State regulations indicate that the first care plan meeting for my mother in assisted living/memory care should occur 21 days after admission and the ED confirmed that I should be contacted about a date for the meeting next week. I'm new to this forum and have posted one question and received invaluable responses! I hope you can help me prepare for the first care plan meeting. I was told that the resident handbook was being updated and almost ready for distribution. I believe that having a copy of the resident handbook and a copy of the admitting care plan to review PRIOR to the meeting will help me to make the best use of everyone's time during the meeting and assure that I can optimize this opportunity to meet with the care team. Does this seem like a reasonable request and, if the handbook is not ready, would it be reasonable to request a copy of the most recent version? Isn't the distribution of a resident handbook on admission a state regulation? I'm willing to delay the first care plan meeting by a few days, as long as I have a direct line of communication with the consulting RN and supervising LPN, in the meantime. Thoughts?
First of all I need to get clear if Mom is in AL or in MC. HUGE difference here. Huge. Everything depend upon the answer to that question. There is no comparison in level of care one to the other.
Secondly, I am concerned there is no handbook, whether old one or new one, and she entered without this. When my brother went into assisted living we were met with two times before decision. On the first meeting we had many questions written out. All were answered. And at that time we were given a complete list of everything we could every have wanted to know about every aspect and cost thereof. We were told the cost, how often there cold be a raise, what the yearly raise could be (3% to 5%), EXACTLY what the levels of care were and what they consisted of. How to help create the care plan, and etc. Did you have any of this?
States vary, but again, there is less regulation on a business that is AL/MC than there is on a nursing home.
Your first care plan meeting should happen as soon as possible because your notes here on Forum have indicated you have a lot of problems and concerns. They should be answered and addressed. You should be able to get answers to all the above I told you for this facility.You should write out all your questions.
We discussed already the timing of medications and how one an MD says early a.m. on empty stomach may have to be delivered by night shift, meaning, yes, a wake up call at 5 to 6 a.m. given that the med nurse has many patients in need of this same service and there is likely one med nurse for many patients.
I don't think I can add to the many questions you have already expressed, and being a very concerned and involved family member as well as a nurse I can leave it in your good hands to make a complete list of your questions regarding staff, regarding vetting of staff, regarding how much staff on each shift, regarding locks on rooms or entry through locks, regarding safekeeping of resident's cash, and etc.
I sure wish you the best of luck in this your first meeting for a care plan.
My first CPM was all about my mom having to do an appeal for being “at need” medically for LTC Medicaid. She moved into NH from IL so did not have fat hospitalization and rehab chart that most do. When State assessment duo (RN & SW) went by to evaluate her, there were items (mainly RX but couple of labs too) left out of her chart. So between these and moms perkiness, it was not medically at need. CPM was a circular firing squad to place blame on this snafu; dietary stood up, spoke to me over the heated cross talk & said, she’s enjoying her meals and left. LSS I had to file the appeal but NH had to get together the info needed for appeal & submit. All was sent in way ahead of the hearing date. Mom was medically eligible.
But at the end of this first CPM, I was presented with a form (it was in moms binder that was held at the nurses station) and asked to sign. It’s basically a page that CPM was held & all going accordingly, yada yada. There was an blank 2 line area above the signature in which you could write in your specific concerns. I wrote in by name that DON and floor charge RN were to do all follow up needed for the Medicaid medical appeal and comply in a timely manner with State required documentation needed AND that SW was to contact me via email as to filings. Then I signed.
It was pretty obvious that this didn’t often happen as couple of staffers both said “all you need to do is sign”. Yeah sure & I’m wearing my size 6 slacks again. Not happening.
For the next CPM, about 90 days later, I went in prepared with 2 things: a sm box of mini muffins and a short typed page of concerns both medical (weight loss at > 10%, continuity of care from her old ophthalmologist involving RX for daily eye drop, etc.) and administrative (billing & back office incompetency). Carrot & Stick. I brought a mini stapler too and stapled the page to the backside of the statement signature page and wrote on the front, “As per attached 1 page listing” then I signed. The expressions on staff faces was priceless. Didn’t stop the DON from reaching for another muffin tho. And the follow up medically was done & I got regular emails from Nursing & SW. Administration stayed a clusterF & I did move mom to another and eons better NH within the year.
imo you have to go in prepared with deliberate concerns and specific questions. It is very much as MJ wrote, if you come in prepared they will know you are engaged in your elders care…. this is important and makes a difference. If you get flummoxed easily, I’d suggest you take another family member to do the note taking so you can concentrate on getting your concerns heard. The DPOA or MPOA are the only ones who can ask questions is the vibe I got. Good luck.
Have some questions ready, bring something to write on, and see how they conduct the meeting. It'll likely be pretty informal and fairly short. However, if you arrive with questions in hand and take notes, they'll at least know you are engaged with the care for your LO.
I try and get to know each of the directors of the AL living facility. Depending on how they respond is also dependent how I respond to them - I always try and keep it professional.
Good Luck.
I want that care plan meeting to be meaningful. I hope that if I request a copy of the handbook and the admitting care plan, they'll understand that going through the motions won't fly.
Updated my foot. That's the sort of response that would make me want to stand in the atrium with a sign saying "HAS ANY RESIDENT OR ANY FRIEND OR RELATIVE OF ANY RESIDENT EVER SEEN HIDE OR HAIR OF ANY SUCH THING AS A RESIDENTS' HANDBOOK IN THIS HERE ESTABLISHMENT? EVER?"
And on the reverse: "HANDS UP EVERYONE WHO'S BEEN TOLD THE NEW VERSION IS PRACTICALLY ON ITS WAY HERE FROM THE PRINT SHOP"
Yes. Ask for the last one. (They won't have one).
I really wouldn't wait for the handbook, new or old, to hold your meeting. Your grandchildren will be pushing up the daisies long before it sees the light of day. You're doing well to have a support plan worthy of the name, I should stick to that.