Editor's Desk: More 'optional' guidance: If they ask, you'll provide

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James M. Berklan, Editor
James M. Berklan, Editor
If there were ever any doubts that the “culture change” we've all heard so much about in recent years was really going to take hold, it's time to put them to rest.

Uncle Sam has put in his order for a heaping dose of resident choice and flexibility. Here's hoping you have your order pad and pencil at the ready, Mr. and Mrs. Long-Term Care Provider. There's no way you are going to last at this job without them.

I'm referring, of course, to the new interpretive guidance covering quality of life and environment. Federal healthcare authorities put it into effect the middle of last month. The new guidance gives surveyors a lot more to consider in 11 key resident care areas.

This is a good thing, many provider advocates believe (see “60 Seconds With”). Consumer advocates are just as jazzed, however, which means providers better keep their antennae up.

Even though the regulations technically have not changed, the prism through which surveyors will judge you has. Eleven F-tags, covering all-encompassing areas such as visitors, roommates, sleeping, eating, dressing and many more, are in play here.

Honing in on one, F-242 Self-Determination and Participation, shows the challenges particularly well. It says you must not only grant a resident her many wishes, but you must be actively seeking information as to what they are. Whether it's bath times and locations, or waking and eating times, you're on the spot to accommodate.
Furthermore, surveyors will be interviewing residents and their family members to make sure it's getting done.

Clearly, this is going to force many providers to become better and more service-oriented. As logistically challenging as it might be, this is not a bad thing. Efforts to institutionalize never met a bigger enemy than this new guidance.
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