The Advocate - February 2018

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February 2018


Note from the State Long-Term Care Ombudsman


This month's guest article is submitted by Julie Pollock, Local Long-Term Care Ombudsman for southwest Iowa:


The new Federal Rules promote person-centered care, which means nursing facilities are required to focus on residents and support them in making their own choices and having control over their daily lives. This concept seems relatively simple to understand, but implementation can be challenging for facilities.

 

In order to comply, staff will need to formulate new systems and ways to ensure that individual residents' needs and preferences are met. Residents should never have any form of reprisal directed at them for exercising their rights, and when a resident has designated someone to assist him/her with decision-making, facility staff should ensure the representative does not exert authority outside of his/her authority. Staff will need to

ensure that residents' preferences are honored, even when those preferences do

not align with what the resident representative wants. 


Additionally, the care planning process reflects a more person-centered approach and each resident may choose individuals he/she wants included in the process and meetings. The interdisciplinary team may include, but is not limited to: the attending physician; a registered nurse with responsibility for the resident; a nurse aide with responsibility for the resident; a member of food and nutrition services staff; and other appropriate staff or professionals in disciplines as determined by the resident’s needs or as requested by the resident. If the resident (and/or resident representative) does not participate in the care planning process because their participation is determined

not practicable for the development of the resident’s care plan, an explanation must be included in the resident’s medical record.


Additional rights related to the care plan include:

  1. The right to be informed, in advance, of changes to the plan of care.
  2. The right to participate in establishing the expected goals and outcomes of care; the type, amount, frequency and duration of care; and any other factors related to the effectiveness of the plan of care.
  3. The right to receive the services and/or items included in the plan of care.
  4. The right to see the care plan, including the right to sign after significant changes to the plan of care.
  5. The facility shall inform the resident of the right to participate in his/her treatment and shall support the resident in this right.
  6. The assessment must include an assessment of the resident’s strengths and needs.
  7. The right to be informed, in advance, of the care to be furnished and the type of caregiver or professional who will furnish care.
  8. The right to be informed in advance, by the physician or other practitioner or professional, of the risks and benefits of proposed care, of treatment and treatment alternatives or treatment options, and to choose the alternative or option he/she prefers.

As always, the Office of the State Long-Term Care Ombudsman (OSLTCO) is available to speak with residents regarding their wishes/preferences and how to best communicate these to staff.


News & Resources

Resident_Tenant Health Safety Welfare
  • Due to the frigid temperatures in January, the OSLTCO received more than the usual amount of calls regarding cold temperatures in nursing facilities. While many facilities already had a plan in place to ensure residents remained warm during these times, this issue prompted our office to review the regulation about space heaters (IAC 481-58.35(5)) and reach out to the Department of Inspections and Appeals and the State Fire Marshal. Guidance was provided that "portable space heaters (in resident areas) are typically only allowed "in the event of a true emergency (such as the failure of the primary heating in the building). In these cases, the Fire Marshal should be contacted. If the use of space heaters is approved, the facility would need to continuously monitor the area where the space heaters are located to ensure there are no combustibles nearby. In essence, it would be a continuous fire watch in the space heater locations. A log of who was present should be kept on site for inspection purposes.”

Involuntary Discharge
  • Many facilities have been sending monthly non-involuntary discharge logs to Cynthia Pederson at our office. Please note that these non-involuntary discharge logs should now be sent to Katie Mulford at Katie.Mulford@iowa.gov.

Managed Care Ombudsman Program

Volunteer Ombudsman Program
  • The website has been updated to include notes from November and January's Statewide Conference Calls. The next conference call will be at 2 p.m. on March 21, 2018, and participation on the call counts for continuing education credit. To connect, dial 1-877-369-0926 (toll-free) and enter meeting ID #832-811-448: https://www.iowaaging.gov/vop-resources  
  • To maintain VOP certification, volunteers in their second year or more of service need 6.0 hours of continuing education units (CEUs) per calendar year. Continuing education may include, but is not limited to: (1) scheduled telephone conference calls with representatives from the OSLTCO; (2) Governor’s Conference on Aging; (3) area Alzheimer’s disease conferences; (4) elder abuse conferences; (5) courses related to aging conducted by a local community college or university, or via the Internet; (6) other events as approved in advance by the OSLTCO. Volunteer Ombudsmen are responsible for reporting continuing education hours to the OSLTCO or designee within 30 days following the completion of the continuing education event. If a Volunteer Ombudsman attends a scheduled telephone conference call with the Office, this will automatically be added to the database.  If completing another form of continuing education, a completed Continuing Education form must be submitted to volunteervop@iowa.gov.

Events & Educational Opportunities

 

Webinar: "Suspicious Activity Reports and Their Role in Identifying and Remedying Elder Financial Exploitation" 
Wednesday, Feb. 7 (1-2:15 p.m. CT)

More Information | Register


Webinar: "Legal Basics: Debt Collection Protections for Older Consumers"
Tuesday, Feb. 13 (1 p.m. CT)
More Information | Register

 

Webinar: "Supplemental Security Income Basics"
Thursday, Feb. 22 (1 p.m. CT)
More Information | Register