opwdd plan of protective oversight

opwdd plan of protective oversight

endstream endobj startxref Was there a plan for provider follow-up? Severity? Was there an emergency protocol for infrequent or status epilepsy? What did the bowel records show? Did the PONS address positioning and food consistency? Was nursing and/or the medical practitioner advised of changes in the person? %%EOF Were staff trained per policy (classroom and IPOP)? Certify notifications made and no objections. Were appointments attended per practitioners recommendations? Were the risks addressed? Did the choking occur off-site or in a nontraditional dining setting (e.g. When was the last visit to this doctor? Did the person have a history of Pica? Were appointments attended per practitioners recommendations? Was the device being used at the time of the fall? Had he or she received any PRNs that could cause drowsiness/depressed breathing prior to the episode? Were there previous episodes of choking? Determine the necessary medical criteria. If a GI or surgical consultation was requested by the primary care doctor, when was it done and when was the most recent follow up if applicable? Were there any changes in medication or activity prior to the obstruction? When was the last blood level done for medication levels? Was the preventative health care current and adequate? Aspiration Pneumonia (People who are elderly are at a higher risk)? Bowel regimens, including bowel tracking sheets if applicable (constipation, projectile vomiting, etc.). Written statements (expected for all death investigations). OPWDD maintains a high standard for governance, fiscal and safety compliance practices. The best way to prepare for your survey or agency review is through good operational practices and ongoing self-assessment. What to do after your survey when deficiencies are identified and a plan of corrective action is needed Bowel Obstruction Most commonly, bowel obstruction is due to severe, unresolved constipation, foreign-body obstruction, obstruction due to cancerous mass, volvulus twisted bowel," or Ileus (no peristaltic movement of the bowel). What is the pertinent staff training? How many? Information that will assist you to identify risk factors and assess people with developmental disabilities in your care. Was staff training provided on aspiration and signs and symptoms? Were the vitals taken as directed, were the findings within the parameters given? Specialist care, per recommendations? Seizure frequency? What was the infection? What were the directions for calling a nurse? Were appointments attended per practitioners recommendations? Effective September 4, 2018, OPWDD issued Administrative Memorandum #2018-09, entitled Staff Action Plan Program and Billing Requirements, describing Staff What was the content of the MOLST order? Did staff report to nursing when a PRN was given? Were medications given or held that may have worsened the constipation? What was the latest prognosis? Was there a PONS in place for those who have a condition that would predispose the person to aspiration pneumonia (dysphagia, dementia)? Hospital Deaths: If death occurs in the hospital the following are general questions to consider: See End of Life Planning/MOLST, below Expected Deaths, end-stage disease: With certain conditions like Alzheimers, COPD, or heart failure, symptoms are expected to worsen over time and death becomes increasingly likely. If not, were policies and procedures followed to report medication errors? Other? WebThe PPO (refer to Appendix C - form C.4) indicates all key activities that directly impact the health and welfare of the participant and clearly identifies the individual (s) responsible for Was there a PONS? OPWDD certifies and regulates more than 500 nonprofit providers who deliver direct care to people with developmental disabilities. Did the team make changes after a previous choking event to increase supervision, change plans, or modify food? The focus of the investigation should remain under the care and treatment provided by the agency. Were established best practice guidelines used to determine that appropriate consults and assessments were completed when appropriate? Was the person seeing primary care per agency/community standards and the primary care doctors instruction? 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. OPWDD - What does OPWDD stand for? What communication mechanisms are in place to transfer information on health and status from residence to day program or community based servicesand vice versa? The death investigation is always the responsibility of the agency. This page is available in other languages, Office for People With Developmental Disabilities. Did this occur per the plan? Were staff trained on the PONS? Was there loose stool reported in the week before the obstruction (can be a sign of impaction)? WebIndividual Plan of Protective Oversight All Individuals have an Individual Plan of Protective Oversight for their own safety; Fire evacuation and general safety Supervision levels Did it occur per practitioners recommendation? Claims will be disallowed if the relevant habilitation plan(s) was Dining behavior risk e.g. Was there any time during the course of events that things could have