Points to ponder

Government Relations
Debbie R. Bera, ADC, Government Relations

I have received several comments from members addressing how much they enjoyed the first Points to Ponder article on the subject of minimum staffing hours. This time the subject of Points to Ponder is the Universal Worker. Since there is a lack of a formal definition of what a Universal Worker is, let’s first attempt to define the term Universal Worker so we can all be on the same page. This is what I could find on the subject: The term refers to people with many skills who can be depended on to complete a variety of tasks in their work day and is used when a person is cross-trained in many departments, and therefore has a little more assignment flexibility. They are often used in call centers (Would this seem to be a good place for this type of worker?) and hospitals to alleviate staff shortages. (Does this seem to be a good reason for this type of worker in and of itself?) It means moving toward a more “holistic” approach to care in which the “Universal Worker” attends to all the living needs of residents: assistance with ADLs, meal service, light housekeeping, laundry, programming, etc. So let’s ponder what having Universal Workers may or may not do for the Activity Profession and those we serve.

CMS Letter Clarifies Use of Produce from Nursing Home Gardens.

On Sept. 7, the Centers for Medicare and Medicaid Services (CMS) released a survey and certification letter that clarifies federal law regarding nursing homes with produce gardens and use of the foods harvested on the menu for the resident population.

The letter advises that nursing homes with gardens will be compliant with the food procurement requirements at 42 CFR 483.71(i) Sanitary Conditions (F371) as long as the facility has and adheres to policies and procedures for maintaining their gardens.

Highlights of the CMS Letter on Produce Gardens:

CMS and FDA “have received inquiries from nursing homes and state survey agencies asking if federal law permits nursing homes to have produce gardens and use the foods harvested on the menu for any portion of the resident population.”

CMS states, “Residents can benefit from having a variety of fresh foods for their consumption, as long as the dangers of food-borne illness are mitigated to the greatest extent possible through the facility.”

Nursing homes with gardens will be compliant with the food procurement requirements at 42 CFR 483.71(i) Sanitary Conditions (F371) “…as long as the facility has and follows policies and procedures for maintaining the gardens.”
Surveyors are instructed to request the policy and procedures if there is an outbreak of food-borne illness and the facility’s primary food services source has been ruled out as the cause of the outbreak.

Facilities must also adhere to any state or local requirements related to food grown on their grounds for resident consumption.

 Tools That Are Advancing Dementia Care in Senior Living
Geralyn Magan Published On: Sep 21, 2011

·Researchers around the country are making strides in helping assisted living and continuing care retirement communities (CCRC) support residents with memory impairments. There are 2 new tools are helping to improve memory in healthy retirement community residents and to measure quality of life among assisted living residents with dementia.

The Mather LifeWays Institute on Aging, a LeadingAge member in Evanston, IL, developed and is testing a tool that allows professional caregivers to assess quality of life among assisted living residents or clients with dementia. To use the scale, the staff member observes the resident during an activity, completes a short survey about that person’s level of engagement in or emotional reaction to that activity, and then gives the person a quality-of-life score.

Mather LifeWays has been working with Benten Technologies to improve the usability of the “Observing Quality of Life in Dementia” scale by linking it to a mobile data entry system that uses an iPod Touch carried by a staff member to record quality-of-life data. That data is transmitted wirelessly to a laptop or desktop computer where it can be incorporated into reports that enhance dementia care practice and the well-being of participants.

In another study, researchers from the University of California Los Angeles (UCLA) found that a brain fitness program offered in senior living communities represented a cost-effective way to address some of the memory-related concerns of healthy older adults.

The study involved 115 older adults living in 2 Maryland CCRCs. Participants had memory complaints but had not been diagnosed with dementia and were not taking any medications for memory loss. Half of the participants were placed on a waiting list for the program and served as the control group. The other half attended 12, 1-hour sessions that were designed to help them understand how memory works and learn basic memory tools. Trainers also discussed the role of a healthy lifestyle in protecting and maintaining memory.

Researchers found marked improvement in verbal memory among older adults attending the classes, as well as improvements in how those adults perceived their memory.

RAI User Manual Updated

CMS released version 1.07 of the RAI User’s Manual (August 31, 2011). The updates included in this

version of the manual will become effective as of October 1, 2011.

Click here to access the CMS MDS 3.0 Training Materials webpage for further information.

Life Safety Code Proposals Approved

Pioneer Network is pleased to announce that all of the proposals that its National Life Safety Task Force: A Rothschild Regulatory Task Force submitted to the National Fire Protection Association (NFPA) have been approved and will be incorporated into the 2012 edition of NFPA 101® Life Safety Code®. The new edition of the Code can be ordered from NFPA. The description of the publication on the NFPA website (www.nfpa.org ) includes that there are: “Revisions in health care occupancy rules to foster a more comfortable, home-like environment.” This is due to the work of the Task Force which was made possible by support from the Hulda B. and Maurice L. Rothschild Foundation. The four proposals cover the following areas that will help to “create home in the nursing home.”

• Kitchens serving no more than 30 residents will be permitted to be open to the corridor and other spaces, and either residential or commercial stoves or cooktops may be used provided certain criteria are met.

• Furniture may be provided in corridors so that residents can sit and rest and then continue to their destination provided certain criteria are met.

• Combustible decorations will be permitted in resident rooms, corridors, on doors, and in common space. There are limitations on the percentage of coverage depending on whether the building is sprinklered and where located.

• Gas or electric fireplaces will be allowed to be used in smoke compartments that contain sleeping rooms, but not within individual sleeping rooms, with some restrictions. Some of the restrictions are that the controls must be locked and a sealed glass front must be provided to prevent anyone from throwing object into the flames.

The importance of these new provisions in the Life Safety Code cannot be overstated. Benefits to people living in nursing homes include an increased feeling that they are really “at home” due to having kitchens that resemble and function like those they had in their own homes; an increased ability to navigate the long corridors of a traditional nursing home without using a wheelchair; the ability for a resident to have more decorations on the wall and door of her or his bedroom in order to further personalize the room and maintain connections with family and community.

Next steps include advocating for the adoption of the 2012 edition of the Life Safety Code by the Centers for Medicare and Medicaid Services (CMS) and subsequent adoption by states across the country.