ENSURING QUALITY CARE
THE AFH JOURNEY BEGINS September 2019 Safety, Oversight and Quality Unit 1
WELCOME Welcome • Your journey towards opening or managing an Adult Foster Home (AFH) begins today. The purpose of the Ensuring Quality Care (EQC) Training is to provide you with the information you need to provide: • Appropriate care; AND • Ready your house to support individual resident choice September 2019 Safety, Oversight and Quality Unit 2
EQC TRAINING The EQC Training covers a broad range of topics necessary to: • Understand the scope of what is expected form an AFH licensee and their caregivers • Prepare your home for residents • Understand your home is now also the home of each resident September 2019 Safety, Oversight and Quality Unit 3
EQC TOPICS • Business basics • Emergency preparedness • Care planning • Fire safety • Common chronic conditions • Food safety and handling • Communication • Infection control • Dementia and challenging • Managing your time behaviors • Medication administration • Documentation requirements September 2019 Safety, Oversight and Quality Unit 4
EQC TOPICS CONTINUED • Normal aging • Resident rights • Nutrition • Safety in the home environment • Personal hygiene • Screening and admission • Privacy, HIPAA and security • Taking care of yourself • Problem solving and conflict resolution September 2019 Safety, Oversight and Quality Unit 5
ADDITIONAL TRAINING Your participation in the EQC training is only the beginning. The EQC training does not cover all aspects of resident care. It is your responsibility to seek additional training such as: • Topics covered that you do not feel adequately prepared to handle • Knowledge needed prior to admitting a resident with a condition you are unfamiliar with • On-going training as required by Oregon Administrative Rule (OAR) • Additional information on successful operation of a business September 2019 Safety, Oversight and Quality Unit 6
ADDITIONAL TRAINING CONTINUED Resources and tools are available to help you find the right information and training. EQC additional tools and resources: https://www.oregon.gov/DHS/PROVIDERS-PARTNERS/LICENSING/Pages/eqc-manual.aspx Safe medication administration: https://www.oregon.gov/DHS/PROVIDERS-PARTNERS/LICENSING/Pages/safe-med- administration.aspx Adult Foster Home training website: https://www.oregon.gov/DHS/PROVIDERS-PARTNERS/LICENSING/APD- AFH/Pages/Training.aspx September 2019 Safety, Oversight and Quality Unit 7
PURPOSE AND KEY TERMS • Activities of Daily Living (ADLs) The purpose is to assist the learner in understanding what • Behavior management information must be gathered • License classification during the screening process, how • Screening to evaluate the information before admitting a resident, and your • Transfer responsibilities in educating potential residents, their family and medical professionals about AFH care. September 2019 Safety, Oversight and Quality Unit 8
OBJECTIVES The learner will be able to: List four major questions to ask during the screening process to determine if a prospective resident is appropriate for your AFH Describe the type of information that needs to be gathered during the screening process and where to find the information Define the three ADL levels and describe the importance of determining the ADL requirements of a prospective resident before admitting them to your foster home Evaluate the information gathered to assist in determining if the AFH can meet the needs of a prospective resident September 2019 Safety, Oversight and Quality Unit 9
INTRODUCTION Preparing for on-going needs: All residents have conditions that will change over time: • Normal aging process • Changes in medication needs • Changes in chronic health care needs • Progression of degenerative conditions. • Be prepared to provide care according to the individual needs and preferences of each resident. September 2019 Safety, Oversight and Quality Unit 10
WHOSE HOME IS IT? Once your home is licensed, your house is also each resident’s home: Within reason, accommodations need to be made reflecting their expectations. Residents have a say in: • Activities • When and where they choose to eat • When the resident goes to bed and gets up each morning • Who their visitors are and when they can visit September 2019 Safety, Oversight and Quality Unit 11
WHOSE HOME IS IT? CONTINUED Imagine how you would feel if you could not: • Arrange your furniture and decorate your room as you like • Lock your bedroom door for privacy • Access snacks when you want • Provide input into mealtimes or the food you are offered • Decide who visits you and when they can visit September 2019 Safety, Oversight and Quality Unit 12
