Sign South Dakota Permission Slip Computer

Document type sign permission slip south dakota computer

hi I'm Donna Fisher the state long-term care Ombudsman and we're going to talk a little bit today about the unbutton program and resident rights specifically resident rights in the assisted living [Music] the purpose of the long-term care Ombudsman program is to protect and improve the quality of care and quality of life for residents of long term care facilities through advocacy for and on behalf of the residents so what exactly does a local Ombudsman do with six local Ombudsman stationed throughout the state who visit facilities on a continual basis the goal for nursing home visits is monthly assisted living visits our goal is bimonthly we also visit registered residential facilities and adult foster care however we have to be invited into those centers in order to enter we just you know nursing homes and assisted livings we are able to enter those by state statute we have the authority to do that however we do not have the authority to just enter registered residential or adult foster center we have to have an invitation into those centers we follow up on complaints determine if the events are likely to have happened work in a person centered advocacy role to resolve those complaints everything we do is confidential and we're not able to share that outside of the Ombudsman program unless we have received express permission from the resident themselves or if the resident is unable to communicate the approval to share that information we would go by the best thought that we would have that you know whether that person would want that information followed up on or shared on or not we protect the residents health safety welfare and rights we identify gaps in facility government or community services and we work to try and fix those gaps we do a lot of information and referrals we send referrals to the long-term services and support specialists and other agencies as appropriate and as we're able we can provide information about and help finding a long term care along with all of the things that you see on your screen and I apologize I don't really read what's on your screen very often okay so really important is this intake flowchart the reason that this is pretty important is the Ombudsman program and the Ombudsman representatives are not mandatory reporters in fact by federal regulation we are mandated not to be mandatory reporters and so if a few soar neglect report would come in to the Ombudsman program the only way we can share that outside of our program is if we are given express permission by the resident themselves and so it's really important that we follow the flowchart and LTSs long-term services and supports intake ApS or law enforcement Department of Health someone else gets that report of abuse or neglect prior to the Ombudsman program because like I said once the Ombudsman program gets that report we can only do our internal information-seeking in and resolution with that we are not able to share that outside of the ombudsman program at all and so that's just really really important for you to know about that's just a really good flowchart to have maybe at your on your computer desk or you know really handy so that you can ask those questions with each caller LTSs can make a referral to the long-term care Ombudsman program and can share information with be Ombudsman however the Ombudsman cannot always share information back with LTSs there are a couple of different ways that you can make a referral to the long-term care Ombudsman program you can make a referral by completing the electronic referral form which is a fillable form that you can type right into and you'll see it there on your screen you can also complete this form it's just a written form but you can just write on an email to the long-term care Ombudsman program or kind of what I think most of your counterparts have found being the easiest way is to actually just print the call or the journal itself and send that over to the LTC OSDs dus in order to print that you can see on your screen you would go to that print button and click the arrow there and you would print it to select that Adobe PDF then you would save that to your computer and then attach that into an email to the LTC old email address and so that seems to be maybe the best way that your counterparts have discovered to email that to us however you know whatever works best for you out of those three referral processes please feel free to use please email it to LT co at state SD us you can always CC the local Ombudsman on that as well but they all have to come into state office for tracking purposes and right there you'll see currently we have six regions multi County regions that are covered by the six Ombudsman once in a while we have a situation where there may be a conflict of interest at a facility and that may require the Ombudsman program to do some shuffling of facilities for a short time so sometimes you know this chart might not be 100% accurate however you would still just go by this chart in making those referrals and we will internally do some of that shuffling so that's nothing anyone else needs to really worry about okay so we're gonna talk a little bit about resident rights specifically a resident rights in the assisted-living chapter 44 7009 is the resident rates in assisted living facilities or centers here in south dakota there are additional rights afforded to residents and nursing homes which I will not maybe go into in depth during this presentation mostly you will be working with individuals that are in an assisted living center and therefore these were you know rights are the ones that you'll maybe need to be most familiar with in your position there are also some additional rights imposed under the HCBS final rule I may touch on some of them in this presentation but encourage you to read the South Dakota home and community-based services statewide transition plan an expectation guide the state statute just ensures that when you leave your home you take your rights as a United States citizen with you to your new home the center must treat every individual that resides there with respect and dignity and care for them in a manner in an environment that promotes maintains or enhances their quality of life there must be equal access to care regardless of diagnosis condition or payment source the center must ensure that a resident can exercise his or her rights without fear of retaliation without coercion discrimination or reprisal it's pretty difficult at times for staff members to not want to you know coerce or interfere or try and convince a resident to make this you know good decisions for themselves an individual retains rights to exercise all their rights not delegated to a representative just because someone may have a power of attorney doesn't mean that they all of their rights are transferred to that power of attorney so sometimes when there's a power of attorney or a guardian there's some maybe confusion or other expectations that may be there if you ever have questions about that please feel free to talk to an ombudsman or