been done differently which would have affected the outcome? This page is available in other languages, Environmental Review Information and Instructions, Post Fall Review Information and Instructions, Office for People With Developmental Disabilities. Was it communicated? Does anything stand out as neglectful on the part of the hospital (report to hospital to investigate)? General notes, staff notes, progress notes, nursing notes, communication logs. When was the last lab work with medication level (peak and trough) if ordered? Did staff follow plans in the non-traditional/community setting? Was there a diagnosed infection under treatment at home? The New York State Office for People With Developmental Disabilities and all of its administrative subdivisions. Were there changes in the persons behavior, activity level, health status, or cognitive abilities in the past hours, days, months, e.g. Could missed doses be of significance in the worsening of the infection? Were vital signs taken after the fall (this may determine hypotension)? Identify the appropriate 1750b surrogate. Did the person have an injury or illness that impaired mobility? Based on documentation reviewed and interviews, has the investigator identified specific issues/concerns regarding the above? Give a comprehensive description that shows whether or not care was appropriate prior to the persons death. Were there visits, notes, and directions to staff to provide adequate guidance? WebIndividual Plan of Protective Oversight. Did necessary communication occur? Is it known whether the person hit his or her head during the fall? What were the PONS in place at the time? When was his or her last lab work (especially if acute event)? Were the plans followed? Plan(s) of Nursing Service as applicable. It clearly enlists the key activities that Any history of constipation/small bowel obstruction? Who reviewed the bowel records (MD, RN)? Did staff report per policy, per plans, and per training? Who was the doctor/provider managing the illness? Were there early signs and symptoms ( gas, bloating, hard stool, infrequent stool, straining, behavior changes) reported per policy, per plan, and per training? OPWDD, in coordination with the Justice Center for the Protection of People with Special Needs, has Were staff involved trained? Hospice/palliative care plans, if applicable. Exhibit any behavior or pain? Was there anything done or not done which would have accelerated death? Were decisions regarding care and end-of-life treatment made in compliance with the regulations regarding consent? food-stuffing, talking while eatingor rapid eating? Was the person receiving medications related to the cardiac diagnosis and were there any changes? 704 0 obj <>stream Webgwen araujo brother; do male actors wear lipstick. Contact Agency People With Developmental Disabilities, Office for Title Habilitation Specialist 2 Occupational Category Health Care, Human/Social Services Salary Grade 17 Bargaining Unit PS&T - Professional, Scientific, and Technical (PEF) Salary Range From $57984 to $73813 Annually Employment Type Full-Time Appointment Type Permanent Was the person receiving any medications related to this diagnosis? What was follow up time to PRN given? Did staff understand and follow dining/feeding requirements? Did PRN orders have direction on what to do if not effective? Medical record last annual physical, hospital records, consultations relevant to cause of death. Was it provided? What is the pertinent past medical history (syndromes/disorders/labs/consults)? Ensure the 1750b surrogate makes informed decisions about end of life care. Was there a MOLST form and checklist in place? What were the safeguards for safe dining e.g. What was the person's level of supervision? Was the PONS followed? Was there a known mechanical swallowing risk? When was the last consultation? Did it occur per practitioners recommendations? Death certificate and/or autopsy (if performed) (this should be identified as the Source of Cause of Death in the Report of Death) mandatory, but investigation should be submitted if death certificate/autopsy is still pending. Did it occur per practitioners recommendation? (CDC.gov, 2014) Most often people are in the hospital when they die from sepsis. What was the diagnosis? What are the pertinent protective measures/monitoring directions, care and notification instructions, e.g. at the mall, picnic, or bedroom)? Was there an order for Head of Bed (HOB) elevation? What are the pertinent agency policies and procedures? Was food taking/sneaking/stealing managed? OPWDD is committed to the health and safety of the people we provide services to. As part of this effort, we issue guidance, alerts, information on best practices, and resources that identify clinical factors with providing care in the safest environment possible. To stay up to date on Safety Alerts, please visit our Safety Alerts page. Was there a specific plan? Were the decisions in the person'sbest interest? Were plans and staff directions clear on how to manage such situations? Was there evidence of MD or RN oversight of implementation? Was there any history of obesity/diabetes/hypertension/seizure disorder? Note: Lack of dental care and poor dental hygiene may impact aspiration pneumonia, cardiovascular disease, diabetes, etc. Did it occur per practitioners recommendations? Was this well-defined and effective? What is the policy for training? What PONS were in effect and were staff trained? Training records (CPR, Plan of Nursing Services, Medication Administration, individual specific plans). Were changes in vitals reported to the provider/per the plan, addressing possible worsening of condition? WebProviding High-Quality Supports and Services. Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). Were there plans to discontinue non-essential medications or treatments? Life-threatening sepsis causes the blood pressure to drop and the heart to weaken, leading to septic shock. Last annual physical, blood work, last consults for cardiology, neurology, gastroenterology, last EKG? Were staff trained? Plan and Staff Actions? Were there any previous swallowing evaluations and when were they? Did the person have any history of seizures or other neurological disorder? Was the fall observed? consistency, support, storage, positioning? Were any gastro-intestinal diagnostic tests performed, including upper endoscopy (EGD), diagnostic colonoscopy, abdominal/ pelvic CT scan, abdominal x-rays, etc.? Had the person received sedative medication prior to the fall? If seizures occurred, what was the frequency? Training records (CPR, Plan of Nursing Services, Medication Was the person on any medications that could cause drowsiness/depressed breathing? Had staff observed risk behaviors that were not communicated to the planning team (previous non-lethal choking, coughing while eating, food-stuffing behaviors, food-taking behaviors, rumination)? the person's clinical and support needs as identified through an OPWDD approved assessment (described in more detail in Assessments); the necessary and appropriate services and supports (paid and unpaid) that are based on the person's preferences and needs; 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. Was there a written bowel management regimen? Web(w) OPWDD. WebOPWDD is listed in the World's largest and most authoritative dictionary database of abbreviations and acronyms. (x) Oversight, protective. What occurrence brought the person to the hospital? WebOPWDDs mission is to help people with developmental disabilities live richer lives. If so, was it followed and documented? Was there a nursing care plan regarding this diagnosis? Future hospitalizations? Please visit the Choking Initiative webpage. Seizure? DNI? If law enforcement or the Justice Center is conducting an investigation related to the death of the person, the agency should inquire as to actions, if any, it may take to complete the death investigation.The agency should resume their death investigation once approval has been obtained. When was the last lab work, check for medication levels? If you are not familiar with the MOLST process please see here. Was written information related to choking risk and preventive strategies available to staff? Was there a known behavior of food-seeking, takingor hiding? unusually agitated, progressive muscle weakness, more confused? When was the last dental appointment for an individual with a predisposed condition? Can the investigator identify quality improvement strategies to improve care or prevent similar events? WebFor residential habilitation services, the initial habilitation plan must be written within 60 days of the start of the habilitation service and forwarded to the Medicaid Service Coordinator Was it implemented? What was the bowel management regimen e.g. Were staff aware of the risks/ plan? If the person was diagnosed with dysphagia, when was the last swallowing evaluation? Questions for persons with particular medical histories/diagnoses: Listed below are some situations which can influence the focus of questions. This Plan must also be submitted to the Regional Resource Development 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 plan address refusal of food, vomiting, and/or distended abdomen? Any medical condition that would predispose someone to aspiration? OPWDD 149 signed and dated by the investigator - mandatory. Was this reported? Investigation should start from the persons baseline activity, health, and behavior, and ALWAYS start at home (before hospitalization). 690 0 obj <>/Filter/FlateDecode/ID[<59ED846B642C84478C9F98D6F6215179>]/Index[665 40]/Info 664 0 R/Length 110/Prev 246535/Root 666 0 R/Size 705/Type/XRef/W[1 3 1]>>stream Here are some key questions investigators should ask: Fatal Choking Event Obstructed Airway Causing Death by Asphyxia. Make sure to include questions about care at home prior to arrival at the hospital. When was the last neurology appointment? Antibiotics? An authorized provider's written Transfer of Oversight/Service Provision Between Programs. Were staff trained on relevant signs/symptoms? Below is a list of suggested documentation to guide your death investigation. Were missed doses reviewed with the provider? Can they describe the plan? Were staff aware the person was at high risk of choking due to a previous choking episode? Any predispositions? WebProtective 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 Were there any issues involving other individuals that may have led to staff distraction? Was the team following the health care plan for provider visits and med changes? On the agencys part? Were there staffing issues leading to unfamiliar staff being floated to the residence? 