The latest RAI Manual changes have been published by CMS. Updated sections include changes that affect G0110 and G0120 ADL Self-Performance and Support, H0200 Toileting Program, K0710 Percent Intake by Artificial Route, and section O Therapy Services.
There are a number of changes to coding instructions that affect assessments for Significant Change in Status, OMRA, Discharge, and Significant Correction.
There are some changes to instructions for coding CAA completion dates.
All LTCS Books publications will be updated in January 2014 to reflect these changes.
Posted by LTCS on September 2, 2013
How to Write a Care PlanThe LTCS Books site now features a number of very useful resources for nurses and long term care professionals.
The new page State Long Term Care and CNA Regulations has links to each state’s Medicaid program, long term care administrative codes, department of health, and certified nursing assistant training and certification regulations. All of LTCS long term care and home health books are up to date with the latest federal regulations, surveyor guidelines, MDS 3.0, and OASIS-C changes. Now you can download the latest regulatory changes for your state.
Online nursing inservices with narration and graphics make learning a pleasure, and are available at a bargain price.
Books are now available as downloads through Google EBooks.
Look inside each book and view its contents on the Amazon author page for LTCS Books author Debra Collins, RN, RAC-CT.
The new Guide to Online RN to BSN Degrees is a complete guide to every online RN program in the U.S. For each state, online programs are listed and described for every university, giving the exact cost per credit hour and with a link directly to the university’s online RN to BSN or RN to MSN program.
Writing Nursing Care Plan Goals
Posted by LTCS on July 9, 2013
The nursing care plan goal can be to prevent a potential problem from occurring, to maintain a present status or level of functional ability, or to resolve a currently existing problem. Goals are usually stated in terms of an action the resident will perform. Elements to focus on in writing the goal are that it is:
Appropriate – for the resident’s needs, strengths, abilities, and cultural background
Realistic – reasonably attainable
Measurable – able to be objectively observed and evaluated
Resident centered – stated in terms of the resident’s actions
Time framed – gives a target date or time estimate for attainment of the goal
Individualized – to the resident’s unique deficits, traits, and preferences
Specific – each problem has a goal specific to it, although each problem may have more than one goal
Resident will wash face and hands during morning care every day.
Resident will verbalize understanding of the need to comply with diabetic diet.
Resident will lose one pound per week over the next thirty days.
Read more about how to write nursing care plans in the book Complete Nursing Care Plans for Long Term Care - 143 nursing care plans in the book and on the CD can be made resident specific and converted to I-care plans in one click.
Posted by LTCS on June 26, 2013 Edit This
The problem statement sums up assessment information into a specific functional category. No federal regulation specifies the exact wording or structure of the problem statement, but the MDS 3.0 RAI Users Manual states that problems should be written in functional or behavioral terms.
Problem statements are traditionally based on a nursing diagnosis. The nursing diagnosis is a problem that nurses can identify and treat. Medical diagnoses can be part of the problem statement, but not the actual problem itself. The most commonly used nursing diagnoses are the ones approved by NANDA, the North American Nursing Diagnosis Association, and are grouped by functional health patterns.
Elements often included are:
Whether the problem is actual or potential
What the problem is related to, such as medical diagnosis
Objective signs and symptoms of the problem, such as physical assessments and observations
Subjective data, such as the resident’s complaints and nonverbal messages
The first part of the problem statement describes the resident’s actual or potential functional deficit:
Medical diagnoses can be added to the statement with the words “related to”:
Activity Intolerance related to COPD
Objective and subjective data can be specified in the form of the words “as evidenced by”:
Activity Intolerance related to COPD
As evidenced by:
Shortness of breath
Resident verbalizes fatigue when walking in corridor
Federal regulations are specific that the facility is responsible for addressing all needs and strengths of residents regardless of whether the issue is included in the MDS or Care Area Assessments (CAAs).
A sound practice for care-planning is to follow a check-list of problem identification:
Address all problems triggered in the CAAs.
Review MDS sections and entries.
Review the resident’s entire chart.
Review the resident’s list of medical diagnoses and all medications.
Focus on the resident’s particular and individual strengths, needs, and preferences. These may become clearer during the care plan meeting, working with the care plan team.
Review the Quality Indicators and Quality Measures triggered by the MDS.
Read all quarterly assessments such as falls, restraints, etc.
The problem should be dated and initialed when entered, changed, or deleted.
Complete Nursing Care Plans for Long Term Care - 143 Nursing Care Plans for Long Term Care in the book and on the CD
Posted by LTCS on September 2, 2013
Long Term Care Nursing PolicyLPN to BSN Online writes, “Nurses in all specialties will find something useful on Google Plus, and the pages listed in this category cover a wide swath of subject matter suited for just about anyone who wears scrubs to work.”
LTCS Books author Debra Collins, RN, RAC-CT is one of the 99 listed.
“One online venue where many nurses and nursing organizations have started connecting with each other is Google Plus,” writes LPN to BSN Online.
“Many hospitals, clinics, and individual nurses use their Google Plus accounts to share news tidbits and discuss the pressing matters that affect the explosively growing field of nursing.
These Google Plus accounts represent individuals and groups from across the nursing spectrum. This list isn’t a ranking, but a repository of great accounts and communities that any nurse who uses Google Plus should follow. Whether you’re a beginning nursing student or experienced pro, you can make friends and even find your next career opportunity through Google Plus.”
Posted by LTCS on July 6, 2013
Weeding through Internet information overload can be difficult when it’s very specific information you want. LTCS Books’ new Guide to Online RN Programs makes this way easier.
For each state online programs are listed and described for every university, giving the exact cost per credit hour and with a link directly to the university’s online RN to BSN or RN to MSN program.
At a glance, find out exactly which universities are offering online RN degrees in your state and exactly what the cost of tuition is. Some programs charge as little as $270 per credit hour, others can run as high as $800 per credit hour. What a difference that can make to a budget!
Having the direct links to the programs enables you to examine the strengths and weaknesses of each program in your state.
Guide to Online RN Programs
- LTCS BooksCEO, President
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