Hitting it out of the Park with Clinical Programming
Just as baseball teams need to collaborate with one another to win a game, so must those who provide care for the elderly in our SNF’s. In order for our residents to “win”, they need everyone working together on the same team.
Understanding of the disease components: Slowness of movement, tremors, limb rigidity, short rapid steps when walking, shuffling gait, freezing in place, lack of facial expression, soft-spoken speech, change in ability to swallow, change in cognition, change in vision
Winning team approach: Encourage physical and cognitive activity which promotes balance, endurance, flexibility, strengthening, walking, problem-solving, and both short- and long-term recall. Refer to therapy to assess residents demonstrating challenges in these areas to promote safe participation in activities of the resident’s choice.
Impact of low vision in SNF residents: Difficulty seeing things up close and/or far away. Sensitivity to light, difficulty locating personal items, walking int o furniture, corners of walls and doorways, difficulty reading, participating in leisure activities, and challenges seeing food items on a plate.
Winning team approach: Arrange clothing in closet by color to allow for a contrast in color between similar shades. Select bathroom towel colors that are in contrast to wall colors. Provide both instructions to activities and reading material in large font. Lighting can both help and hinder our vision; minimize glare to increase ease of viewing objects, and avoid dim lighting to increase awareness of surrounding area during mobility. Refer to the physician and therapy to perform visual assessments to identify opportunities for maintaining safety and highest possible levels of independence.
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BIMS AND PHQ-9
Audit to verify the primary DX in I0020B is correct.
This ICD-10 should represent the primary medical condition that resulted in the resident’s admission to the SNF.
- Is the diagnosis documented by the physician in the last 60 days?
- Does the documentation support that it meets the requirement of an active diagnosis in the last 7 days?
Are you and your residents ready for communal activity?
Per CMS, communal activities and dining may begin to occur while following all active COVID-19 restrictions (additional limitations should be considered based on the status of COVID-19 infections currently in the facility)
• Social distancing (6+ feet between residents). Residents may eat in the same room with social distancing (e.g., limited number of people at each table and with at least six feet between each person)
• Use of proper face covering (except while eating) and appropriate hand hygiene
• May be facilitated for residents that meet the following criteria:
- Residents who have fully recovered from COVID-19
- For those not in isolation for observation or with suspected or confirmed COVID-19 status
Tips for safe and successful group activities:
- Ability to perform handwashing before and after the group activity
- Proper PPE and cleaning supplies available (masks, sanitizer, etc.) distancing based on the size of group and space Scheduling considerations to plan for appropriate
- Are residents able to adequately see and hear at the distance they are required to be?
- Identify residents that may be a risk for breaking social distance precautions (impulsive, difficulty following instructions, etc.)
Is your facility prepared to facilitate indoor visitation?
Facilities may begin allowing indoor visitation, EXCEPT for the following due to an ongoing high risk of COVID-19:
- Unvaccinated residents, if the nursing home’s COVID-19 county positivity rate is >10% and <70% of residents in the facility are fully vaccinated
- Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated until they have met the criteria to discontinue Transmission-Based Precautions
- Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine (short-term monitoring or quarantine for other reasons)
** CMS and CDC continue to recommend facilities, residents, and families adhere to the core principles of COVID-19 infection, including physical distancing (maintaining at least 6 feet between people).**
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KEY ENCORE NEWS
Our PDPM Calculator is here and will help assist with:
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Contact your TPM, RVP, or SVP to obtain the link today!
Please email Ryan Jones for additional information: [email protected]