Archive for: Preparation
Responding to an elopement
It is absolutely critical that your facility has a plan in place for responding to an elopement. If you see a resident who you know should not leave trying to exit the building, stop the resident by distracting him or her with something of interest. Offer a diversion activity or a snack to get attention. If that doesn’t work and the resident refuses to cooperate, get help from other staff if possible. Whether or not you have help, do not leave the resident for any reason. A confused person can wander out into the street or fall into a ditch in seconds. Continue redirecting the resident into the building. Should you suddenly discover that a resident is missing, the following steps should be taken:
- Conduct a thorough and organized search of the building immediately and rapidly. Each employee should have specific search instructions and all nooks (i.e. showers, closets, under beds) should be checked.
- Do a thorough search of the grounds. If there is enough help, two people should go outside immediately and walk around the building with each going in the opposite direction.
- If the resident is not found, call the administrator right away and explain in detail what happened. Follow his or her instructions. The administrator will likely contact the resident’s family, but you may need to contact 911 to notify police and emergency responders.
- If the police take over the search, be prepared to provide important information about the resident (name, gender, physical description, time discovered missing, mental and physical condition, contact information for any known friends and relatives).
Trainer’s tip: Stay calm and don’t forget about the other residents
When dealing with an elopement, it is critical that staff stay calm so as not to alarm the other residents. Never leave them unattended for more than a few second. When the missing resident is found make sure you:
- Do not scold the resident or show anxiety as the individual is likely confused and frightened
- Reassure the resident
- Get the resident back into a regular routine as soon as possible
- Contact everyone whom you informed of the elopement, letting them know the resident has been located
- Assign a nurse to assess the resident as soon as possible
- Document the elopement properly and get whoever found the resident to fill out an incident report
This is an excerpt from HCPro’s book, The CNA Training Solution, Second Edition.
CMS releases final MDS 3.0
The Centers for Medicare & Medicaid Services (CMS) released the much anticipated final MDS 3.0 on October 29, giving long-term care providers approximately one year to prepare for implementation of this new assessment tool.
In addition to the various item subsets for each MDS 3.0 assessment and tracking document, CMS released the following files:
- MDS 3.0 Item Matrix (V1.00) – This document identifies the items required for each type of assessment along with how the item is used
- MDS 3.0 RAI Manual – The publishing of the RAI manual has been delayed. It is anticipated that chapters 1, 2, 3, 5, and 6 will be published in November. Chapter 4 (Care Area Assessments (CAAs)) & Appendix C (CAA resources) will be posted in December. When published the manual will include: Description and instructions for types of assessments and tracking documents, each MDS 3.0 item, the Care Area Assessment, submission and correction of MDS 3.0 records, SNF and Swing Bed Prospective Payment System (PPS) policy for the MDS 3.0, and the RUG-IV classification system.
The zip file labeled “Data Technical Files V1.00 October 2009″ on the CMS Web site contains all of the following MDS 3.0 technical specification information:
- MDS 3.0 Data Submission Specifications (V1.00) – Detailed data submission specifications for MDS 3.0.
- RUG-IV SAS Package (V.100) – Thoroughly tested SAS code for RUG-IV classification with documentation and test data.
- RUG-III MDS 3.0 Mapping Specifications (V1.00) – This document presents logic that can be used to produce RUG-III classifications using assessment items contained on MDS 3.0.
- MDS 3.0 CATs Specifications (V1.00) – For each Care Area, this document provides Care Area Trigger (CAT) specifications for the MDS 3.0 items used in triggering the Care Area, the conditions for triggering, and Visual Basic code for triggering. The CATs are replacing the MDS 2.0 Resident Assessment Protocols RAPs.
Stay tuned for additional analysis.
To view the final MDS 3.0, visit our Resources page.
For additional files, visit the CMS Web site.
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