MRSA in Residential Care Facilities for the Elderly

We frequently get the question of what to do with MRSA in the assisted living. 

Licensing classifies MRSA and other antibiotic resistant bacteria as "Prohibited Health Conditions".  The reason being that elderly individuals usually have weaker immune systems than younger individuals.  As such, it is to be dealt with in a very serious way. 

The RCFE Evaluators Manual (The Blues) says the following"

"If a resident is diagnosed with a methicillin-resistant staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) infection, the resident must be relocated elsewhere, such as to an acute care hospital or a skilled nursing facility, until the infection is cleared unless the facility applies for and receives an exception."

To read the entire Section 87615, Prohibited Health Conditions click HERE.  Go to page 108 in the PDF, the section begins near the end of the page.

Guidelines for treatment of MRSA from the Infectious Diseases Society of America - click HERE.

Responding to Confusion in our Residents with Dementia

Q - How do we interact with are residents when they are confused?

A - When our residents are confused or even forgetful it is so easy to become impatient.  We're often busy with many issues at a time and forget that we are there to be a support for our people.  It is important in these situations to remain calm and patient.  Our responses need to be loving and respectful.  It is even helpful in your response if you use words like "I think" or "maybe" instead or "remember".  Please look at this checklist from the Alzheimer's Association and share it with your caregivers.

The checklist is here .

California Food Handler Card Law (SB 602)

In the last few weeks our office has received several calls requesting information about Senate Bill 602 (SB 602), aka The California Food Handler Card law.  This law took affect July 1, 2011.  Currently, clarification on how this affects residential care facilities is hard to find.  There is some great information out there on the subject, however.  Thank you ACCA member Brian P. for your help on this.
For starters, this law seems to specifically address "retail" food handlers.  It raises the question, how do we define "retail"?  Since the care we provide is charged to the resident and it must require food service then it is safe to assume we fall into this "retail" area.  We recommend having your staff trained and assessed with a Food Handler Card on file.  At the very least it will keep you out of hot water and your staff will be better as well.

We plan on providing the California Food Handler training in the near future.  We'll keep you posted.

Check out the following links for more information.

Read the Guidelines & FAQ

Read the Bill (SB 602)

What is a KIT Inspection? & Heat Related Information

We have been getting a lot of questions on the new "KIT" Inspections process by the LPA's.

"KIT" stands for "KICKED in the TUSH"!

Just kidding, it stands for Key Indicator Tools.  The Community Care Licensing Division (CCLD) is continuing to test the Key Indicator Tools (KIT) that have been developed for use during inspections to facilities and homes to check for compliance with licensing standards. This test will be used to further refine the KIT inspection protocol and develop additional tools for all facility types. All inspections are still subject to all laws and regulations regardless of the type of inspection.  For example, if during a KIT inspection, CCLD observes a violation that is not listed on the KIT, CCLD will still address that violation. For additional information, visit the MYCCL website at http://www.myccl.ca.gov/ and click on New Directions.

Heat Related Information

Tips for Licensees to Prevent Heat-Related Illnesses:

http://ccld.ca.gov/res/pdf/heat.pdf

 

Tips for Licensees to Prevent Heat-Related Illnesses (Spanish):

http://ccld.ca.gov/res/pdf/heatSP.pdf

Office of Emergency Services - Heat Preparedness:

http://www.oes.ca.gov/Operational/OESHome.nsf/ALL/AA07C0C051F70991882572F3005C15CF?OpenDocument

CA Department of Public Health Tips for Preventing Heat-Related Illness:
http://bepreparedcalifornia.ca.gov/EPO/BeInformed/NaturalDisasters/ExtremeHeat/TipsPrevHeatIllness.htm

Licensing News on Hospice and Oral Syringes

Happy Father's Day to all you Dads and bless all you Moms for putting up with us.

News from Licensing.  Licensing is now asking the facilities that have the Hospice Waiver to apply for a "Total Care Exception" and submit it as an addendum to be added to your Hospice Waiver.  Once your Total Care Exception is approved you will still have to notify licensing when a resident on hospice becomes total care.  We will have this available to purchase next week.  Please call the office, if you purchased the Hospice Waiver from us then the addendum will be $49.00.  If you need the Hospice waiver with the addendum the price is $159.00.

Medical Marijuana is a hot topic.  Licensing has little to say about it but did say to treat it as any other medication.

Clarification on the use of oral syringes.  It is now clear that unlicensed trained staff can use an oral syringe to draw up and measure liquid oral medications.  The oral syringe can then be handed to the resident to self administer.  Staff may not administer the medication.