WHAT IS AN AFH? Adult foster homes are highly regulated businesses and must be run in accordance with: • All applicable state and federal Medicaid and Medicare laws and regulations • Applicable federal and state business regulations • OARs for adult foster homes • Fair housing rules and guidelines September 2019 Safety, Oversight and Quality Unit 13
WHAT IS AN AFH? CONTINUED An adult foster home is also a place of employment, and you must follow all applicable employment laws, BOLI (Bureau of Labor and Industry), including wage and hour laws. September 2019 Safety, Oversight and Quality Unit 14
WHAT IS AN AFH? CONTINUED There are additional responsibilities of an AFH provider, such as: Routine maintenance of the interior and exterior of the home: • Painting • Yard maintenance and debris removal • Keeping exits and walkways clear and accessible Ensuring adequate supplies Keeping electrical and plumbing in good working order September 2019 Safety, Oversight and Quality Unit 15
WHAT IS AN AFH? CONTINUED Owning and operating an adult foster home is not an 8am to 5pm job. For example, it requires a significant time commitment and typically requires more than one person to be managed successfully. Proper management includes: • Maintenance of home and property • Resident care and service needs • Nighttime care needs • Laundry • Nutritional needs • Financial records • Resident and facility records September 2019 Safety, Oversight and Quality Unit 16
SCREENING September 2019 Safety, Oversight and Quality Unit 17
PURPOSE AND KEY TERMS Assist the learner in understanding: • What information needs to be shared with the prospective resident • What information must be gathered during the screening process • Behavior management • License classification • Screening September 2019 Safety, Oversight and Quality Unit 18
INTRODUCTION Referrals come from a variety of sources: • Prospective residents, their family or friends • Healthcare practitioners • Nursing facilities and hospital discharge planners • Local Aging and People with Disabilities or Area Agency on Aging staff, such as: • Case manager; or • Transition coordinator September 2019 Safety, Oversight and Quality Unit 19
FINDING THE RIGHT MATCH Before accepting a prospective resident: • Visit the person in their current setting; and • Gather enough information to make an informed decision The decision to admit a person to an AFH often results from a crisis. Many times hospital social workers, physicians, families, case managers or the potential residents may try to push for an immediate decision. It is vital that you take the time to gather information from as many sources as possible before deciding to admit a resident. September 2019 Safety, Oversight and Quality Unit 20
FINDING THE RIGHT MATCH CONTINUED You are the only one who can determine if you are qualified, willing and able to care for a new resident. Taking in a resident without adequate information: • Leads to turmoil for the resident, his or her family, the other residents in the AFH and you as the licensee • May result in corrective action from APD for admitting a resident without being able to meet their needs September 2019 Safety, Oversight and Quality Unit 21
ALERT Once admitted, a resident can only be asked to leave for specific reasons as allowed by Oregon Administrative Rules. September 2019 Safety, Oversight and Quality Unit 22
FINDING THE RIGHT MATCH CONTINUED Avoid unnecessary challenges by ensuring: • You can support the prospective resident’s needs an expectations • Prospective residents, families, or the resident’s representative understand your home’s policies, residency agreement and resident’s rights • You have completed a thorough screening of each resident prior to admission • You are aware of the limitations of the AFH and your staff September 2019 Safety, Oversight and Quality Unit 23
SDS 0902 Use the mandatory SDS 0902 form to identify required information including, but not limited to: • Medical diagnosis, medications and nursing care • Personal care needs, including night care needs • Cognitive and communication care needs • Nutritional needs • Activities and lifestyle preferences; and • Other data to assure you can meet the resident’s care needs September 2019 Safety, Oversight and Quality Unit 24
SDS 0902 CONTINUED September 2019 Safety, Oversight and Quality Unit 25
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