CMS Checklist Review of Care and Services for Dementia Patients Part II
Jeannine LeCompte, Compliance Research Specialist
Inspectors from the Centers for Medicare and Medicaid (CMS) use a checklist when touring a facility caring for residents diagnosed with dementia. To generate an effective care program, it is helpful to know what they are looking for.
An inspector will review the facility’s care plan and its implementation and ask the following questions:
– Did the staff identify, document, and communicate specific targeted behaviors and expressions of distress as well as desired outcomes?
– Did the facility implement individualized, person-centered interventions by qualified persons and document the results?
– Did the staff communicate and consistently implement the care plan, over time and across various shifts?
The inspector will also look to see if there had been any sudden change in a resident’s condition and medical causes of behavior or other symptoms, and in such a case, if a physician had been contacted and treatment initiated.
The inspector will determine if there are a sufficient number of staff to consistently implement the care plan, and will focus on observations of staff interactions with residents who have dementia to see if staff consistently apply basic dementia care principles for those individuals.
A failure by the facility to provide or arrange services by qualified persons in accordance with the resident’s written plan of care will result in a citation.
Other factors which will be considered include:
- Are antipsychotic medications given by staff for purposes of discipline or convenience, or to treat the resident’s medical symptoms?
- Do staff, in collaboration with the practitioner, adjust the interventions based on the impact on behavior or other symptoms as well as any adverse consequences related to treatment?
The inspector will also seek to establish if the care plan is modified when concerns related to the effectiveness or adverse consequences of a resident’s treatment regimen are identified.
In summary, an inspector will look to see if the facility has provided all necessary care and services for a resident with dementia “to support his or her highest practicable level of physical, mental, and psychosocial well-being” in accordance with the comprehensive assessment and plan of care.
Source:
National Partnership to Improve Dementia Care in Nursing Homes, Checklist Review of Care and Services for a Resident with Dementia (for use with the Interpretive Guidance at F309), Centers for Medicare & Medicaid Services
