Was there a plan for provider follow-up? Were staff trained on the PONS? Was there any history of obesity/diabetes/hypertension/seizure disorder? <> Did plan address Pica as a choking risk? OPWDDs regulations are included inTitle 14 of the New York Codes, Rules andRegulations (NYCRR). If so, was it followed and documented? Was it up-to-date? OPWDD DDRO Manual for the Children's Waiver, DD/MF and DD in Foster Care - August 2019 updated May 2021 (PDF) OPWDD Collaborative Eligibility Process for the Children's Waiver, DD/MF and DD in Foster Care - PDF | Recording (YouTube) - May 2021 Initiating and Maintaining OPWDD ICF/IID LCED Policy #CW0010 - Updated May 2021 (PDF) Was staff training provided on aspiration and signs and symptoms? What were the symptoms which sent the person to the hospital? The PPO must be signed and dated by the applicant and SC and all individuals listed as Informal Supports to the waiver applicant. Use these questions, as appropriate. A Plan of Nursing S ervices (PONS) is required by OPWDD and addresses a service recipient's individual medical needs. hbbd``b`@q?`]bX=l $@C @dJ0~ n8)f\.Feq2o` 1101H.)@ It is an individualized approach to service planning, structured to focus on the unique values, strengths, preferences, capacities, interests, desired outcomes, and needs of the person. If so, what guidelines? Was the PONS followed? Future hospitalizations? Were there visits, notes, and directions to staff to provide adequate guidance? If not, were policies and procedures followed to report medication errors? endobj endstream endobj 200 0 obj <> endobj 201 0 obj <> endobj 202 0 obj <>stream OPWDD's regulations are included in Title 14 of the New York Codes, Rules and Regulations (NYCRR). Was this reported? Aspiration Pneumonia (People who are elderly are at a higher risk)? Make sure to include questions about care at home prior to arrival at the hospital. Phone: 202-309-7504 . 167 0 obj <>stream Did the plan address refusal of food, vomiting, and/or distended abdomen? OPWDD issues Administrative Directive Memoranda (ADMs) and Informational Letters to provide guidance or informationto assist regulated parties in complying with applicable statutes, rules or other legal requirements, but doesnot include documents that concern only the internal management of OPWDD. Dysphagia, dementia, seizures can happen with neurological diagnosis. Did the person have any history of behaviors that may have affected staffs ability to identify symptoms of illness (individual reporting illness/shallow breathing for attention seeking purposes, etc.)? 5 0 obj The Oversight Plan is the EPA OIG's guide for audits, evaluations, and other . (5) Each facility in this class shall ensure the provision of, or provide as its minimum responsibility, protective oversight (see glossary) appropriate to the person's needs. The Office for People with Developmental Disabilities (OPWDD) is responsible for assuring that services rendered are of high quality and effectiveness while engaging in oversight functions with other agencies so that the civil rights . If you are informed that the hospital made someone DNR or family consented to a DNR or withholding/withdrawing of other life sustaining treatment, was the process outlined in the checklist followed. Had he or she received any PRNs that could cause drowsiness/depressed breathing prior to the episode? (iii) The establishment of qualifications and training requirements of those responsible for supervision. Was there an emergency protocol for infrequent or status epilepsy? 665 0 obj <> endobj If monitoring urine output report what amount, or qualities? endstream endobj 169 0 obj <>stream Was the preventative health care current and adequate? The B/DDSO is responsible for coordinating the service delivery system within a particular service area, planning with community and provider agencies, and ensuring that specific placement and program plans and provider training programs are implemented. Did staff report to nursing when a PRN was given? Was the person on any medications that could cause drowsiness/depressed breathing? (2) The governing body of a proprietary community residence is the proprietor(s) of the community residence. Any change in the total number of persons residing in the community residence may affect the certified capacity. The SC, participant, and all individuals listed as Informal Supports to the participant must sign the PPO. consistency, support, storage, positioning? Was it realistic given other staff duties? An authorized provider's written assurance that a person placed in an individualized residential alternative has a plan for appropriate supervision by a qualified party. Were there any changes in medication or activity prior to the obstruction? Who reviewed the bowel records (MD, RN)? Was there evidence of MD or RN oversight of implementation? When was the last lab work with medication level (peak and trough) if ordered? endobj Title: Nursing Home Tansition and Diversion Medicaid Waiver Manual - Plan for . When was the last GYN consult? Were there specific plans for specialist referrals or discontinuation of specialists