myself just because someone might have a power of attorney doesn't mean that the power of attorney is invoked you know I might have a power of attorney today that doesn't mean that I can't make my own decisions typically those are in place once a person becomes incapacitated however there are so many different powers of attorneys out there that it's really important not to just assume that they're in effect when they may not be if a resident does have the resident representative or power of attorney they the facility must honor the decisions made by that power of attorney or resident representative or guardian and individuals wishes and preferences must be taken into consideration an individual that has appointed a power of attorney the power of attorney should be acting in accordance with what that individual would want or would have wanted not within their own placing their own bias and their own thoughts on the situation they have the right to be informed of changes in their care plan they have the right to receive services that are included in their care plan they have a right to see their care plan they have the right to participate in their care plan meetings they have a right to invite people to their care plan meetings that may not receive an invitation they have the right to be informed in advance of the care that will be furnished they have the right to be informed of how much the services are going to cost they were right to be informed of whether the service will be paid for under Medicaid or if it will be an additional charge they have the right to know in advance if their physician or anyone else has been contacted individuals have a right to choose their physician or their own mental health practitioners or or pharmacist there are some caveats to that I mean the the doctor has to be Medicare Medicare Medicare or Medicaid certified to enter the facility the pharmacist has some additional requirements as well as the mental health providers and so as long as the folks that their residents choose meet all the requirements then they are able to have those individuals provide services to them and this next slide kind of talks a little bit about the physician needing to be licensed in acceptor so the slide just talks again a little bit more about that choosing of the position so just familiarize yourself with that as well every individual deserves to be treated with respect and dignity you know sometimes that's pretty difficult when a resident is maybe challenging or having a challenging behavior to have your response be one of dignity respect and freedom but you know a facility staff member should always have a response that is in dignity respect and freedom to the individual cultural ethnical and religious differences need to be appreciated and recognized always you know call the individual by the name that they would prefer if you're not sure what the individual would like to be called please you know ask them what their preference is on their name so that you're aware and you're respecting their wishes and honoring what they would like to be called residents have the right to make poor choices just like you and I if an individual is choosing to leave the facility and partake in alcohol or smoking or no drives or whatever the case may be I'm just making those poor decisions we all have the opportunity to make poor decisions just because we're in an assisted living center or nursing home or any other center or facility doesn't mean that we no longer have the capacity to make those poor decisions we do we have the right to listen to the doctor or not drink soda if we want to smoke a cigarette you know anything that is legal or illegal if we choose to do so but we also have to face the percussions of our choices and what the individuals at the facility needs to do is inform the residents of those you know possible side effects of making the poor decisions make sure that you're always knocking on an individual's door before walking in make sure that you always respect their privacy and don't just walk into their room without announcing yourself individuals have the right to talk to anyone inside or outside of the center they have the right to talk to their LTSs worker they have the right to talk to them buds men the federal on buds men federal and state surveyors they have the right to join or talk to any church or clergy that they desire they must be allowed to utilize a telephone in private to resist the temptation that to make decisions based solely on what you think is best for the individual make sure that you're encouraging choice to the individual and really listening to what their wishes are and incorporating that into your work individuals have the right to plan their day to take part in various activities in the center or in the community there's a really good video it's called the thin edge of dignity it really gives a really good perspective from the residents viewpoint and that really is just great but they do have the right to plan their daily activities when they want to wake up when they want to go to bed when they'd like to eat this can be challenging for the facilities or the center's but they really must adhere to and recognize each individual's right to do so each assisted living must provide a bed a bedside stand in a chair to residents this is in the Department of Health Regulations that those things are supplied they must keep on hand two times the license capacity of linens so if the facility is licensed for ten they need to keep 20 sets of linens and so that's what's really important information for you to know the facility or the center must provide linens equipment and supplies for personal care and for other eighty elves for measurement with the needs of the residents served so they need to take into consideration each individual that they serve and what their needs are each individual resident has the right to medical care and treatment they have the right to choose their physician they have the right to be told in a language they understand about what their cares are what's in their care plan again they have the right to participate in their care plan meetings they have the right to refuse treatment just because the individual lives in a facility or a center does not take away their right to refuse treatment the facility must inform the resident consult the residents physician or notify the residents legal representative if there was an accident in Korea resulting in injury or a potential for necessary physician intervention if there's a significant change in the residents physical mental or psychosocial status the need to alter treatment significantly or a decision to transfer or discharge the resident from the center again residents have the right to choose a personal physician residents have the right to request copies and the facility may not charge more than a community standard rate for those copies if the resident does refuse treatment they must be fully informed of any alternative treatments and the expected outcome when refusing treatments individuals must be fully informed of their health statuses and be free again from interference coercion