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- 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
ConsultantsDebbie@MDSCarePlanBuilder.com
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
Debbie Ohl & AssociatesLTC Consultants & Educators
MDSCarePlanBuilder.comThinkTheThoughts.com
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.
Debbie Ohl & AssociatesLTC Consultants & Educators
MDSCarePlanBuilder.comThinkTheThoughts.com
7. Program Objectives
Discuss the expectations of person centered care planning.
Debbie Ohl & AssociatesLTC Consultants & Educators
MDSCarePlanBuilder.comThinkTheThoughts.com
8. Not on handout
Debbie Ohl & AssociatesLTC Consultants & Educators
MDSCarePlanBuilder.comThinkTheThoughts.com
"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
9. Program Objectives
Identify the seven components of the care plan and at least one key
factor of each as it relates to RAI expectations.
Debbie Ohl & AssociatesLTC Consultants & Educators
MDSCarePlanBuilder.comThinkTheThoughts.com
10. Program Objectives
Discuss the three primary content areas to be considered in care
planning.
P
C
P
Debbie Ohl & AssociatesLTC Consultants & Educators
MDSCarePlanBuilder.comThinkTheThoughts.com
11. Evolution of Care Planning
Debbie Ohl & AssociatesLTC Consultants & Educators
MDSCarePlanBuilder.comThinkTheThoughts.com
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.
16. Debbie Ohl & AssociatesLTC Consultants & Educators
MDSCarePlanBuilder.comThinkTheThoughts.com
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.
17. Debbie Ohl & AssociatesLTC Consultants & Educators
MDSCarePlanBuilder.comThinkTheThoughts.com
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.
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