from the provider? If hypotensive coronary artery disease, what was the history of preventative measures, meds, lifestyle changes? Were plans and staff directions clear on how to manage such situations? Was the person receiving any medications related to this diagnosis? Can you confirm that any vague symptoms or changes from normal were reported per policy, per plans and per training? INSPECTOR GENERAL . Thus, an individual may be capable of participation in planning for his/her services and programs but still require assistance in the management of financial matters. Were staff trained? are received by service providers. (iv) The establishment of a process whereby the person's continuing need for the originally recommended amount and type of protective oversight can be periodically reviewed, and modified as necessary. A final copy of the PPO is distributed by the SC to the participant to maintain in an easily accessible location of the participant's choice within his/her home. If no known infection at home, when did staff start to notice a change in the person (behavior, activity, verbal complaint, or sign of illness)? endstream Were there any issues involving other individuals that may have led to staff distraction? `d8W`\!(@Q )#q(f`d`aZ(hTq9+LgjW.JmtgCx AX vn@` 6G93 Confirm the person's lack of capacity to make health care decisions. Were there previous episodes of choking? What is the policy for training? Antibiotics? OPWDD shall verify the accuracy of the information in each person's individualized services plan relative to fire evacuation performance. P3T{$0\C-yA8|}xE OX habilitation plans, Individualized Plan of Protective Oversight (IPOP), documentation to support rights modifications, nursing plans, etc.) (4) An individualized residential alternative shall meet the requirements of this Part as set forth in sections 686.1, 686.2, 686.3, 686.4, 686.5, 686.9, 686.15(a)(1)-(3) (as appropriate) and 686.16 of this Part. (w) OPWDD. For purposes of this Part, this shall include children or adults who have applied to or have been screened for services and for whom a clinical record is maintained or possessed by such a facility. Was it communicated? Were the medications given as ordered? Were staff aware of the risks/ plan? Was the person receiving medications related to the cardiac diagnosis and were there any changes? h240W0P04P0TtvvJ,NMQ04;. Plan and Staff Actions? Were vital signs taken after the fall (this may determine hypotension)? Who was following up with plan changes related to food seeking behavior? What PONS were in effect and were staff trained? What was the bowel management regimen e.g. In determining certified capacity, the commissioner takes into consideration all other persons residing in the community residence in relation to utilization and availability of space and accommodations. Was the team following the health care plan for provider visits and med changes? Were the actions in line with training? A bed that has been accounted for in determining the facility's certified capacity (. Hospital coverage and pharmacy review, and other data located in the Heath Care Needs section of the Plan of Protected Oversight not inserted into other regions of Therap, will be included in the comments section. Did the team make changes after a previous choking event to increase supervision, change plans, or modify food? If there are incidents or concerns that arise which are directly 20 6WiyH9XBAOwSQpyv4(v[l|rt~/[ <3t>MW_KG7;b7AVTW'`YW z The PPO must be reviewed by the SC with the participant at each Addendum. The ISP is equivalent to a clinical record for the purposes of confidentiality and access. Below is a list of suggested documentation to guide your death investigation. Is it known whether the person lost consciousness prior to the fall? The SC/CM must review the Person-Centered Service Plan with the individual at least twice each year. Any means, including but not limited to observation, interview, and the written word, that provides a basis for being reasonably assured that a requirement has been met. Any predispositions? Phone: (202) 898-2578 | Fax: (202) 898-2583 | info@advancingstates.org. Claims will be disallowed if the relevant habilitation plan(s) was not developed, reviewed or revised as where at leastrequired annually one of the residential habilitation plan reviews was conducted at the time of the ISP meeting. They must be designed to empower the person by fostering development of skills to achieve desired personal relationships, community participation, dignity, and respect. CFCO, authorized in the Affordable Care Act, allows states to expand access and availability of long term services and supports. If there are no changes to the PPO, the participant and the SC sign the last page of the Addendum indicating that the PPO was reviewed and there were no changes. The New York State Department of State provides free access to all New York State regulations online atwww.dos.ny.gov. Was there loose stool reported in the week before the obstruction (can be a sign of impaction)? endstream endobj startxref The first page of the house-specific Plan of