From Paper to Person

1.From Paper to Person
MDS 3.0 Care Planning
Presented by
Debbie Ohl RN, M.Msc., PhD.
Ohl and Associates
Committed to Quality Care & Professional Excellence
613 Compton Road
Cincinnati, Ohio 45231
MDSCarePlanBuilder.com

2. Debbie Ohl RN, M.Msc., PhDOhl and AssociatesLong Term Care [email protected]
Debbies 30 year consulting practice is an outcome of learning lessons the hard way as a nursing director, sometime nurses aide and behind the scenes administrator. Sheis a regulatory compliance and interdisciplinary care planning specialist, authoring more than a dozen manuals including HcPros, Big Book of Care Plans.
As a nationally recognized expert, Debbie has presented for many prestigious organizations including the National Institute for Health , the American College of Nursing Home Administrators, the National Health Care Lawyers Association, and numerous Health Care Organizations, andNursing Facilities throughout the country.
Recently completing her Ph.D in Holistic Life Coaching, Debbie brings a unique perspective on the impact that thoughts, feelings, and actions have on ourselves and those we serve.
Debbie Ohl & AssociatesLTC Consultants & Educators MDSCarePlanBuilder.comThinkTheThoughts.com
3. Tennessees Top Deficiencies
Not in handouts
Given care & services to get or keep the highest quality of life possible.
Develop a complete care plan within 7 days.
Prepare care plan with the care team.
Check and update the care plan.
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.
Give professional services that follow each resident's written care plan.
4. Quality Degree of excellence or worth
LifeA manner or way of existing
AutonomySelf-governance, self-sufficiency
Quality of Life
RAI The path to improvement.
5. Getting to the Care Plan
6. Program Objectives
Identify and discuss 3 to 5 new terms used in conjunction with the MDS 3.0 and how they can be used in care planning.
Discuss the expectations of person centered care planning.
8. Not on handout
"Person-centered planning begins when people decide to listen carefully and in ways that can strengthen the voice of people who have been or are at risk of being silenced.
John O'Brien
A Little Book about Person Centered Planning
Identify the seven components of the care plan and at least one key factor of each as it relates to RAI expectations.
Discuss the three primary content areas to be considered in care planning.
P
C
P
11. Evolution of Care Planning
12. Debbie Ohl & AssociatesLTC Consultants & Educators MDSCarePlanBuilder.comThinkTheThoughts.com
1935

Poor houses

13. SSA established public assistance 14. For profit homes proliferate1950

SSA requires States to license NH

15. SSA does not specify enforcement standards1956
Feds find NH substandard
1965
Medicare/Medicaid programs fundedby Feds
Standards put in place
1970
NH atrocities hit front page of news papers
1972
Comprehensive Welfare Reform Act funds state survey and certification to establish uniform standards and conditions.
Emphasis is on institutional framework: CAPACITY to deliver care.
Mid 70s-early 80s
Patient Care & Services Survey born to correct emphasis on capacity to deliver to ACTUAL delivery of care.
Controversy over legitimacy.
Paper compliance in the form of policies was nearing its end.
1975-76
Use of paper in the form of care plan takes center stage to insure care delivery....
or at least begins the process.
Phase 1
Paper to Person 1976-1987
EVERY resident must have a plan.
EACH discipline must have a plan.
Every diagnosis must be on plan.
All medications must be on the plan.
Total Confusion
Result:Multi-disciplinary
conflict,fragmentation,
confusion,manydeficiencies.

Care plan contentexpectations have increasing demanding. i.e. goal measurability.

Phase II1987
Interdisciplinary Team Building
QUALITY of CARE
OBRA solidifies standards and creates a framework for continuity of care.
Care plan goals, interventions and target dates progressively used to site deficiencies.
Emphasis is on Quality of Care.
Unified care planning efforts begin with name change to IDT.
1995 MDS 2.0 Raises the Bar

Assessment process formalized.

18. Increased expectations in terms of documentationand care delivery. 19. RAPS about paper not process.

Health & Medicine

From Paper to Person