I have great news for those who have been guarded in their efforts to bring culture change or person centered care to their fundamental business philosophy. CMS has released new interpretive guidelines for 12 F-tags impacting Quality of Life and Environment. They are liberating, they are exhilarating and exactly what those of us who have been preaching the gospel of culture change has been waiting for. Most importantly, the new interpretations get right to the heart of choice, empowerment, respect, relationships and creating community. These new guidelines become effective on June 17th, but surprisingly, many homes are not yet aware of how they will impact their day-to-day routines, business and decisions.
At first glance or in skimming CMS’s new guidelines, you may say, “oh, we already do all that.” As a consultant who visits homes throughout the country, I say that you should probably read through those new guidelines a little closer. I have been reading, studying and absorbing them for several months and every time I read through them, I see something I missed the time before. Here are just a couple things I want to point out:
* Have you sent letters to family members and residents letting them know that your home is open to visitors 24 hours a day?
* Have you provided education for your team about unrestricted visiting hours?
* Have you interviewed your residents to determine their life-long routines?
* Have you implemented brain-storming sessions and education with your team to help them understand the changes to long established work routines?
* Have you looked with a non-medical eye at your home to determine how you will eliminate all medical appearances from areas that residents frequent?
* Have you educated your team on speaking the language of dementia in order to meet the new guidelines of working with the resident’s behavior instead of against it?
* Does your therapy department know that their schedule must now be secondary to the residents schedule and desires?
* Did you know that blanket and routine use of bed and chair alarms is no longer acceptable?
These are just a few areas that will require intense education and long and short term planning. It is vital that we give these new CMS guidelines more than a fleeting glance if we are to stay in compliance.
-- Teresa McCann, Senior Consultant and Director of Development
Monday, May 18, 2009
Friday, May 8, 2009
Coming Soon!
Centers for Medicare & Medicaid Services (CMS) is making revisions to the interpretive guidelines affecting 12 Quality of Life and Environment F-Tags. The changes are based on public recommendations from the April 2008 symposium “Creating Home in the Nursing Home” co-sponsored by CMS and the Pioneer Network. These revisions being implemented June 17, 2009 focus on creating person-centered living environments.
The Institute team is putting the finishing touches on a manual designed to assist nursing homes with understanding and implementing these changes.
Check back soon for a product update!
Monday, December 15, 2008
Touring Guidelines for Person-Centered Care Homes
A tour is a wonderful way to give a potential consumer an “inside look” at your home. If you have the added benefit of working for an organization that practices Person-Centered Care, you may find yourself in the happy situation where the community sells itself.
One of the first questions to answer is, “Who is responsible for giving tours?” In an organization with a typical, top-down management style, the admissions coordinator and the administrator are usually the two individuals most often expected to give tours. However, in a home that embraces Culture Change, every team member, and often even residents can be expected to provide the same service. Just as we advocate that team members give tours to potential employees, we do the same in the admissions process. After all—who knows the home better than the people who work in it everyday?
Remember, a tour is not the time to be collecting payor or clinical information. That takes place later, behind closed doors in a sit-down with the admissions coordinator, administrator or social worker. The tour is a time for your home to shine—and any member of your team should be educated on how to put the home in its best light.
We recommend that you choose three individuals who are not managers to give basic tours that are available on the day shift. It does not matter what their role in the home is—but they must be capable of the following:
* Possess a clear speaking voice
* Exhibit a friendly and caring attitude
* Demonstrate pride in the home
* Be familiar with the home’s Person-Centered Care assets
* Have some longevity with the home
* Possess current knowledge of recent survey results
* Know the names of all elders and team members in the home
* Keep the tour moving and on-time without appearing to be rushed
* Be able to answer questions easily without becoming flustered
* Know when to redirect certain questions pertaining to clinical and financial matters for the post-tour sit-down with the appropriate team member
* Listen to understand the needs of the person touring
In some cases you may want to reward a team member who has longevity, excellent performance evaluations and is highly-respected by their colleagues with the opportunity to give tours. This can be a wonderful way to thank your team members, and give them an added level of authority—by recognizing their expert knowledge with regard to Culture Change.