Protective Oversight will be uploaded as an attachment. It clearly enlists the key activities that affect the health and welfare of an individual. Was there a known behavior of food-seeking, takingor hiding? about ADM#2021-04R Crisis Services for Individuals with Intellectualand/or Developmental Disabilities (CSIDD) Service Requirements and Billing Standards. Was there a known mechanical swallowing risk? It is attached with the ISP packet and sent to the RRDS for review and signature. Providers may disclose PHI to health oversight agencies, (e.g., the government agency which licenses the provider), for legally authorized health oversight activities, such as audits and investigations. This includes providing information and plans in a language understood by the person, language interpretation during meetings if the person is limited-English proficient, explaining a document orally or in a language other than English, or providing it in an alternative format such as pictures or Braille; Providing a method for a person to request updates to his or her plan, including who to notify and the means of notifying (phone or email) that person when a change is sought; and. Were the risks addressed? If seizures occurred, what was the frequency? Guidance, What communication occurred between OPWDD service provider and hospital? What is the pertinent past medical history (syndromes/disorders/labs/consults)? Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). What did the bowel records show? Did the person require staff assistance to stand, to walk? 911? Over 126,000 New Yorkers are people with intellectual or other developmental disabilities. A designation for individuals in a supportive community residence who have attained independent living skills but who remain in the facility while they demonstrate their proficiency in these skills and/or make provisions for moving to independent living. Start or increase another medication that can cause constipation? The policymaking authority of a community residence responsible for the overall operation and management of one or more community residences operated by an agency. hQj@}T%+H lCj!am\dfX[C93s@ #ob |Cg`>/oQzd-xU?r0;`iEf&6p&-\!8!U|^,G\`=tGY_%.] |z$52>F A condition of a person, or lack thereof, which, when addressed, enhances the person's quality of life and/or ability to cope with his or her circumstances or environment. What were the PONS in place at the time? This document may be known by a different name but it must comprise the elements described in this definition. Scheduling meetings with the person at times and locations convenient for the individual; Providing necessary information and support to ensure that the person, to the maximum extent possible, directs the process and is enabled to make informed choices and decisions related to both service and support options and living setting options; Aware of cultural considerations, such as spiritual beliefs, religious preferences, ethnicity, heritage, personal values, and morals, to ensure that they are taken into account; Communicating in plain language and in a manner that is accessible to and understood by the individual and parties chosen by the person. (3) OPWDD shall verify that each person has a plan for protective oversight, based on an analysis of the person's need for same, and that such need has periodically, but at least annually, been reviewed, revised as appropriate, and integrated, as appropriate, with other services received. Sudden changes: If the change was reported to you as sudden or within 24-hours of an ER or hospital admission, review notes a few days back and consider interviews regarding staff observations during that time. Did the choking occur off-site or in a nontraditional dining setting (e.g. ",#(7),01444'9=82. about ADM #2015-02 Service Documentation for Community Transition Services, about ADM #2018-06R2 Transition to People First Care Coordination, about ADM #2022-05 Medication Administration Training Curriculum for Direct Support Staff, Office for People With Developmental Disabilities, Title 14 of the New York Codes, Rules andRegulations (NYCRR), 1915(c) Childrens Waiver and 1115 Waiver Amendments, Management of Communicable Respiratory Diseases. p`FE @"U $RE 0.U RE 0.U@Z>)ES What was the diagnosis? 686.16 Certification of the facility class known as individualized residential alternative. (s) Funds, Mental Hygiene Law, section 41. Had the person received sedative medication prior to the fall? What are the pertinent protective measures/monitoring directions, care and notification instructions, e.g. Was there any illness or infection at the time of seizure? Severity? Any place operated or certified by OPWDD in which either residential or nonresidential services are provided to persons with developmental disabilities. Was the agency RN involved in communications? Home; Our Practice; Services; What to expect. Specialist care, per recommendations? Plans are revised at least every six months and must be signed. Site specific Plan of Protective Oversight Individual Plan of Protective Oversight Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols) . Were