RESIDENT RIGHTS Continuation

Catherine Denlinger, MSW, LSW
Director of Social Services
The GRAND of Dublin

RESIDENT RIGHTS

This SSS (Social Services Series) will be the continuation and completion of Ohio & Federal Nursing Home Residents’ Bill of Rights. During our last series we looked at the first five resident rights. We will resume summarizing the resident rights continuing with number twenty-five.

25. Residents have the right to be informed in writing of the basic rate charged by the center, services available and any additional charges related to such services. The basic rate of the center shall not be changed unless a 30 day notice is provided to the resident and/or the resident’s responsible party.

26. Residents have the right to receive their bill on a monthly basis for any charges not included in the basic rate.

27. Residents have the right to be free from financial exploitation. Residents have the right to manage their own financial affairs and/or the right to quarterly accounting statements if the center is delegated this responsibility. Residents have the right to review a complete record of their funds, transactions, bills, etc.

28. Residents have the right to access their valuables/property that are on deposit at the center at reasonable hours.

29. Residents have the right to receive notice prior to a room change and/or having a roommate as well as an explanation to the fact. The Grand has all private rooms.

30. Residents have the right not to be discharged or transferred from the center unless for the following reasons: for the safety of other residents in the center, the health of residents in center would be endangered, the resident’s health has improved and he/she no longer meets the criteria for services provided in the center, and/or the welfare/needs of the resident cannot be met in the home. Other reasons may be that the resident has failed to pay for the services provided in the home, the center’s license has been revoked and/or the home is being closed, the resident receives Medicaid and the center is terminating the Medicaid program w/in the center, the resident receives Medicare and the center is terminating the Medicare program w/in the center.

31. Residents have the right to voice grievances and recommend changes to the center’s employees, to The Department of Health, or to any other person not associated with the center (Ombudsman, Legal Rights, family, friends, etc.). Residents are able to do this per their choice, free from restraint, interference, coercion, discrimination or reprisal.

32. Residents have the right to be informed of any significant change in their health status as well as their responsible party/emergency contact. The center shall make every reasonable effort to notify the resident and/or their responsible party/emergency contact as soon as the significant change is noted.

PPIs: Something To Think About

Andrea M. Hartley CPhT
Pharmacy Technician / Central Supply Manager
The GRAND of Dublin

PPIs: Something To Think About

Do you have one of these PPIs in your medicine cabinet?

  • Prilosec (omeprazole), available as an OTC and prescription
  • Nexium (esomeprazole), available as an OTC and prescription
  • Prevacid (lansoprazole), available as an OTC and prescription
  • Zegerid (omeprazole & sodium bicarbonate), OTC only
  • Protonix (pantoprazole), prescription only
  • Aciphex (rabeprazole), prescription only
  • Dexilant (dexlansoprazole), prescription only

20-30% of Americans use a PPI (proton Pump Inhibitor) to manage symptoms of GERD (gastroesophageal reflux disease), acid reflux, frequent heartburn and ulcer symptoms, and several other indications.  These medications have been a mainstay in treatment of stomach acid-related disorders since their introduction in 1989.  In layman’s terms, they work by binding to the proton pumps in the cells of our gastric glands and causing them to reduce acid secretion.

Their safety and efficacy have made PPIs one of the most prescribed medications.  The first PPI was approved for over-the-counter sales in 2003, allowing the convenience of self-treatment.  However, the approval for OTC sales has also contributed to the overuse & misuse of PPIs.

Many people who don’t necessarily need PPIs are using them and this can lead to problems due to a higher risk of bone fracture and higher risk of obtaining certain bacterial infections, among other things.

If you use a PPI, consider talking to your doctor about it at your next appointment. Some of the questions that patients need to ask their physicians are:  Should I be taking this?  Would a lower dose be effective? Is there an alternative to this medication?  Do the risks outweigh the benefits in my situation? Find out if another medication, such as an antacid (Tums, Mylanta, Maalox etc.) or H2 blocker (Tagamet, Pepcid, Zantac, Axid) might be better for you to use.  Or there may be some lifestyle changes you could try to reduce your symptoms.

