LTC Floor Rehabilitation

May 08, 2009 06:46 AM

by SitcomNurse

Anyone out there work in a Rehabilitatin center that is LTC?

I have posted to Rehab. Nsg., but cant seem to gt the information I am seeking.

I need information on a Restorative Nursing program, so I know im not going to get fired in 1 year!
I am creating a nursing rehab program from scratch, with the help of someone who also has never been in rehab nursing.

I have read the MDS(teach it for my facility) but it dosent give guidelines.

I want to know what kind of documentation is needed for a group program. Should there be seperate paperwork from the forms I already have the CNA's signing? (we do not have appointed RNA's) Does the documentataion need to be different? Other than the fact that there are only 2 people in the group(no more than 4 allowed) I still have the CNA's just documenting on the forms for accountability(CNA's not charting here, just flow sheet accountability).

currently I am charting weekly on certain persons who are in capture or Medicare/Caid issues. I know that this is not outlined either, but to follow progress, and report progress to change the plan of care.. that is what I am doing.

Even my DON has no advice for me on this. And I attended seminars before I was working on the 'launch' of this program, so, now my questions are different. Somehow I thought I would be able to find the answers, but I cannot!

Please help, Im most desperate!

Ruthiegal · May 08, 2009, 07:48 AM

Re: LTC Floor Rehabilitation

Try doing a google search for Restorative Nursing Program Guidelines. I just did and got 190,000 hits and some of the first web sites that come up look like they may have much of the information you seek.

barefootlady · May 08, 2009, 11:38 AM

Re: LTC Floor Rehabilitation

There will definately need to be some sort of work sheet for the CNA's who work rehab residents. If machines are applied, if machines are removed, residents compliance with rehab duties covered by CNA, braces, special supplies used and residents compliance with this, so many things to consider, so much to cover. Good luck.

lpnflorida · May 08, 2009, 07:36 PM

Re: LTC Floor Rehabilitation

http://app2.health.state.pa.us/commo...&COUNTY=BUTLER

The above link is to an inspection record of a facility who was sited for failure to provide restorative services, to the right it shows how they plan to rectify this. Perhaps this will give you a direction.

SitcomNurse · May 09, 2009, 08:39 AM

Re: LTC Floor Rehabilitation

Originally Posted by barefootlady

There will definately need to be some sort of work sheet for the CNA's who work rehab residents. If machines are applied, if machines are removed, residents compliance with rehab duties covered by CNA, braces, special supplies used and residents compliance with this, so many things to consider, so much to cover. Good luck.

I already have seperate sheets for the CNA's to use, aside from the regular flow care sheets they use, this is to distinguish the daily care from the NR care. No machinary yet, but I think in about 2 years, when the program is sucessful, I may be able to vie for a staff! Probably only a year after that I could actually have it!! lol.

Thanks for the well wishes!

SitcomNurse · May 09, 2009, 09:17 AM

Re: LTC Floor Rehabilitation

Originally Posted by Ruthiegal

Try doing a google search for Restorative Nursing Program Guidelines. I just did and got 190,000 hits and some of the first web sites that come up look like they may have much of the information you seek.

That was alot of information!!! Some of which I already have, and of course your smattering of job postings, seminar listings from 2004(I wanted to go!!) and advertisements for this book, that nursing facility, etc.

I have 5 good links that I will follow up on. after page 6, it gets all....advertisey..

I have looked up so many differen combinations of NR wording, but never those 4 in combination.

Lastly, even with the links that I saved, none of them acutally lays out a guideline for a group porgram.
They state the viability, state the fun, but not the documentation necessity.

One more lead to follow up on, And I sooooo appreciate everything that you had to offer!!

*noc4senuf* · May 13, 2009, 09:09 AM

Re: LTC Floor Rehabilitation

Since the RUGS rates change if they have qualifying rehab minutes, we have to prove that they are actually being done. We have a separate form for each type of rehab broke out into each day of the month which allows to show how many minutes they have received under each category.

cheleb61 · May 14, 2009, 06:43 PM

Re: LTC Floor Rehabilitation

In my facility we have a daily flow sheet for each resident on a Restorative program. The RNA documents the # of minutes each exrecise was performed. There is also a comments section where they are required to write how the person did the exercise, how many feet walked, etc. The form has a column for each day (Sun-Sat) and rows for different programs (PROM, AROM, Ambulation, Dining, etc). The Restorative Nurse has to do a weekly sumary on every resident in the program and a monthly summary on all Restorative Dining residents. Our charts actually have a Restorative section in them. I was in charge of the Restorative program so if you have any other questions, feel free to ask.

SitcomNurse · May 18, 2009, 01:07 PM

Re: LTC Floor Rehabilitation

Ok, so if im on the right track....
I have a MED A person, with about a 2 week turnover to the unit for the RUL category. Then it changes again.
On this person I am writing weekly notes.
On others, who are 'simply' nursing rehab, I am writing notes just about weekly, if not, then they are definately in a 10 day period. this is all well and good nw, but ultimately the charing will be only monthly or for maintenance persons, quarterly with the MDS. Since there is no definition for the program on charting other than 'periodically' this is what our building has decided on.
Of course if the program changes in any way, a note is written.

The forms I use now have 3 sections in them, for each shift or meal with initials and minutes recorded. Then the bottom has a total for minutes daily.

The top lists the program(ambulation, ROM, etc), the goals(specific to the program for that person) and any devices.(utencils, walkers, braces etc.)

For group, I do not have a seperate page or file, I do not mention the word group in any way, on any form. I only have 2 persons (so far) in the group, and the CNA documents for both of them. They are both on the same program(AROM to BLE), and adhere to the same documentation principals as noted above.

Does this sound reasonable? Am I leaving anything out?

sometimes God turns on the Sitcom Nurse channel. Its like Comedy Central for him.

cheleb61 · May 19, 2009, 05:36 PM

Re: LTC Floor Rehabilitation

That sounds reasonable to me. We only have to chart weekly because that is what corporate has said we must do.

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LTC Floor Rehabilitation

LTC Floor Rehabilitation

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