Specialist care, per recommendations? If the participant's situation has changed and he/she now has a legal guardian, the SC will request and obtain the guardian documentation. Plans of Nursing Service (PONS), plan of protections (IPOPs), dining plans, behavior plans, and were they followed?
There are several resources to support the planning process and the delivery of exceptional care in the most integrated community settings. Seizure frequency?
Were staff trained? Were there any diagnoses requiring follow up? Was there a PONS for dysphagia/dementia/seizures? A condition of a person, or lack thereof, which, when addressed, enhances the person's quality of life and/or ability to cope with his or her circumstances or environment.
Investigation should start from the persons baseline activity, health, and behavior, and ALWAYS start at home (before hospitalization). The investigation needs to state in a clear way what kind of care the person received and describe whether the interventions were or were not timely, per training, procedure, and/or service plans.
The assessment of capability in relation to each issue as it arises will be made by the person's program planning team.
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Was there a plan for provider follow-up? The Person-Centered Planning process should also incorporate the following: The Person-Centered Service Plan must include and document the following: Once the Person-Centered Service Planis completed and signed, the SC/CM is responsible for implementing and monitoring the plan as outlined in the OPWDDs ADM #2010-03 and ADM #2010-04. Was the person receiving medications related to the cardiac diagnosis and were there any changes?
Could it have been identified/reported earlier? (2) A facility in this class housing nine or more persons shall meet the physical plant, Life Safety Code and environmental requirements for supervised community residences listed in sections 635-7.1, 635-7.2 and 635-7.3 of this Title. OPWDD shall verify that staff and persons residing in the facility are trained and evaluated regarding their performance of said plan. (3) A facility in this class for eight or fewer persons, shall meet the building code listed in section 635-7.1(h)(1)(ii) of this Title or for New York City in section 635-7.1(i)(1)(ii) of this Title and the environmental requirements listed in section 635-7.4(b)(3) of this Title.
Other? Guidance,
NY Department of State-Division of Administrative Rules. Additionally, the service plan should be reviewed when: Habilitation providers are responsible for all requirements as outlined in OPWDDs ADM #2012-01, as well as all requirements and standards outlined in the Administrative Directive Memorandums for the specific service being provided.
habilitation plans, Individualized Plan of Protective Oversight (IPOP), documentation to support rights modifications, nursing plans, etc.) Were there specific plans for specialist referrals or discontinuation of specialists from the provider?
Any predispositions? Providers may disclose PHI to health oversight agencies, (e.g., the government agency which licenses the provider), for legally authorized health oversight activities, such as audits and investigations.
The death investigation is always the responsibility of the agency.
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What are the pertinent agency policies and procedures? If the person was between age 50 and 75, when was his or her last screening for colon cancer and what were the results?
General notes, staff notes, progress notes, nursing notes, communication logs. What was the course of stay and progression of disease? Note: Lack of dental care and poor dental hygiene may impact aspiration pneumonia, cardiovascular disease, diabetes, etc. Plan and Staff Actions?
OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK, CHAPTER XIV.
When was the last blood level done for medication levels?
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The SC/CM must follow up with the person,the circle of support or planning team, and habilitation providers to ensure that the plan is being properly implemented.
Individual Plan of Protective Oversight.
This Plan must also be submitted to the Regional Resource Development Specialist with all Service Plans, and reviewed, at lease every six months by the Service Coordinator. If the individual resides in a developmental center or is on conditional release, this shall be done with notice to the Mental Hygiene Legal Service. A temporary use bed must be a conventional bed in a designated bedroom. If so, what guidelines? What was the diagnosis? Written statements (expected for all death investigations). Did staff report to nursing when a PRN was given?
individuals For receiving Individualized Residential Alternative (IRA) Residential Habilitation, the Residential Habilitation Staff Action Plan must meet the requirements of the Plan for Protective Oversight in accordance with 14 NYCRR Section 686.16.
Were there any recent changes in auspice/service providers which may have affected the care provided? Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? The tool identifies risk factors and the services needed to mitigate them, and assigns specific persons who will be responsible for providing the necessary service and oversight. Did plan address Pica as a choking risk? Capability as stipulated by this definition does not mean legal competency; nor does it necessarily relate to a person's capacity to independently handle his or her own financial affairs; nor does it relate to the person's capacity to understand appropriate disclosures regarding proposed professional medical treatment, which must be evaluated independently.
consistency, support, storage, positioning?
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It clearly enlists the key activities that affect the health and welfare of an individual.
Were staff aware of the risks/ plan? The Centers for Medicare and Medicaid Services (CMS) approved the States Medicaid Plan Amendment to add the Community First Choice Option (CFCO) set of services.
Addressed in the plan: money management, medication management, kitchen safety, back-up staffing for unscheduled staff absences. food-stuffing, talking while eatingor rapid eating? Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). If you are seeking specific legal advice in relation to these regulations, you should contact a licensed attorney in your local community. ADMS, Determination of the nature of the material is that of the agency/facility. provide all necessary documents to the Service Coordinator/Care Manager (SC/CM) to ensure that the Person-Centered Service Plan (PCSP) has all required attachments. (1) In addition to the facilities in the community residence class known as supervised community residences and supportive community residences, there shall be a class of facility known as an individualized residential alternative.