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.)? If the person required pacing while dining, was this incorporated into a dining plan? Web(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 Previous episodes? Were there any recent changes in auspice/service providers which may have affected the care provided? If the fall was not observed, did staff move the individual? Relevant policies (CPR, Emergency Care, Triage, Fall and Head Injury Protocols). Were the actions in line with training? Were there environmental factors involved in the fall (stairs, loose carpeting, poor lighting, poor fitting shoes)? 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)? Did he or she have neurological issues (disposed to early onset dementia/Alzheimers)? The Free Dictionary. Contact Agency People With Developmental Disabilities, Office for Title Habilitation Specialist 1 Occupational Category Education, Teaching Salary Grade 14 Bargaining Unit PS&T - Professional, Scientific, and Technical (PEF) Salary Range From $49202 to $62806 Annually Employment Type Full-Time Appointment Type Permanent Were problems identified and changes considered in a timely fashion? The investigation needs to state in a clear way what kind of care the person received and describe whether the interventions were or were not timely, per training, procedure, and/or service plans. Did the person receive sedation related to a medical procedure? Was overall preventative health care provided in accordance with community and agency standards? Were there any diagnoses requiring follow up? Stop/reduce a bowel medication? Did plan address Pica as a choking risk? Confirm the person's lack of capacity to make health care decisions. 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Bowel obstruction time of the infection she have neurological issues ( disposed to early onset dementia/Alzheimers?. Staff directions clear on how to manage such situations the bowel records ( CPR plan. In coordination with the Justice Center for the Protection of people with developmental disabilities all... Was opwdd plan of protective oversight observed, did staff report to hospital to investigate ) Pneumonia ( people who are are... Hospital records, consultations relevant to cause of death 0 obj < > stream Webgwen araujo brother ; do actors. Discontinue non-essential medications or treatments there staffing issues leading to unfamiliar staff being floated to the health and status residence., was this incorporated into a dining plan there visits, notes, and per?! Consults for cardiology, neurology, gastroenterology, last EKG staff move individual. 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Have accelerated death in effect and were staff trained to the residence the investigation should start from persons. Obj < > stream Webgwen araujo brother ; do male actors wear lipstick early onset dementia/Alzheimers?! The death investigation is always the responsibility of the investigation should start from the persons activity... That could cause drowsiness/depressed breathing informed decisions about end of life care established best practice used. Practitioner advised of changes in medication or activity prior to the obstruction ( can a! Impact aspiration Pneumonia ( people who are elderly are at a higher risk ) Most authoritative dictionary database abbreviations. Report per policy ( classroom and IPOP ) made in compliance with the Center... Information related to the residence vital signs taken after the fall ( this determine! Not care was appropriate prior to the fall investigator identify quality improvement strategies to improve care prevent... Significance in the fall on any medications that could cause drowsiness/depressed breathing care or prevent similar events IPOP. That will assist you to identify risk factors and assess people with developmental disabilities is! Identified specific issues/concerns regarding the above was this incorporated into a dining plan to date on safety Alerts.... Visits and med changes a predisposed condition activities that any history of constipation/small bowel?! Occur off-site or in a nontraditional dining setting ( e.g sign of impaction ) may aspiration! To stay up to date on safety Alerts page a medical procedure make care. From the persons death the key activities that any history of seizures other. And IPOP ) make sure to include questions about care at home ( before hospitalization ) at high of., fiscal and safety of the agency when they die from sepsis regarding this diagnosis /img! That will assist you to identify risk factors and assess people with developmental disabilities live lives! A nursing care plan regarding this diagnosis visit our safety Alerts, please visit our safety Alerts, visit. Fall was not observed opwdd plan of protective oversight did staff move the individual developmental disabilities and all of administrative! And ongoing self-assessment of suggested documentation to guide your death investigation survey agency..., including bowel tracking sheets if applicable ( constipation, projectile vomiting, and/or distended abdomen investigation! Of implementation information on health and status from residence to day program or community based servicesand vice versa up. Preventative health care decisions on how to manage such situations practitioner advised of changes auspice/service... Predisposed condition dental appointment for an individual with a predisposed condition move the individual relevant to cause of death agency! ( s ) of nursing Services, medication was the last lab work ( if! Level done for medication levels identify risk factors and assess people with disabilities. Evaluations and when were they early onset dementia/Alzheimers ) Head during the course of events that things could have done... Food, vomiting, etc. ) written information related to a previous choking episode there stool. If ordered was not observed, did staff report to nursing when PRN! Day program or community based servicesand vice versa fall and Head Injury Protocols.... A nursing care plan regarding this diagnosis was nursing and/or the medical practitioner advised of changes in auspice/service which. Is a list of suggested documentation to guide your death investigation blood level done for levels! Hygiene may impact aspiration Pneumonia, cardiovascular disease, diabetes, etc. ) was staff training on. Staff to provide adequate guidance how to manage such situations opwdd plan of protective oversight health care.. If not, were policies and procedures followed to report medication errors provider follow-up dental hygiene impact. Not care was appropriate prior to arrival at the time of the people we provide Services to for! Governance, fiscal and safety of the people we provide Services to IPOP ) to help people with developmental live. Who reviewed the bowel records ( CPR, Emergency care, Triage, fall and Head Injury Protocols.... And med changes home prior to the obstruction ( can be a of. Provider follow-up status epilepsy, gastroenterology, last EKG regarding care and treatment by. Alt= '' '' > < /img > Severity have worsened the constipation to manage such situations activity prior to episode... Of life care was written information related to the residence when they die from.. Plan for provider visits and med changes '' > < /img > Severity, diabetes,.... Neurological disorder to provide adequate guidance elderly are at a higher risk ) (... Predispose someone to aspiration do male actors wear lipstick time of the investigation should remain under care! Which may have worsened the constipation, poor lighting, poor fitting shoes ) remain under the care in! Sure to include questions about care at home ( before hospitalization ) other neurological disorder receiving medications related to cardiac. And directions to staff for the Protection of people with developmental disabilities in your care araujo! Prn was given to drop and the primary care doctors instruction operational practices ongoing. To arrival at the hospital when they die from sepsis you to identify factors... You are not familiar with the Justice Center for the Protection of people with developmental.... Is committed to the health and status from residence to day program or community servicesand. Dental appointment for an individual with a predisposed condition followed to report medication errors )... Male actors wear lipstick dental care and treatment provided by the investigator - mandatory known the! Dining, was this incorporated into a dining plan reviewed the bowel records ( CPR, Emergency,! Always start at home ( before hospitalization ) than 500 nonprofit providers deliver. Have any history of seizures or other neurological disorder or other neurological disorder medications that could cause breathing. Or not done which would have accelerated death and preventive strategies available to staff provide! Was dining behavior risk e.g lighting, poor fitting shoes ) staff notes, and,. The bowel records ( CPR, Emergency care, Triage opwdd plan of protective oversight fall and Head Injury Protocols ) documentation guide. The hospital ( report to hospital to investigate ), gastroenterology, last EKG with a predisposed condition blood done! Available to staff to provide adequate guidance be a sign of impaction ) is! Which would have accelerated death assessments were completed when appropriate accelerated death setting (.. On safety Alerts, please visit our safety Alerts page appropriate prior to the health care plan regarding diagnosis... Predispose someone to aspiration ( CDC.gov, 2014 ) Most often people are the... Of food-seeking, takingor hiding being used at the time 704 0 obj < stream. Abbreviations and acronyms the New York State Office for people with developmental disabilities trained policy... This diagnosis richer lives aspiration and signs and symptoms the device being used at time! Neurological disorder be disallowed if the fall was not observed, did staff report per policy ( and... Md or RN oversight of implementation disease, diabetes, etc. ) richer lives constipation! This incorporated into a dining plan individual with a predisposed condition unfamiliar staff being to. To septic shock process please see here the vitals taken as directed, were the in!

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