discrimination or reprisal individuals in assisted living centers can give themselves certain medications under certain conditions so if their doctor and the assessments at the assisted living determine they are able to give themselves medications then they could do so confidentiality it's really important that all patient charts and records are kept in a safe place that individuals are not talked about in the community or in a place where others can overhear individuals have the right to have their pain recognized and addressed individuals have the right to work they have the right to perform work in the facility or in the center or in the community or not they have the right to receive a wage if they desire to work if the individual wants to perform services on behalf of the facility or the center the resident may perform those services if the plan of care includes documentation of the need or the desire to work the nature of the service performed is specific and compensation for paid services is at or above standard rate the resident also must agree to the work arrangement there are centers in the state where individuals you know take care of a lawn they take care of flowers they take care of facility pets there's this one Center that has like a small farm in the backyard and one of the residents kind of feeds all the animals and they you know clean up the stalls and all of that and so if there's just some kind of arrangement with between the folks at the facility and the residents residing there then everything should be good to go individuals have the right to their own clothing and possessions everyone has the right to their personal possessions as long as space allows and so sometimes you can get into a situation where an individual that's living in a center wants to have maybe boxes and stacks of items there is fire and health safety codes that the center has to comply with and so anything that would put put that at jeopardy or at risk would be over and above the allowed perso al possession requirement all of these rights that I've talked about so far and we'll talk about you know each individual in the center has these rights however if they start infringing upon someone else's rights by exercising their rights then the rights of all kind of Trump the rights of one and so that can be kind of um a sticky wicket sometimes and so you may need to request them Ombudsman assistance um to weed through some of those things freedom from abuse and restraint restraints medication must never be used to impose discipline or for the convenience of staff restraints are not allowed at all in an assisted living center if they are believe you are to notify the Department of Health facilities must our centers must safeguard against resident abuse of any type sexual verbal physical mental involuntary seclusion exploitation by anyone and theft of personal property visiting policies must permit and encourage visits by family and friends centers must permit residents to send and receive unopened mail to have access to stationary postage and writing implements at the residents expense access and use of a telephone without being overheard and visit or share a room with the spouse if they both agree have their door closed and require people to knock before entering they have the right to have their door locked if they have been deemed safe to have a lock and would like to do so talk privately with family and friends and other individuals again they have the right to be with them belong to any church that they want they have the right to utilize the Internet in private sometimes we run into situations where individuals are using you know a center or facility computer often times these are maybe more out in a public area their rights to look at legal adult things such as pornography would possibly infringe upon the rights of others not to view pornography and so there's kind of a fine line in that however if their individual is in their room and they want to look at legal pornography or whatever it is they want to look at they should be allowed to do so even if it is off of the server of the facility or center financial affairs centers are not allowed to require residents to deposit their personal funds within the center but if a resident chooses to do so and gives off written authorization the center must hold the funds in accordance with South Dakota codified laws they have the right to be told if there title to Medicare Medicaid and how to apply for those services admission transferring discharged individuals must be provided information regarding their options and responsibilities while living at the center so yes while we you know advocate for resident rights the resident has to also abide by some of the regulations no matter where a person lives there's always rules that you have to go by whether it be an apartment or a dormitory or a center or a facility you know you you have certain rules that you have to abide by and usually in the admissions agreement you're signing that you're gonna agree to these rules and so they need to do so information must be present presented to the resident before they are admitted so that's where the admission policy comes in a description of the policy which includes the length of time the bed will be held for the resident any any policies regarding the bed hold and readmission rates should be given to the resident signed and dated admissions agreements must be completed upon the resident writing at the center the admissions agreement again should state all policies of the center and expectations of the resident and it should also state what the center will provide the center must notify the resident and family members or client advocates in writing at least 30 days before the transfer discharge the notice must specify specific reasons for discharge the effective date of the transfer and the location of which the resident will be transferred or discharged to must also include conditions under which the resident may request or refuse transfer within the center and a description on how to appeal those decisions individuals have the right to voice their grievances and complaints and must not be retaliated against if they exercise those rights the complaint can be anything really anything regarding abuse neglect misappropriation of the residents property and more the center must adopt a grievance process and have the process available to the residents residents and family and the public have the right to examine the most recent survey results and any plans of Corrections that are in effect like I see it before there are some additional resident rights for nursing home residents but we didn't kind of get into that and then there are just a few additional requirements under the HCBS final rule an individual you know must be able to lock their doors they must have access to the greater community some of those kind of things and I encourage you to take a look at the HCBS guide to expectations and transition plan all right if you have any questions ever about the ombudsman program or resident rights feel free to contact myself or one of the local ombudsman thanks and welcome to LTSs