there any recent changes in auspice/service providers which may have affected the care provided? (3) recreational and cultural activities. Was there a MOLST form and checklist in place? routine medications, PRN medications? (3) A facility in this class for eight or fewer persons, shall meet the building code listed in section 635-7.1(h)(1)(ii) of this Title or for New York City in section 635-7.1(i)(1)(ii) of this Title and the environmental requirements listed in section 635-7.4(b)(3) of this Title. Was overall preventative health care provided in accordance with community and agency standards? Can the investigator identify quality improvement strategies to improve care or prevent similar events? Were there any surgeries or appointments for constipation and/or obstruction? Those criteria which specify the basis of documenting compliance for the purposes of issuing an operating certificate. The New York State Department of State provides free access to all New York State regulations online at www.dos.ny.gov. (1) OPWDD shall verify that each individualized residential alternative has implemented a facility evacuation plan. The development and documentation of the Person-Centered Service Plan is the primary and ongoing responsibility of the Service Coordinators/ Care Managers (SC/CM). Individual Plan of Protective Oversight. %%EOF Was nursing and/or the medical practitioner advised of changes in the person? Were changes in vitals reported to the provider/per the plan, addressing possible worsening of condition? Did the personrequire agency staff to support him or her in the hospital? stream Did staff understand and follow dining/feeding requirements? Text Size:product owner performance goals examples jefferson north assembly plant. Were appointments attended per practitioners recommendations? Was it related to a prior diagnosis? <> Exhibit any behavior or pain? %PDF-1.5 When was his or her last EKG? Were there medical conditions that place a person at risk for infection or the particular infection acquired (diabetes, history of UTIs, wounds, incontinence, immobility, or history of aspiration)? What are the pertinent agency policies and procedures? This posting is not intended to replace official publication of regulations in the New York State Register, published by the New York State Department of State. A copy is also provided to each waiver service provider listed in the ISP. Did the person have a history of Pica? Inspector General's Fiscal Year 2023 Oversight Plan. Was there bowel tracking? hVKo8+ ~ bTuaJiNws)zof8C?KC2%D(pmZdhD$IB$gWhp*U> OGW9ZTkz6EE'#1i> |DwK,]~]#NG[:(]U%RYSwqxwu0"c.Cg,m6~bY!qSPT}32^W0wvv_&br5;P&vP/UYmrvb[^Bka>XBL)%Z WO Revised Protocols for the Implementation of Isolation and Precaut Protocols for the Management of mpox (monkeypox) in OPWDD Certifi ADM #2022-06 Direct Provider Purchased/Agency Supported/Contract ADM#2021-04R Crisis Services for Individuals with Intellectualand ADM #2015-02 Service Documentation for Community Transition Servi ADM #2018-06R2 Transition to People First Care Coordination. Developed/reviewed Individualized Plan of Protective Oversight to ensure document captured the needs of each individual enrolled in the program . Once reviewed and signed by the RRDS, the PPO is returned to the SC, who distributes it to the participant and any waiver service provider listed in the current Service Plan. Were the plans followed? Which doctor was coordinating the health care? hbbd```b``f3@$S*X2tA0HY``0&I30KD_@# .l2Xm8_)I`W10RP ^` respective service environment. individuals For receiving Individualized Residential Alternative (IRA) Residential Habilitation, the Residential Habilitation Staff Action Plan must meet the requirements of the Plan for Protective Oversight in accordance with 14 NYCRR Section 686.16. Did staff follow plans in the non-traditional/community setting? This shall include children or adults who have applied to or have been screened for services and for whom a clinical record is maintained or possessed by such a facility. Plan(s) of Nursing Service as applicable. Did the person have any history of seizures or other neurological disorder? To request a document in another language, email[emailprotected]. Summary Job Description: The Residential Manager for our OPWDD-funded Individualized Residential Alternatives (IRAs) is an essential position and is responsible for the daily operations of 2 to 3 residential programs, by supervising, leading, and developing a competent and professional workforce, ensuring compliance with all federal, and state . Were established best practice guidelines used to determine that appropriate consults and assessments were completed when appropriate? Medical, about Management of Communicable Respiratory Diseases, about Revised Protocols for the Implementation of Isolation and Precautions for Individuals Exposed to COVID-19 Residing in OPWDD Certified Facilities, about Protocols for the Management of mpox (monkeypox) in OPWDD Certified Facilities, about ADM #2022-06 Direct Provider Purchased/Agency Supported/Contract Services Delivered by Providers Who Are Not The Fiscal Intermediary. Plain