Activity-Based Care

There is more to good care than just handing out medications, assisting with showers and providing nutritious meals. What makes one facility stand out against others is often the level of activity that is visible to your visitors. So, understanding how care and activities work together can be a big part of making a facility successful. The fact is activities are not all games and crafts, especially in RCFEs providing dementia care and ARFs with highly active individuals. Activities can include dressing, grooming, meal prep, meal clean up and when appropriate, community outreach. Keep in mind that activities should be whatever is best for the individual and should not be what best serves the community. Please view the link for more considerations on Activity-Based Care. 

Football, Concussions & Dementia

We should start this week by saying that even though our 49er's didn't win Super Bowl XLVII they played an amazing second half and a great season.

Continuing with football, Tom Dempsey, the legendary NFL kicker who had no toes on his right foot, is suffering from dementia.  He is part of a study conducted by the well-known brain specialist Dr. Daniel Amen.  Some of us at Community Care Options had a chance to see Dr. Amen speak a few years ago and he addressed this issue around contact sports and brain injury.  Dr. Amen is beginning to see a connection between amongst retiring NFL players.  I've linked an article from the N.Y. Times below for you to enjoy.

For Former Kicker, the Price of Fearlessness

Educational Resources

We're always looking for new sources for information on aging and dementia.  One website that I consistently use for information when developing a new training is ALZ.ORG.  The Alzheimer's Association has a wealth of research news, caregiver techniques, and support information for families and professionals.  Please have a look at their website whenever you do an "in service" training with your staff.  Specifically look at THIS PAGE for professional care providers.

SSI / SSP Rates for 2013

I just wanted to make you all aware of the updated rates for SSI/SSP.  Please  refer to this Evaluator's Manual change for the specifics OR continue reading below.

SSI/SSP Rates

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Non-Medical Out-of-Home Care (NMOHC) Payment Standard

Effective January 1, 2013

Supplemental Security Income (SSI)	$710.00
State Supplementary Payment (SSP)	$412.00 _________
Total NMOHC Payment Standard	$1122.00*
The NMOHC Payment Standard includes the following components:
Room and Board	$482.00
Care and Supervision (maximum)	$511.00 _________
Amount Payable for Basic Services	$993.00**
Personal and Incidental Needs Allowance (must be provided to the recipient) (minimum)	$129.00 _________
	$1122.00

* Amounts are double for SSI/SSP couples

** NOTE: Recipients who have income in addition to their SSI/SSP check (for example, a pension, Social Security retirement, or disability benefits) can be charged the $993.00 amount for basic services plus an additional $20. Because federal rules do not count the first $20 of a recipient's income against his/her SSI/SSP grant, an SSI/SSP recipient with other income has an extra $20 that people who receive only an SSI/SSP check do not have. Neither federal nor state law restricts the recipient in how this additional $20 is spent. Thus, if the recipient agrees in the admission agreement to pay the additional $20 for basic services, the facility may charge the additional amount.

Private Duty Caregivers

I have been getting a lot of questions on Private Duty Caregivers. The
following is the latest from Community Care Licensing. This is from the
quarterly updates at the following link:

http://ccld.ca.gov/res/pdf/ASCspring2012.pdf

PRIVATELY PAID PERSONAL ASSISTANTS

An RCFE licensee cannot require a resident to hire a 24-hour caregiver.
Under Health & Safety Code section 1569.312, a RCFE must provide basic
services, which by definition include assistance with activities of daily
living. Regulation sections 87464(f) - Basic Services and 87608(a) - Personal
Assistance and Care describe these services that required to be provided by
the licensee to meet the needs of residents such as safe and healthful living
accommodations; personal assistance and care; observation and supervision;
planned activities; food service; and arrangements for obtaining incidental
medical and dental care. The licensee cannot delegate these services.
The services of privately paid personal assistants do not relieve the licensee
of the responsibility to meet all licensing statutory and regulatory
requirements. The licensee must ensure that there is always sufficient staff
to meet the resident’s needs, and that staff are aware of the resident’s
current overall health and safety needs.

Adult and Senior Care Update – Spring 2012 Page 4
Privately paid personal assistants may only provide services other than those
the licensee is required to provide. The assistants can provide companionship,
or additional baths beyond what the licensee is required to provide. They
cannot assist the resident with care relating to any incidental medical
services described under regulation sections 87605 through 87631. Some of
those services include postural supports, oxygen administration,
colostomy/ileostomy care, catheter care and injections.
The RCFE statutes and regulations do not prohibit RCFE residents from hiring
private paid personal assistants and do not require a private paid personal
assistant to be an employee of a RCFE. In addition, licensees are not
prohibited from requiring in their admission agreement that residents hire
only employees of the licensee. Private paid personal assistants must,
however, have a criminal record clearance or exemption, and can only provide
specified services to the resident.