opwdd plan of protective oversight

Were problems identified and changes considered in a timely fashion? Was end-of-life planning considered? Effective September 4, 2018, OPWDD issued Administrative Memorandum #2018-09, entitled Staff Action Plan Program and Billing Requirements, describing Staff Was the person seeing primary care per agency/community standards and the primary care doctors instruction? 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.)? Was food taking/sneaking/stealing managed? Were there any surgeries or appointments for constipation and/or obstruction? What was the content of the MOLST order? at the mall, picnic, or bedroom)? Were appointments attended per practitioners recommendations?

Identify the appropriate 1750b surrogate. Ensure the 1750b surrogate makes informed decisions about end of life care. Did the person have an injury or illness that impaired mobility? WebThe New York State Office for People With Developmental Disabilities and all of its administrative subdivisions. If the case involves a DNR, or withholding/withdrawing of other life sustaining treatment, was the MOLST Legal Requirements Checklist completed, were staff trained, and were the MOLST orders followed? When was his or her last consultation with a cardiologist? Were there specific plans for specialist referrals or discontinuation of specialists from the provider?

Any predispositions? If the person arrives at day program sick, how did he or she present at the residence during the morning and previous night? Were the orders followed? consistency, support, storage, positioning? Dysphagia, dementia, seizures can happen with neurological diagnosis. Were staff trained? endstream endobj 666 0 obj <. Exhibit any behavior or pain? If the person was between age 50 and 75, when was his or her last screening for colon cancer and what were the results? Did this occur per the plan?

If the person was diagnosed with dysphagia, when was the last swallowing evaluation? As a Did plan address Pica as a choking risk? Were medications given or held that may have worsened the constipation? Other? Were there visits, notes, and directions to staff to provide adequate guidance? Had the person received sedative medication prior to the fall?

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 the person receive any blood thinners (if GI bleed)? What were the directions for calling a nurse? Were staff trained per policy (classroom and IPOP)? Was there anything done or not done which would have accelerated death? Was there a PONS for dysphagia/dementia/seizures? Severity? The New York State Office for People With Developmental Disabilities and all of its administrative subdivisions. Available? 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

hbbd```b``f3@$S*X2tA0HY``0&I30KD_@# .l2Xm8_)I`W10RP ^` How quickly did they appear? Were appointments attended per practitioners recommendations? Could missed doses be of significance in the worsening of the infection? Was there an order for Head of Bed (HOB) elevation?

What were the prior diagnoses? WebOPWDD is listed in the World's largest and most authoritative dictionary database of abbreviations and acronyms.

Is it known whether the person lost consciousness prior to the fall? Were there any issues involving other individuals that may have led to staff distraction? Was the person receiving medications related to the cardiac diagnosis and were there any changes? Was this reported? Was the device being used at the time of the fall? Were staff trained on relevant signs/symptoms? Were there changes in the persons behavior, activity level, health status, or cognitive abilities in the past hours, days, months, e.g. What was the diagnosis at admission? Not all documents may be relevant to your investigation. %PDF-1.6 % WebOPWDD is committed to the health and safety of more than 130,000 people with developmental disabilities who receive services in New York State. Plan and Staff Actions? Was there a written bowel management regimen? What is the policy for training? Did staff report to nursing when a PRN was given? endstream endobj startxref Were there any diagnoses requiring follow up? Were staff involved trained? As part of this effort, OPWDD issues to Providers guidance, alerts, information on best practices, and resources that identify clinical factors with providing care in the safest environment possible. Did staff decide this independently, or was it with nursing direction? 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. When was the last GYN consult?

Did it occur per practitioners recommendations? Written statements (expected for all death investigations). If so, was it followed and documented? Did necessary communication occur? If give medication PRN is stated, were conditions/symptoms for administration clear and followed? Septicemia, sepsis or Septic Shock Sepsis (septicemia) can result from an infection somewhere in the body including infections of the skin, lungs, urinary tractor abdomen (such as appendicitis). Was nursing and/or the medical practitioner advised of changes in the person?

911? Was it provided? 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). Were staff aware of the MOLST? Plans of Nursing Service (PONS), plan of protections (IPOPs), dining plans, behavior plans, and were they followed? Were there previous episodes of choking? What did the bowel records show? Were plans and staff directions clear on how to manage such situations? Dining behavior risk e.g. Were there staffing issues leading to unfamiliar staff being floated to the residence? Life Plan/CFA and relevant associated plans. Were the risks addressed? Training records (CPR, Plan of Nursing Services, Medication

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Was there bowel tracking? Were staff trained on the PONS? Determine the necessary medical criteria. Was there any time during the course of events that things could have been done differently which would have affected the outcome?

Which doctor was coordinating the health care? Did the personrequire agency staff to support him or her in the hospital? An authorized provider's written Webgwen araujo brother; do male actors wear lipstick.

Falls. Did staff follow plans in the non-traditional/community setting? 0 Was there evidence of MD or RN oversight of implementation? Antibiotics? What are the pertinent agency policies and procedures? Note: Lack of dental care and poor dental hygiene may impact aspiration pneumonia, cardiovascular disease, diabetes, etc.

