 · Organizational
Development
· Clinical Direction
· Quality Improvement
· Policy Consultation
· Regulation Compliance
· Survey Assistance
· Knowledgeable Support (PPS & Consolidated
Billing) |
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| The well being of facilities is as important to us as our
patients. Our services must be integrated into interdisciplinary
care in an emotionally healthy environment for both staff and
residents. Because communication is critical we have several
unique features to our service. We provide a written log as
well as a face to face exit conference at the end of each day
to enhance continuity of care. area clinical psychologist with
networked access to all case notes is available 24 hours a day
by pager/cell phone. We ask that each facility designate a clinical
liaison staff so that we begin each day with a brief update
on new referrals and residents under our care. |
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| Frequently Asked Questions |
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| Residents' behavioral/emotional problems
seem worse in certain situatons. How will you help? |
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| After we have assessed the resident and established a plan
of treatment, we establish a close working relationship with
the nursing staff and direct care staff and encourage them to
discuss their concerns and ask for suggestions. We provide case
management information to encourage follow through on interventions
and strategies. We assess environmental factors to determine
irritants and reinforcers which could impact on a resident.
Interventions such as altering a noise level or changing a meal
seating arrangement may eliminate a maladaptive behavior and
are far preferable to a restraining intervention. |
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| We will also consult with facility quality assurance and medical
staff to identify patterns and trends which affect residents
psychosocial well being and will participate in the development
and monitoring of solutions. |
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| Do you help with surveys? |
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| The clinical documentation requirements of the regulations
are carefully and uniformly met through the forms and educational
materials developed and used by PSYCHOLOGICAL TRANSITIONS. We
have participated in many state and federal surveys and are
available 24/7 to explain our services to surveyors. |
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| Can you help with residents who are
aggressive to each other or staff? |
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| When requested, we will review incident reports, assess the
resident,, and help develop individual clinical interventions
and behavior management strategies. We will address the underlying
reasons for maladaptive behaviors such as frustration, depression,
inadequate coping skills, medications reactions, comorbid physical
conditions, etc.. |
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| How do you handle restraints? |
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| Every alternative intervention should be attempted to manage
behavior. These include environmental, changes in staff interventions,
counseling, behavior management plans, etc. We are committed
to an integrated approach to management of residents' behavior
and emotional health which uses all interventions possible prior
to medications and during the course of use of pharmacological
treatment to minimize and/or eliminate the need. We are never
proponents of physical restraints to manage behaviors. |
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| We will review psychotropic medication trends and offer suggestions
for behavioral, environmental, and other interventions which
may allow reduction strategies. |
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| We have some residents with Alzheimer's
Disease who wander or become upset especially during ADLs. Can
they benefit from psychological services? |
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| Psychosocial interventions are extremely important and effective.
We have worked in facilities where aggressive incidents have
been reduced significantly. Although Alzheimer's Disease is
progressive and irreversible, and the victims have cognitive,
communication and perceptual losses, there is still a great
deal of emotional stress which does respond to treatment. We
have extensive experience and special training in the treatment
of residents with Alzheimer's Disease and related dementias.
We will work with residents to increase effective self expression,
to decrease frustration, to minimize effects of change or transfer
trauma, and to assist with management of catastrophic reactions. |
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| We will also work with families or support groups to increase
understanding of Alzheimer's Disease. |
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| How do you communicate with the facility
staff? |
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| We ask each facility to designate a contact person or persons
and we give them a brief exit interview after each day. We also
leave contact information for the MDS nurse to assist in accurate
case mix scores. |
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| We will also arrange with the facility to provide training
sessions with the staff if the facility wishes this or when
the resident might benefit from changes in staff conduct or
environmental changes. |
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| We will also attend care plan meetings when there are issues
relating to the resident's behavior or psychosocial well being.
We will meet with the treatment team when it is needed to coordinate
care or communicate goals and objectives. |
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| What type of documentation do you
provide? |
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| We always leave written notes covering each session. Our services
are based on a goal and measurable objective. We monitor progress
with performance based outcomes. Our documentation coordinates
with the care plan. All documentation is HIPAA compliant. |
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| What will your relationship be with
our physicians? |
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| We try to meet or talk by phone to attending physician to
introduce ourselves and our services. Our services are provided
only with a physician's order so effective communication is
essential. We also work with psychiatrists to make sure that
psychological services interface well with psychiatric interventions. |
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| When will you be at our facility? |
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| We can come to the facility on a regularly scheduled day,
usually weekly. We are available by phone 24/7 to help with
an emergency situation or behavioral crisis. |
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| Will the facility always have the
same psychologist? |
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| Absolutely. In addition to the doctoral level psychologist
providing services. Additionally, we have substitute coverage
available for vacations and illness. |
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| Do you have experience with the legislation
governing Long Term Care Facilities? |
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| We provide consultation regarding staff practice and compliance
with OBRA and state regulations. We have been involved with
OBRA since its promulgation and prior to that with the ICF-MR
legislation upon which OBRA was modeled. |
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| Do you have references whom we can
call? |
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| Yes. We will gladly provide you with the names and phone numbers
of administrators, directors of nursing, and other relevant
clinicians with who we currently provide services. |
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| Who does the billing? |
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| We do. We bill the appropriate responsible parties or the
insurance carriers such as Medicare, Medicaid, Blue Cross, Travelers,
etc. |
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| How do you decide which residents
to see? |
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| We see only residents who are referred by the designated clinician
or care team. We discuss the clinical reasons for the referral
and goals, and we terminate services when the goal is met or
when it seems likely that the resident has attained maximum
benefit from services. |
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