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CMS toughens enforcement of caregiving regulations!

All areas involve CNA caregiving

Many nursing homes will see a lower quality measure rating as a result of these changes,says the CMS, and added that this action will raise the stan- dards that nursing homes need to meet in order to get a high rating.

The Centers for Medicare and Medicaid Services

(CMS) has recently significantly toughened its nursing home quality of care requirements.

And this has resulted in one-third of nursing homes having their ratings lowered by the fed- eral government.

The areas that CMS is going to be tougher on are what they call their “Quality Measures” caregiving areas.

And CNAs need to be aware of these stronger guidelines because they’re directly involved in many of the Quality Measures caregiving areas.

You do not want your nursing home’s ratings lowered because of improper care, as that could be devastating… these ratings are posted on the In- ternet for all to see when evaluating nursing home placement. The ratings are posted on the CMS site called Nursing Home compare.

And, more importantly, you do not want the el- ders under your care to be suffering from these se- rious conditions because of lack of proper care.

The areas that CMS will be looking at more closely, in giving your nursing home its rating include:

The percent of your elders who have had a fall that caused an injury. This means your falls-prevention activities are critical to good resi- dent care, just as they’ve always been. Falling is

one of the most common causes of early death of an elder.

Percent of your elders who have had a uri- nary tract infection. CNAs are often involved with urinary catheter care, and poorly maintained catheter care is a frequent source of infections.

You need to be skilled in these areas, because these infections can be life-threatening to your el- ders.

Percent of your elders who are in pain. Un- discovered pain is one of the most frequent prob- lems found in elders. CNAs are often the ones most involved with their elders, and who are most likely to find out if they are in pain.

Percent of elders with pressure ulcers. Pres- sure ulcers are a frequently reported problem with nursing homes and are an indication of very poor caregiving.

The fact is, they are highly preventable by using just a few easy-to-master caregiving techniques, which often significantly involve CNAs.

Percent of your elders who have lost bowel and bladder control. Early detection of bladder and bowel problems can begin early treatment, and often save the elder from much more serious prob- lems in this area, including permanent loss of con- trol. CNAs need to be observant to find, and report, these problems as soon as possible.

How many of your elders were physically restrained during the year. The CMS says “Re- straints should only be used when they are neces- sary as part of the treatment of a resident’s medi- cal condition. Only a doctor can order a restraint. Restraints should never be used to punish a resi- dent or to make things easier for the staff.”

Percent of your elders who need help with daily activities. The CMS is watching for any in- creases in this percentage over the last year.

For all residents medically able, caregivers need to work with their residents every day in order to prevent decline that will cause them to need in- creasing amounts of help with daily activities. This may include regular exercise and other programs.

Percent of your elders who lose too much weight. The CMS says a loss of 5% or more in body weight per month is too much, and may indi- cate a medical problem, depression, eating difficul- ties, and so on.

How many of your elders have depression.

You do not want to have many of your elders suf- fering from depression, and CNAs can be very im- portant in preventing this condition.

Some of the things proven to help depression in- clude: getting the elder involved in activities, help- ing them socialize more, encouraging daily conver- sation with them, playing their favorite music, and more.

Percent of your elders who have had the

flu and pneumococcal vaccines. CMS wants as many of your residents as possible to get these two shots. CNAs can help encourage them to do so.

Percent of your elders who are getting an antipsychotic medication. The CMS wants nursing homes to only use these meds when need- ed, and the caution against overuse.

This is because research shows that use of these meds can cause an early death.

The agency wants you to use other methods of preventing problem behaviors, which CNAs are of- ten heavily involved with.

These include regular exercise programs, remi- niscence, music, and social activities.

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Nurse Aide/ VIP June 2015

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