It is important to have three individuals ready to give the tours in case there is a need for more than one tour to take place at a time or in case someone is unavailable in a meeting or otherwise involved in an activity.
The preceding is an excerpt from our manual, "Marketing & Admissions for Person-Centered Care Organizations." The manual is available for purchase on our website, www.caregivereducation.org
One of the first questions to answer is, “Who is responsible for giving tours?” In an organization with a typical, top-down management style, the admissions coordinator and the administrator are usually the two individuals most often expected to give tours. However, in a home that embraces Culture Change, every team member, and often even residents can be expected to provide the same service. Just as we advocate that team members give tours to potential employees, we do the same in the admissions process. After all—who knows the home better than the people who work in it everyday?
Remember, a tour is not the time to be collecting payor or clinical information. That takes place later, behind closed doors in a sit-down with the admissions coordinator, administrator or social worker. The tour is a time for your home to shine—and any member of your team should be educated on how to put the home in its best light.
We recommend that you choose three individuals who are not managers to give basic tours that are available on the day shift. It does not matter what their role in the home is—but they must be capable of the following:
* Possess a clear speaking voice
* Exhibit a friendly and caring attitude
* Demonstrate pride in the home
* Be familiar with the home’s Person-Centered Care assets
* Have some longevity with the home
* Possess current knowledge of recent survey results
* Know the names of all elders and team members in the home
* Keep the tour moving and on-time without appearing to be rushed
* Be able to answer questions easily without becoming flustered
* Know when to redirect certain questions pertaining to clinical and financial matters for the post-tour sit-down with the appropriate team member
* Listen to understand the needs of the person touring
In some cases you may want to reward a team member who has longevity, excellent performance evaluations and is highly-respected by their colleagues with the opportunity to give tours. This can be a wonderful way to thank your team members, and give them an added level of authority—by recognizing their expert knowledge with regard to Culture Change.
It is important to have three individuals ready to give the tours in case there is a need for more than one tour to take place at a time or in case someone is unavailable in a meeting or otherwise involved in an activity.
The preceding is an excerpt from our manual, "Marketing & Admissions for Person-Centered Care Organizations." The manual is available for purchase on our website, www.caregivereducation.org
Wednesday, November 5, 2008
Making a Choice to Enhance Life!
Choosing a Nursing Community for Your Loved One
Nursing communities of the past were often thought of by the public as cold, sterile, and unfriendly places. This is because, in many ways, nursing organizations were operated much like hospitals focused on medical diagnosis and treatment of injury or illness.
Today many nursing homes are embracing a new, social model of care giving that seeks to balance medical care with our social needs as human beings.
When a loved one requires long term care, the placement options available to families are often confusing. Making this choice can be one of the most challenging decisions a family must face. Advocacy groups have done a remarkable job in making sure families can be well informed of the clinical issues surrounding their available choices. However, there are many other aspects to take into consideration when making the long term care placement decision for a loved one.
Today, more and more nursing communities understand that they must place equal focus on enhancing the Quality of Life of each resident in their community in order to provide the most life-affirming experience possible.
While meeting clinical needs might consist of medication assistance, toileting and bathing, Quality of Life needs relate to basic human desires for comfort, emotional well-being, physical, mental and spiritual engagement and the ability to nurture.
One could think of this as a foundational shift in the philosophy of care giving; a shift away from providing solely a safe institutionalized existence to that of promoting a life worth living.
The Institute for Caregiver Education’s mission is to foster the highest Quality of Life for elders and caregivers through cultural transformation and professional development.
Our goal is to assist nursing care providers in enhancing the Quality of Life focus within their communities. We promote growth and change by empowering their teams to create holistic environments that care for the body, the mind, and the soul—for all whom they serve.
Further, we believe that this transformation can be successful only when families are empowered to understand the differences between a medical model and a social model of care and, thus, become advocates for change.