If you use a PPI, it’s definitely something to think about.

Resident Rights – Ohio & Federal Nursing Home Residents’ Bill of Rights.

Catherine Denlinger, MSW, LSW
Director of Social Services
The GRAND of Dublin

Resident Rights

This SSS (Social Services Series) will be a continuation of Ohio & Federal Nursing Home Residents’ Bill of Rights. During our last series we looked at the first five resident rights.  We will resume summarizing the resident rights continuing with number six.

  1. Residents have the right to request and obtain the name and any specialty of any physician and/or any other person that is responsible for his/her care or coordination of care in the center.
  2. Residents have the right to request/assign/select an attending physician that is not on the staff of the nursing center if they so wish (in accordance with the rules and written policies/procedures of the nursing center).
  3. Residents have the right to partake in the decisions that affect his/her life including but not limited to communication with the physician and/or staff of the nursing center regarding their care/treatment planning, medical condition, prognosis, etc. Residents further have the right to access their medical record as well as to give and/or withhold informed consent for treatment after the consequences of that choice is explained.
  4. Residents have the right to withhold payment for physician visits if the physician did not actually visit the resident.
  5. Residents have the right to confidentiality of their medical records. Residents have the right to refuse the release of their records to anyone outside the nursing center, except in cases of a transfer to another center, hospital or health care system.
  6. Residents have the right to privacy, especially during medical examination and/or care/treatment of their person.
  7. Residents have the right to refuse care/treatment.
  8. Residents have the right to be free from physical/chemical restraints or prolonged isolation. Physical or chemical restraints or isolation may be used in an emergency situation without authorization of the attending physician only to protect the resident from injury to self or others.
  9. Residents have the right to utilize the pharmacy of their choosing.
  10. Residents have the right to exercise all civil rights.

To review these rights in more detail please visit: Lawriter – ORC – 3721.13 Residents’ rights. codes.ohio.gov/orc/3721.13 and/or https://www.ohca.org/nursing_home_residents_bill_of_rights

Resident Rights in a Nursing Center

Social Services Series

Catherine Denlinger, DOSS, MSW, LSW
Director of Social Services
The GRAND of Dublin

Resident Rights in a Nursing Center

resident rightsIn 1987, the Federal Government enacted the Nursing Home Reform Act.  This law mandates that residents living in a long term care facility have the same basic rights of those residing in the community.  This law states that nursing centers “must provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care”.  This law stresses the importance of a resident’s dignity, comfort and self-determination.  There are currently 32 resident rights.  These rights can be found on numerous sites on the Web.   In this SSS (Social Services Series) we will be listing all of these rights.  At this time, we look at the first 5 resident rights.

  1. Residents have the right to a safe and clean living environment.
  2. Residents have the right to be free from physical, verbal, mental and emotional abuse and to be treated at all time with courtesy, respect and full recognition of dignity and individuality.
  3. Residents have the right to adequate and appropriate medical treatment, nursing care and to ancillary services.
  4. Residents have the right to have all reasonable requests and inquiries responded to promptly.
  5. Residents have the right to have their clothes and bed sheets changed as the need arises.

Here at The Grand of Dublin, our staff strives to provide the best possible quality of care to each and every resident.  We treat our residents with respect and promote their independence as well as focus on their comfort needs.  Our center provides a home-like environment so that residents can focus on their medical improvement.  We treat each resident in a holistic manner and provide the necessary services for their physical, mental and psychosocial well-being.

The list of resident rights that we will be listing over the next several SSS can be found at the following site:

www.http//codes.ohio.gov/orc/3721.13

When and How to Wash Your Hands

by Frank Mackovine
Dietary Director
The GRAND of Dublin

When and How to Wash Your Hands

WHEN?

  • Before, during, and after preparing food
  • Before eating food
  • Before and after caring for someone who is sick
  • Before and after treating a cut or wound
  • After using the toilet
  • After changing diapers or cleaning up a child who has used the toilet
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal feed, or animal waste
  • After handling pet food or pet treats
  • After touching garbage

wash hands, handwashing

HOW?

  • Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your
  • hands, between your fingers, and under your nails.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse hands well under clean, running water.
  • Dry hands using a clean towel or air dry them.

With not much effort you can keep you and your loved ones safe from illness and yes, even those that you don’t like!

What You Need to Know about Skilled Nursing

by Jada Palm
Hospital Liaison
Danielle Batdorff, BSHA/HIS
Director of Admissions
The GRAND of Dublin

What is skilled nursing?

Skilled nursing is a type of intermediate care in which the patient or resident needs more assistance than usual. This setting is designated for physical, occupational, and speech therapies, to aide in strengthening the patient who has a goal of returning to their home at baseline. Skilled nursing services are offered to patients who need IV medications administered, who may have wound care needs, or who may need teaching on medication management. (Newly diagnosed diabetics, for example)

What is the difference between short-term care and long-term care?

Short term care is a temporary solution that may last from a few days to a few months. Long term care is typically utilized for in-house placement for the duration of the patient’s life.

What social activities are offered?

Skilled nursing facilities offer a full calendar of social events and activities. Residents are encouraged to join in as many activities and social events as they like. Some examples include; art classes, bingo and cards, game and movie night, quest performers and church services.

In addition, they offer wellness programs, exercise classes, beauty salons, small dining areas, café and restaurant style dining rooms, and outdoor sitting and walking areas.

Here at The GRAND, we offer weekly ice cream socials, wine and cheese nights, and happy hour to our social calendar.

What should I bring with me?

It is recommended that you bring comfortable clothing for working out in therapy along with good fitting shoes. Personal hygiene items (all labeled with your name), photo ID, insurance cards, advanced directive paperwork (Power of Attorney and Living Will paperwork). You may bring snacks to keep in your personal mini fridge.

What are the rooms like?

Some facilities offer both single and double occupancy rooms. Each facility has its own characteristics which make it unique and sets it apart from the other down the street. An example; The GRAND offers single occupancy rooms with walk-in showers, individual heating/cooling units, refrigerators, Wi-Fi and cable. Patient’s medications are locked securely in each patient room and we strive to provide a home like atmosphere.

What does Medicare cover?

Medicare part A covers skilled nursing care under certain conditions for a limited time.

  • You must have a qualifying hospital stay. This means you meet the minimum 3 night inpatient hospitalization requirement.
  • You have part A and days left in your benefit period.
  • Your doctor has ordered skilled services due to a medical condition which requires the need for 24/7 nursing care and therapy services offered 5 to 6 days a week.

Medicare covered services include;

  • A semi-private room
  • Meals
  • Skilled nursing care
  • Physical and Occupational Therapy
  • Speech-Language Pathology Services
  • Medical Social Services
  • Medical supplies and equipment used in the facility
  • Ambulance transportation (when other transportation endangers ones health) to the nearest supplier of needed services that aren’t available at the SNF
  • Dietary Counseling

Medicare part A will pay as follows;

  • Days 1-20 – pays at 100% with no patient responsibility
    • (Remains $0 co-insurance for 2018)
  • Days 21-100 – patient responsibility of $164.50 per day co-insurance
    • (2018 co-insurance will be $167.50)

Additional information can be obtained through Medicare.gov

How do I find out what my insurance will cover?

Insurance benefits and eligibility will be checked prior to admission to the building, but you may also call the member services number on your card and a customer service representative will provide you with details of your coverage options.

What is the next step and what can I expect once I select a facility?

Once you have selected a facility you will notify your hospital social worker and he/she will send the referral to the building for review. You may choose to tour the building. Your clinical is then reviewed by the admissions and nursing team to make sure we can clinically manage your stay, and then the hospital liaison will visit you in the hospital to answer any questions you may have. If you need an authorization from your insurance to admit, our corporate case manager will start that process.

What are your staffing ratios?

In our skilled setting, our ration is 1:12 or 1:13, with an STNA on each hall. Our staffing ratios are significantly below average.

How often is therapy provided and will I have a schedule?