Language document providing information and guidance about mpox. What was the latest prognosis? Furthermore, OPWDD cannot provide individual legal advice or counseling. If the individual resides in a developmental center or is on conditional release, this shall be done with notice to the Mental Hygiene Legal Service. The SC does not forward the guardian documentation to waiver service providers only to the RRDS as stated above. Identify the appropriate 1750b surrogate. Was there a PONS for dysphagia/dementia/seizures? % Did it occur per practitioners recommendations? Available? OPWDD assumes no responsibility for any error, omissions or other discrepancies between the electronic and printed versions of documents. (1) all relevant habilitation plans (for individuals receiving habilitation services); (2) all relevant plans or documents pursuant to subdivisions 636-1.4(c) and (d) of this Title that support modification to an individuals rights specified in paragraphs 636-1.4(b)(1)-(4) of this Title; and. For purposes of this Part, a bed in a designated bedroom that is not occupied or encumbered by a person living in the residence and is immediately available for use by a person with developmental disabilities who is in need of short-term relocation. Written statements (expected for all death investigations). Capability as stipulated by this definition does not mean legal competency; nor does it necessarily relate to a person's capacity to independently handle his or her own financial affairs; nor does it relate to the person's capacity to understand appropriate disclosures regarding proposed professional medical treatment, which must be evaluated independently. The form contains two pages. Artificial hydration/ nutrition? Documentation related to the plan, if required. The SC is responsible to communicate with the waiver service providers that the participant now has a legal guardian who they need to communicate with as needed. What was the person's level of supervision? OPWDD shall verify that staff and persons residing in the facility are trained and evaluated regarding their performance of said plan. When was his or her last consultation with a cardiologist? An authorized provider's written assurance that a person placed in an individualized residential alternative has a plan for appropriate supervision by a qualified party. They are children and adults with a range of abilities and needs. This function may include assisting activities by the assigned qualified party, but does not include habilitation or skill training. The goal of the ISP is to ensure the provision of those things necessary to sustain the person in his/her chosen environment and preclude movement to an ICF/DD. Such plan for supervision, at a minimum, shall be at a level that results in the assigned party being either on-site or on-call and available for drop-in or personal representation. xU]k@|?T? <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The local administrative unit, responsible to the Division of Program Operations of OPWDD, that has major responsibility for the planning and development of community residential and other program services. The basis of documentation may include facility specific record; specified forms or reports; specified contents of records, reports or forms; and/or other means of assessing compliance such as interviews with individuals, employees or volunteers, and/or onsite observation of activities and the environment. Protective Oversight Assisted Living Facility (ALF) Shall mean any premises, other than a residential care facility, intermediate care facility, or skilled nursing care facility, that is utilized by it s owner, operator, or manager to provide twenty-four (24) hour care and services and protective oversight to three (3) or more residents who are How many? endobj Diet orders and swallow evaluation, if relevant. If the person required pacing while dining, was this incorporated into a dining plan? Other? EPA Office of Inspector General issues Fiscal Year 2023 Oversight Plan When was the last consultation? The maximum monthly amount a person can be required to contribute to the cost of care in a community residence. JFIF ` ` C 199 0 obj <> endobj Reassessment of the person's functional needs. The funds are made available in accordance with section 41.36(n) of the Mental Hygiene Law and payment is made on a semiannual basis to the agency. 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( this may determine hypotension ) examples jefferson north assembly plant either residential or nonresidential services are provided each... 126,000 New Yorkers are People with intellectual or other neurological disorder similar events text Size: owner! That can cause constipation and procedures followed to report medication errors vitals reported to the fall f\.Feq2o... As stated above or infection at the time of seizure criteria which specify the basis of documenting compliance for purposes., evaluations, and all individuals listed as Informal Supports to the obstruction can!, evaluations, and other Funds, Mental Hygiene Law, section 41 endobj Title nursing...