Five guiding principles form the foundation of the Institute’s work to assist communities in this transformation. When implemented together and woven throughout all areas of nursing community care a community can be truly transformed. These principles are: Choice, Community, Relationships, Respect, and Empowerment
We encourage families to look at the physical issues and medical concerns that accompany the need for nursing home placement and beyond—to seek a community that also enhances life and supports individuality. In addition to clinical daily care-related issues, family members should also seek indicators of social transformation that may include:
Indicators Present in the Physical Environment:
· Welcoming front porches and entryways
· Family living rooms, common spaces indoors and out
· Personal furnishings are encouraged
· Nursing stations are open and inviting
· Bathing spas with personalized bathrobes and heating lamps
· Comfortable and supportive furniture
· Resident rooms with a view of greenery of some kind
· Play areas for children
Organizational Indicators of the Social Environment:
· A great first impression
· A tour that includes the admissions director, team members, and residents
· Community calendars with age/gender appropriate opportunities
· Expansive menus, buffet or family-style dining options and open-ended dining times
· Family and friends support groups
· Absence of rigid bathing schedules
Indicators of Empowered Team Involvement:
· Team members happy, satisfied and engaged in their work
· Employees knowledgeable in resident-directed care
· Able to participate in mentoring program
· Genuine engagement with residents
· Availability of educational programs to further team skills and knowledge
Evidence of Resident Involvement:
· Opportunities for residents to participate in menu planning
· Resident self determination regarding preferences for bath, bed, meal and medication times and approaches
· Residents engaged in productive, dignified activities not limited to a posted schedule
· Resident mentoring opportunities offered and encouraged
It is important to have the confidence that you are making the best decision possible on behalf of your loved one. Make that decision easier by determining which community has excellent quality of care and enhances life through a vital nurturing and life affirming community.
Do you need more information about how to choose a community that has embraced Culture Change? Visit our website for additional guidance!
Nursing communities of the past were often thought of by the public as cold, sterile, and unfriendly places. This is because, in many ways, nursing organizations were operated much like hospitals focused on medical diagnosis and treatment of injury or illness.
Today many nursing homes are embracing a new, social model of care giving that seeks to balance medical care with our social needs as human beings.
When a loved one requires long term care, the placement options available to families are often confusing. Making this choice can be one of the most challenging decisions a family must face. Advocacy groups have done a remarkable job in making sure families can be well informed of the clinical issues surrounding their available choices. However, there are many other aspects to take into consideration when making the long term care placement decision for a loved one.Today, more and more nursing communities understand that they must place equal focus on enhancing the Quality of Life of each resident in their community in order to provide the most life-affirming experience possible.
While meeting clinical needs might consist of medication assistance, toileting and bathing, Quality of Life needs relate to basic human desires for comfort, emotional well-being, physical, mental and spiritual engagement and the ability to nurture.
One could think of this as a foundational shift in the philosophy of care giving; a shift away from providing solely a safe institutionalized existence to that of promoting a life worth living.
The Institute for Caregiver Education’s mission is to foster the highest Quality of Life for elders and caregivers through cultural transformation and professional development.Our goal is to assist nursing care providers in enhancing the Quality of Life focus within their communities. We promote growth and change by empowering their teams to create holistic environments that care for the body, the mind, and the soul—for all whom they serve.
Further, we believe that this transformation can be successful only when families are empowered to understand the differences between a medical model and a social model of care and, thus, become advocates for change.