The tool identifies risk factors and the services needed to mitigate them, and assigns specific persons who will be responsible for providing the necessary service and oversight. (ii) Facilities of 1-3 beds where on-site 24-hour per day supervision is provided. Should any information in the PPO change in the interim, the SC is responsible for making updates at that time and acquiring signatures from the participant and any individuals listed as Informal Supports to the participant. about ADM #2015-02 Service Documentation for Community Transition Services, about ADM #2018-06R2 Transition to People First Care Coordination, about ADM #2022-05 Medication Administration Training Curriculum for Direct Support Staff, Office for People With Developmental Disabilities, Title 14 of the New York Codes, Rules andRegulations (NYCRR), 1915(c) Childrens Waiver and 1115 Waiver Amendments, Management of Communicable Respiratory Diseases. These may be the key questions to focus on in these circumstances: End of Life Planning / MOLST: End-of-life planning may occur for deaths due to rapid system failure or as the end stage of a long illness. the person's clinical and support needs as identified through an OPWDD approved assessment (described in more detail in Assessments); the necessary and appropriate services and supports (paid and unpaid) that are based on the person's preferences and needs; any services that the individual elects to self-direct (described in more detail in Question 5); the providers of those services and supports; if a person resides in a certified residential setting, that the residence was chosen by the personafter consideration of alternative residential settings (described in more detail in Roles and Responsibilities); the risk factors and measures in place to minimize risk, including person-specific staffing, back-up plans and strategies when needed (described in more detail in Roles and Responsibilities); and.
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WO Did the team identify these behaviors as high risk and plan accordingly?
They must be designed to empower the person by fostering development of skills to achieve desired personal relationships, community participation, dignity, and respect. Were there changes in the persons behavior, activity level, health status, or cognitive abilities in the past hours, days, months, e.g.
A copy of the PPO must be provided to the participant by the SC to be maintained in an easily accessible location of the participant's choice within his/her home.
What occurrence brought the person to the hospital? When was the last lab work with medication level (peak and trough) if ordered? On the agencys part?
Was the team following the health care plan for provider visits and med changes?
Was the device being used at the time of the fall?
The PPO must be redone by the SC with the participant each time an RSP is developed for submission with the RSP packet to the RRDS for review. 3 0 obj
Sudden changes: If the change was reported to you as sudden or within 24-hours of an ER or hospital admission, review notes a few days back and consider interviews regarding staff observations during that time. Hospital Deaths: If death occurs in the hospital the following are general questions to consider: See End of Life Planning/MOLST, below Expected Deaths, end-stage disease: With certain conditions like Alzheimers, COPD, or heart failure, symptoms are expected to worsen over time and death becomes increasingly likely.
Were staff trained on relevant signs/symptoms? A copy of this guardian documentation is forwarded to the RRDS. Were the orders followed? Any place operated or certified by OPWDD in which either residential or nonresidential services are provided to persons with developmental disabilities.
Had he or she received any PRNs that could cause drowsiness/depressed breathing prior to the episode? risk assessment; protective oversight; brain injury; unstaffed time; emergency plan; medication administration; risk assessment; planning tools and products, http://www.advancingstates.org/node/50465. Billing, HCBS, Was the plan clear? (4) service coordination, including assessment, service planning and coordination, linkage and referral, follow-up and monitoring.
Any history of aspiration?
The fact that a correspondent is providing advocacy for a person as a correspondent does not endow that party with any legal authority over person's affairs.
U.S. Environmental Protection Agency . The plan shall include provisions for ensuring: (i) The assessment of each person's need for the amount and type of supervision necessary including both staff and/or technology as appropriate to the person and circumstance. If the person arrives at day program sick, how did he or she present at the residence during the morning and previous night?
Determine the necessary medical criteria.
Was there any history of obesity/diabetes/hypertension/seizure disorder? Was it up-to-date?
OPWDD issues Administrative Directive Memoranda (ADMs) and Informational Letters to provide guidance or informationto assist regulated parties in complying with applicable statutes, rules or other legal requirements, but doesnot include documents that concern only the internal management of OPWDD. Did the plan address refusal of food, vomiting, and/or distended abdomen?
Direct Support, How frequent were the person's vital signs taken? endstream
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(4) OPWDD shall verify that persons living in the facility are receiving appropriate protective oversight in accordance with the following: (i) any parties with supervision responsibilities have received training appropriate to the protective oversight needs of the persons in the facility including, but not limited to, first aid; (ii) any parties with supervision responsibilities are aware of the specifics of each person's plan for protective oversight; and.
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Were plans and staff directions clear on how to manage such situations? Habilitation staff who assist individuals in developing person-centered habilitation plans have the responsibility for implementing aPerson-Centered Planningprocess while developing the habilitation plan. Did it occur per practitioners recommendation? xU]k@|?T?
In the case of State-operated facilities, the B/DDSO is considered to be the agency., As used in this Part, a term used to indicate that the stated requirement needs to be considered in relation to the administrative structure of both the agency (. It is an individualized approach to service planning, structured to focus on the unique values, strengths, preferences, capacities, interests, desired outcomes, and needs of the person. Developing strategies to address conflicts or disagreements in the planning process, including a clear conflict of interest guidelines for people, and communicating such strategies to the person.
Was the agency RN involved in communications?
This plan for Protective Oversight must be readily accessible to all staff and natural supports. Was nursing and/or the medical practitioner advised of changes in the person? Once this happens, multiple organs may quickly fail and the patient can die.
The SC, participant, and all individuals listed as Informal Supports to the participant must sign the PPO. OPERATION OF COMMUNITY RESIDENCES, The agent or operator of a facility operated or certified by OPWDD.
This website is intended solely for the purpose of electronically providing the public with convenient access to data resources. 0
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