Therapy is provided at the discretion of your ordering physician, the therapy team, and your needs. You can ask for a specific schedule if that works better for you. Our therapy team will meet with you upon admission and plan your schedule based on the recommended physicians order.

What sets your facility apart from the others?

The GRAND offers several amenities that set us apart from competitors. From the Digger and Finch pub, our ice cream parlor, movie theater, beauty salon, pharmacy, chapel, licensed in-house therapy team and team of dedicated nurses and STNA’s and low patient/staff ratios.  We offer outstanding services to our residents.

What are your visitation hours and/or restrictions?

Each facility will have set hours of operation. The most common hours of operation most facilities follow are 8am to 8pm, 7 days per week. The GRAND’s hours are 8:30am to 8pm, Monday through Friday and 9am to 8pm, Saturday and Sunday. There may or may not be restrictions on when visitors can be with their loved one. The GRAND does not have such restrictions and provides security 7 nights per week.

NeuroGym Sit-to-Stand Trainer

NeuroGym Sit-to-Stand Trainer

by Jeanne Seliskar, MA, CCC/SLP
Director of Rehabilitation

The GRAND of Dublin

With The GRAND’s focus on the best outcomes and discharge plans for our patients, the NeuroGym Sit-to-Stand Trainer has become an integral part of many of our therapy sessions at The GRAND.  With the action of coming to a fully upright standing posture being a significant  factor in returning  home, it is essential that this part of a patient’s mobility be prioritized and addressed effectively to achieve a functional level.

NeuroGymThe NeuroGym Sit-Stand Trainer uses a counter-weight mechanism to provide a safe and effective way to strengthen weight-bearing muscles and increase standing stability and endurance.  Unlike other tools that passively lift people to, or maintain them in, a standing position, the Sit-to-Stand Trainer enables an individual to actively initiate the motion of standing up, even with weakened or seemingly unsuccessful efforts.  Through continued training and gradually reducing the counter-weight, a patient can relearn the skill for standing up.  Equipped with a weight-stack and a locking pulley system, the counter-weight can be easily applied to the Sit-to-Stand Trainer.  Because it is mounted on wheels, early steps can be attempted in all directions.

NeuroGymThe Key Benefits of this equipment are:  1) early weight bearing and active mobilization at the hips and knees; 2) improvement of standing balance and stability; 3) Significant improvement of transfers; 4) improvement of patient rehabilitation with reduced physical strain to the therapist.

The GRAND is using this equipment routinely in many case to progress patients who would otherwise not ever leave the wheelchair to stand and walk leading to a significantly improved quality of life.

Polypharmacy In Older Adults

By Andrea Hartley, CPhT
Pharmacy Technician and Central Supply Manager
The GRAND of Dublin

Polypharmacy In Older Adults

polypharmacyPolypharmacy is defined as the use of more medications than are medically necessary or the use of too many medications. This is a growing concern for older adults: nearly 50% of the population age 65 and older takes one or more medications that are not medically necessary.  Not medically necessary means a medication is not needed, not effective or that it is a duplicate of another medication.

You may be at risk if you take 5 or more medications at home or 9 or more medications in a nursing home setting.  At home, medications for high blood pressure and high cholesterol are some of the most over-prescribed drugs.  In a nursing home setting, laxatives, diuretics and medications for heartburn or GERD were the most over-prescribed.

Polypharmacy can result in negative consequences such as adverse drug events, drug interactions and medication non-adherence.  Taking too many medications also causes healthcare costs to rise for companies and consumers.  Serious health issues can also come from this problem, like functional decline, cognitive impairment, and increased risk for falls and incontinence.

At The Grand, a consultant pharmacist looks over every resident’s drug regimen monthly and makes recommendations to the physician on unnecessary drugs.

Preventing Polypharmacy

To prevent polypharmacy in the home setting make sure you or your loved one uses only one pharmacy whenever possible.  Stick with one primary care doctor as well.  If a specialist visit is necessary be sure to have a list of all the drugs you or your loved one takes in hand for the appointment.  Be sure to include over the counter medications or supplements on the list.