Five guiding principles form the foundation of the Institute’s work to assist communities in this transformation. When implemented together and woven throughout all areas of nursing community care a community can be truly transformed. These principles are: Choice, Community, Relationships, Respect, and Empowerment
We encourage families to look at the physical issues and medical concerns that accompany the need for nursing home placement and beyond—to seek a community that also enhances life and supports individuality. In addition to clinical daily care-related issues, family members should also seek indicators of social transformation that may include:Indicators Present in the Physical Environment:
· Welcoming front porches and entryways
· Family living rooms, common spaces indoors and out
· Personal furnishings are encouraged
· Nursing stations are open and inviting
· Bathing spas with personalized bathrobes and heating lamps
· Comfortable and supportive furniture
· Resident rooms with a view of greenery of some kind
· Play areas for children
Organizational Indicators of the Social Environment:
· A great first impression
· A tour that includes the admissions director, team members, and residents
· Community calendars with age/gender appropriate opportunities
· Expansive menus, buffet or family-style dining options and open-ended dining times
· Family and friends support groups
· Absence of rigid bathing schedules
Indicators of Empowered Team Involvement:· Team members happy, satisfied and engaged in their work
· Employees knowledgeable in resident-directed care
· Able to participate in mentoring program
· Genuine engagement with residents
· Availability of educational programs to further team skills and knowledge
Evidence of Resident Involvement:
· Opportunities for residents to participate in menu planning
· Resident self determination regarding preferences for bath, bed, meal and medication times and approaches
· Residents engaged in productive, dignified activities not limited to a posted schedule
· Resident mentoring opportunities offered and encouraged
It is important to have the confidence that you are making the best decision possible on behalf of your loved one. Make that decision easier by determining which community has excellent quality of care and enhances life through a vital nurturing and life affirming community.Do you need more information about how to choose a community that has embraced Culture Change? Visit our website for additional guidance!
Friday, October 10, 2008
Pitfalls to Culture Change
Our team is often asked what some of the biggest pitfalls regarding management practices can be when transitioning to a social model of care. Overall, most challenges occur when management takes a dictatorial role and not a guiding role.
Here are some of the biggest pitfalls that we see again and again:
1. FAILURE TO SUPPORT YOUR TEAMS WILL RESULT IN A LACK OF CARING!
2. Stop and Start will not fly~ team members have “BEEN THERE/DONE THAT”
3. YOU CANNOT expect YOUR Team Members TO FEEL EMPOWERED ONLY WHEN IT IS CONVENIENT FOR YOU.
4. Employees will not remain ZAPPED when they are SAPPED
5. SUPPORT your team’s decisions
6. Turn down a team’s decision and you won’t have to worry about what their next decision will be because there probably won’t be one…
7. Walk the talk…Your team will be watching!
8. “Do as I say, Not as I do” philosophy will result in a home that is filled with resentment and anger
9. Adopt an open door policy and create an organization that is transparent. Secrecy builds walls, community breaks them down.
10. If you aren't the person to Champion Change in your home, that is OK--just step aside and empower someone else to lead the charge.
For more information about how to successfully lead your home through Culture Change, please visit us at www.caregivereducation.org
Here are some of the biggest pitfalls that we see again and again:
1. FAILURE TO SUPPORT YOUR TEAMS WILL RESULT IN A LACK OF CARING!
2. Stop and Start will not fly~ team members have “BEEN THERE/DONE THAT”
3. YOU CANNOT expect YOUR Team Members TO FEEL EMPOWERED ONLY WHEN IT IS CONVENIENT FOR YOU.
4. Employees will not remain ZAPPED when they are SAPPED
5. SUPPORT your team’s decisions
6. Turn down a team’s decision and you won’t have to worry about what their next decision will be because there probably won’t be one…
7. Walk the talk…Your team will be watching!
8. “Do as I say, Not as I do” philosophy will result in a home that is filled with resentment and anger
9. Adopt an open door policy and create an organization that is transparent. Secrecy builds walls, community breaks them down.
10. If you aren't the person to Champion Change in your home, that is OK--just step aside and empower someone else to lead the charge.
For more information about how to successfully lead your home through Culture Change, please visit us at www.caregivereducation.org
Sunday, September 7, 2008
Monday, September 1, 2008
Assisted Living Conference
The Institute for Caregiver Education will be providing an exciting 2 1/2 days of education and networking at the APCA 2008 Fall Conference. This year it will be held at the Ramada Inn in State College, PA. Marketing, Dynamic Living and Dementia, Community Life, and Enhanced Dining will be some of focus for topics. Please visit www.apcaofpa.org for further information.
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