2.0, some facilities are still struggling with the time constraints that are involved. Is it easier than it appears? Are we stressing too much? Can we learn to utilize the process to provide better care to our residents? The answer would be a resounding YES! Attend this training to learn a common sense approach to the MDS 3.0 and the development of a person-centered comprehensive care plan. Leave with a different perspective of the entire RAI process!

 

Session Length: 1-Day Stand-Alone Training - 6 hours

 

Intended Audience: Interdisciplinary Care Team; Long Term Care

 

Detailed Day Agenda Forwarded Upon Request


CATs, CAAs & Care Planning for Activities and Social Services

CATs provide a flag for the IDT members, indicating that a triggered care area needs to be assessed more completely prior to making care planning decisions. For the MDS 3.0, we now have Care Area Assessments (CAAs) and CAA Summaries. In this session, Ms. Selman will provide guidance and instruction on the Care Area Assessment (CAA) Process, the utilization of the Care Area Triggers (CATs) and their relationship to the development of an individualized, person-centered comprehensive care plan. She will specifically address the CAAs that have implications for the activities and social service departments, as well as identify specific related care areas that can negatively impact a facility's survey. Surveyors will expect the plan of care to address identified factors with the goal of: (1) improvement where possible or (2) maintenance and prevention of avoidable declines. The RAI helps nursing home staff look at residents holistically, as individuals for whom quality of life and quality of care are mutually significant and necessary. Ms. Selman will demonstrate how the RAI process culminates in the development of an individualized, person-centered care plan that meets resident needs and survey requirements.

 

Session Length: 6 hours

 

Intended Audience: Social Workers, Social Service Designees, Activity & Recreation Professionals, Nurses; Long Term Care


Resident Voice - Assuring Quality of Life Through the MDS 3.0

The Office of the Inspector General (OIG) has taken tremendous interest in determining how the MDS 3.0 can be utilized to assure an elder's quality of life. As a result, surveyors are looking more closely at the link between documentation on the MDS and the delivery of care and services to the elders in our facilities regarding quality of life.

Guidance from the Centers for Medicare & Medicaid Services (CMS): "The facility must create an environment that is respectful of the right of each resident to exercise his or her autonomy regarding what the resident considers to be important facets of his or her life." This includes actively seeking information from the resident regarding significant interests and preferences in order to provide necessary assistance to help residents fulfill their choices over aspects of their lives in the facility.

What is "quality of life?" Does one definition fit everyone? How do surveyors assess this important aspect of an elder's life? The RAI helps nursing home staff look at residents holistically "as individuals for whom quality of life and quality of care are mutually significant and necessary." Interdisciplinary use of the RAI promotes this emphasis on quality of care and quality of life. Nursing homes have found that involving all disciplines in the RAI process has fostered a more holistic approach to resident care and strengthened team communication. This interdisciplinary process, which includes input from the elder and/or their family/legal representative, directly influences an individual's experience of care, including: workplace practices, the nursing home's cultural and physical environment, elder/staff satisfaction, clinical and care practice delivery, shared leadership, family and community relationships, and Federal/ State/local government regulations.

 

84% of all elders living in a healthcare setting are capable of providing information regarding what they consider to be the most important facets of their lives. There are several MDS 3.0 sections that require direct interview of the elder as the primary source of information (e.g., mood, preferences, pain). Self-report is the single most reliable indicator of these topics.Guidance from the MDS 3.0/RAI Manual indicates that staff should actively seek information from the resident regarding these specific topic areas; and that resident interview/inquiry should become part of a supportive care environment that helps residents fulfill their choices over aspects of their lives.

 

This session will seek to provide guidance/suggestions/recommendations on the utilization of the MDS/RAI process in meeting quality of life requirements for each individual residing in a health care setting. Through resident voice and professional interdisciplinary assessment, the delivery of care and services become a dynamic, collaborative process. This process assures that the elder is able to attain and/or maintain their highest practicable level of physical, mental and psychosocial well-being.

 

Session Length: Full-day intensive (6 hours), or condensed 3-hour version

 

Intended Audience: Interdisciplinary Care Team (nursing, social services, activities/ recreation, dietary, nursing assistants, therapists)

 



Build Your Own 1-2 Day Intensive Training

Choose any combination of session topics from Cat's "repository" to build your own 1-2 day intensive training. Need help? Contact Cat at healthcarecomm@aol.com.