If you believe you may take too many medications, most pharmacies and primary care doctors will look over your medications and counsel you on some you may not need.  Use the resources you have to prevent you or your loved one from becoming a victim of polypharmacy.

 

How Does A Social Worker Help Me In A Skilled Rehab Nursing Center?

How Does A Social Worker Help Me In A Skilled Rehab Nursing Center?

by Catherine Denlinger, MSW, LSW
Director of Social Services
The GRAND of Dublin

Social WorkerSocial workers are a part of the interdisciplinary team that will assist you from the admission process to your discharge from a center. The team consists of Nursing, Activities, Dietary, Therapy and Social Services.  Our emphasis is on advocating, empowerment and making sure that your psychosocial needs are met.  We will assist you with advocating your wants/needs.  We want to make sure that your stay is as comfortable as possible.   We will empower you to increase your independence.  We want you to ensure your resident rights are respected and that your dignity is maintained.  We will assist with referrals needed to assure your psychosocial well-being.  We can assist with arranging counseling services, psychiatric services, spiritual services and so forth.  A social worker will assist you with making safe discharge plans for home.   This may be returning home to live alone, with family, at a Senior Living Center in Assisted Living, Independent Living or Long Term Care.  We will assist you with making sure that you have your medication, follow up appointments, home medical equipment and home health care services or outpatient therapy services arranged.

Here, at The Grand of Dublin, you will be met by a social worker shortly after your arrival.  We will welcome you to the center, provide you with our business card, explain our role and assist with any concerns/issues and/or questions that you may have.  We will further discuss preliminary discharge planning and schedule a care conference with you and your loved one(s) for a few days after you arrive.  At the care conference, along with the interdisciplinary team, we will discuss goals, length of stay, discharge planning in more detail and address any issues/concerns that you or your loved one(s) may have.  During your stay, we are here to ensure that your psychosocial needs are met in a timely manner.  We are available to you if you need us for anything!  Toward the end of your stay with us, we (along with some members of the interdisciplinary team) will meet with you to discuss and finalize your needs for a safe discharge.  We will order your home medical equipment if needed, discuss follow-up appointments and set up home health care services and/or outpatient therapy services for you.  We can make referrals to social service agencies.  We will also meet with you to review your medication needs along with our Pharmacy Technician.  Our social services department looks forward to meeting you and assisting you through your recovery process.

Volunteer Life

By Sara Katula
Activities Director
The GRAND of Dublin

Volunteer Life at The Grand of Dublin

A volunteer is a vital part of the senior living community and have many advantages not only for the residents but for the volunteers themselves. Volunteering your time, talent, and skills can provide meaningful activities and programs for residents.

Volunteer JoeAt the Grand of Dublin, our volunteer coordinator sets up volunteers with activities and tasks that are beneficial to the volunteer and resident. The residents receive extra one on one attention as volunteers visit with them and do different activities. Volunteers can help with a wide array of activities including bingo, ice cream socials, crafts, meals, and musical performances. Religious services are very important to the majority of our residents. Columbus Vineyard Church volunteers their time and provides a non-denominational service once a month; St. Peter’s Catholic Church comes in monthly for Mass and Communion, and a Worship Praise Group that comes in monthly to perform on Main Street so all residents, staff, and visitors can either join a long or just listen. One of our dedicated volunteers, Joe Hudak who comes in at least once a week helps serve at our ice cream social every Wednesday and performs gospel Hymns in the chapel on Thursdays.

We have a variety of different volunteer programs offered including our Dublin Power plus program and our junior volunteer program. Our junior volunteer program consists of volunteers from Dublin and Olentangy City schools, and Bishop Watterson Catholic Schools. Our goal is to help encourage these junior volunteers to make this a long term commitment after their school program is completed.

Last year, The Grand of Dublin had over 1,000 events or activities ran by volunteers. Most of our residents develop relationships with these volunteers and look forward to their visits. Volunteering at senior living communities helps improve the life of residents, add to job experiences, and build friendships. If you are interested in volunteering at The Grand of Dublin please contact Tarah Boyer at tboyer@grandofdublin.com.

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