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June to November, 2006
These are comments shared by
nursing home activity professionals who have gone through their
annual survey since the implementation of the new guidance for
F-248. These comments are their impressions of their experience
and are not a formal part of the regulations or investigative
protocols.
If you would like to share comments about your
survey and have them posted here anonymously - you
can send them via e-mail to debbiehommel@comcast.net
*They commented they liked seeing the "small"
group programs and liked the BBQ outside.
*They really liked that residents where engaged
and as they stated "Appearing to really be having fun and enjoying
themselves"
*They did interview my staff, and asked about
resident abuse
*They are looking at care plans for weight
loss, making sure all depts. are working on this together.
*They did not interview the director but did
interview the activity staff in regards to transporting residents
back from activities.
*They were very happy with activity planning
monthly, menu planning monthly and resident council notes reflecting
resident rights.
*For advisories, they were very interested
in seeing proof of intergenerational programming and trips.
*They were really into resident rights and
making sure the residents knew their rights. *They looked to make
sure Ombudsmen phone number was not only posted in lobby but in
recreation room as well.
*They commented that they liked seeing the
CNA and nursing help out at activities and having "Fun" with the
residents.
*The only questions they asked activity staff
was who and where certain residents were. Staff were asked to
name all the residents in the activity rooms.
*They seemed to be really tuned into the very
low functioning.
*They liked the special event, brightly colored
and highly decorated types of programs where we include all different
levels of residents as in our monthly themed luncheons. They were
here for our luncheon and another big themed party which was held
on our lower functioning unit.
*Another big plus is our Resident Council meeting
with them each year. Our residents love all the activities and
special events we create with their input and this really shows
each year in the interview.
*We redid our basis assessment to accommodate
our LTC as well as the sub-acute pts. The asked the staff about
stress related work.
*They were looking for seat belt alarms, checking
residents' closets, checking times residents to be turned by (clock)
rotation while in bed.
*They looked at both act. Calendars, assessment
sheets and care plans and suggested some residents should be using
a sippy cup as they were having a hard time holding a regular
cup during one of our acts.
*They did a lot more looking in the care plans,
nursing notes and recreation quarterly notes.
*Some of our staff stated that the surveyor
looked into activity notes and then went and watched the activities.
*Some staff were asked questions about the
residents' participation.
*The care plans, MDS, documentation - they
are really checking hard to see if all dept. and all info match.
*They are checking meds, especially pain, and
psych.
*Checking all documentation- pain notes, med
charting, behavior- pain assessments
*They are asking the assistants their job duties.
My assistant told them everything she could think of that benefit
the resident, socialization, adaptive supplies, exercise, types
of programs, feeding, gloves, hand washing, special things we
do for some: smokers, room visits, remove seat belt, transport,
and position, so on. The State said I've been watching you- you
know your residents well and show respect and are very good with
them.
*The State asked for documentation on room
visits on one resident. We do documentation in a book just for
our benefit and keep it in our office. The book was not completely
filled in (missing days). The surveyor asked about the person
getting a room visit and the staff told him a lot of information
(showing they knew the resident and were doing room visits) the
surveyor said you just need to document all you do.
*They checked into isolation residents and
room visits on all that don't or can't attend. Looked at care
plans and progress notes for these residents.
*They asked one activity assist. to name the
residents in the room
*They were concerned about the residents that
were in isolation but on the positive side they were not concerned
about the social aspect of the isolation. Guess they could see
we visit often with TV, radio, books, crossword puzzles offered
in room.
*Eye glasses were also big- one resident went
to the hospital and returned with no glasses- - family was bringing
in another pair- that was documented - but family never brought
them in.
*They are looking at falls-incidents. Although
we have done a great job on doing investigations and follow ups
on them-they still felt the issues were not investigated enough
to include behavior and conditions on the shifts before should
have been assessed- those shifts should have filled out report-
behavior- foot wear- how they were walking-sitting.
*Feeding- make sure the staff are sitting facing
the resident- and not talking to anyone else, lap buddy- seat
belt off.
*I did a lot of work organizing and preparing
for each area of programming r/t to the population needs, and
interdisciplinary training. They asked me a lot of questions about
the residents, and monitored the diversional group in our kitchen
area. They liked the home like feeling. I got mix match tea cups
for the kitchen, and serve coffee and tea each morning. I did
make a special calendar for this group so staff will think out
of the box once in awhile, but main feeling is being with friends,
and sharing good times. It's a lot of fun and everyone loves the
residents.
*I did tell them about our sensory group that
runs 7 days a week. They did not monitor that group. Everything
was care planned and documented. They did stop in the groups for
the more independent residents for a brief period.
*One surveyor did tell out administrator that
it's all about activities and the new guidelines were mentioned.
*On this particular day, the activities department
was on an out trip, and the resident was care-planned to have
manipulatives in front of her when not involved in other events.
The nursing department actually wrote that, but with activities
being gone, it was not done. When the activities staff person
frpm another floor came by and saw her without something to do,
she was invited to another program. The surveyor stated the nursing
department needed to implement what they wrote they would do,
and the activities department needed to write more about what
they do as an alternative to the manipulatives.
"looking a little more than usual, but
they are quiet."
"they hardly spoke to me or my staff"
"They said in the exit, they will be looking
more at activities - next year."
*They really scrutinized voting practice. They
wanted to see lists of who was voting, who declined voting and
methods to assist with absentee ballots and actually getting them
out to the polls.
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