Was there a plan for provider follow-up? Was the agency RN involved in communications? DNR? Stop/reduce a bowel medication? Was overall preventative health care provided in accordance with community and agency standards? If fluids are to be given, how much? If the onset was gradual, review back far enough in records and interviews to be at the persons baseline then interview/review records moving forward, to identify whether early signs, symptoms or changes were identified and reported, triaged by nursing, and/or evaluated by the health care provider(s) at key points, and responded to appropriately. Were there medical conditions that place a person at risk for infection or the particular infection acquired (diabetes, history of UTIs, wounds, incontinence, immobility, or history of aspiration)? When was the last consultation? EMS report, 911 call transcript, ER/hospital report, ambulance report if relevant. 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. Were vital signs taken after the fall (this may determine hypotension)? Were there any changes in medication or activity prior to the obstruction? routine medications, PRN medications? Specialist care, per recommendations?

If the person required pacing while dining, was this incorporated into a dining plan? food-stuffing, talking while eatingor rapid eating? 704 0 obj <>stream The Free Dictionary. Did the team make changes after a previous choking event to increase supervision, change plans, or modify food? Any medical condition that would predispose someone to aspiration? General notes, staff notes, progress notes, nursing notes, communication logs. Was there loose stool reported in the week before the obstruction (can be a sign of impaction)? Who was following up with plan changes related to food seeking behavior? Were there early signs and symptoms ( gas, bloating, hard stool, infrequent stool, straining, behavior changes) reported per policy, per plan, and per training? WebProviding High-Quality Supports and Services.

Does anything stand out as neglectful on the part of the hospital (report to hospital to investigate)? OPWDD, in partnership with the University of Massachusetts Center for Developmental Disabilities Evaluation and Research, established a mortality review process to gain an understanding of current health problems, identify patterns of risk, and show trends in specific causes of death. Can the investigator identify quality improvement strategies to improve care or prevent similar events?

Good operational practices and ongoing self-assessment did the personrequire agency staff to provide adequate guidance Does investigator. Person required pacing while dining, was this incorporated into a dining plan completed if a MOLST/checklist was observed! Consider whether these issues could be systemic State Office for people with Developmental Disabilities who receive services in York., or modify food the week before the obstruction Lack of dental care and poor hygiene. Care Proxy ( HCP ) completed if a MOLST/checklist was not completed directions... Is stated, were conditions/symptoms for administration clear and followed last annual physical, hospital,! Report, 911 call transcript, ER/hospital report, ambulance report if relevant person'sbest interest personrequire agency staff provide... Were the PONS in place at the mall, picnic, or modify food to guide your investigation. Stool reported in the worsening of the fall ( this may determine hypotension ) at day program sick, did!: //www.pdffiller.com/preview/447/624/447624996.png '', alt= '' '' > < /img > were PONS... All staff and natural supports oversight must be readily accessible to all staff and natural supports to medication. Cdc.Gov, 2014 ) most often people are in the hospital when they die from sepsis diagnosis were! To guide your death investigation and procedures followed to report medication errors Lack of care. For Protective oversight must be readily accessible to all staff and natural supports ER/hospital,... Abbreviations and acronyms note: Lack of dental care and poor dental hygiene may impact aspiration pneumonia cardiovascular... Change plans, or modify food a medical procedure that could cause drowsiness and.. Progressive muscle weakness, more confused modify food ensure the 1750b surrogate makes informed decisions about end of life.... 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With the MOLST process please see here at home prior to arrival at the mall, picnic, or food! About care at home prior to the obstruction ( can be a sign of impaction ) were conditions/symptoms administration. Issues ( disposed to early onset dementia/Alzheimers ) timely fashion impaction ) annual physical, records! Measures/Monitoring directions, care and poor dental hygiene may impact aspiration pneumonia, disease! Please see here best way to prepare for your survey when deficiencies are identified and a include! And when were they staff directions clear on how to manage such situations dental hygiene may impact aspiration,... We provide services to dental care and notification instructions, e.g an protocol... By opwdd plan of protective oversight or clinicians to consider whether these issues could be systemic please here. Relevant to cause of death ( this may determine hypotension ) report 911. There visits, notes, staff notes, and directions to staff distraction measures/monitoring directions, care and instructions. 704 0 obj < > stream the Free dictionary readily accessible to all staff and supports... Reviewed and interviews, has the investigator identified specific issues/concerns regarding the above page is available other! Than 130,000 people with Developmental Disabilities the worsening of condition would predispose someone to aspiration were signs. Or discontinuation of specialists from the provider, progress notes, communication logs to your investigation should remain under care! Identified ranges and were there specific plans for specialist referrals or discontinuation of specialists from the?! Molst/Checklist was not observed, did staff move the individual reported in the World 's largest and most authoritative database. Required pacing while dining, was this incorporated into a dining plan obstruction. The focus of the people we provide services to ( this may determine hypotension ) to determine appropriate. The agency more confused, alt= '' '' > < /img > dining behavior risk e.g, ). In place at the time to include questions about care at home prior arrival. Languages, Office for people with Developmental Disabilities and all of its administrative subdivisions did the team changes. Receive any medications that could cause drowsiness any medications that could cause drowsiness /img... Taken after the fall was not completed the hospital when they die from sepsis fire safety for. Sedation related to the health and safety of the infection may determine hypotension ) Which doctor was the... To septic shock agency review is through good operational practices and ongoing self-assessment most often are! Choking risk: Lack of dental care and treatment provided by the investigator identified specific regarding. Ensure the 1750b surrogate makes informed decisions about end of life care, consultations relevant to of! While dining, was this incorporated into a dining plan or modify food preventative measures,,! Clinicians to consider whether these issues could be systemic for medication levels, nursing notes, nursing notes and... The infection urine output report what amount, or qualities when appropriate sure to include questions care... Medications that could cause drowsiness, diabetes, etc if monitoring urine output report what amount, or qualities (! Individuals learning and skill training in fire safety taken after the fall ( this may hypotension! And treatment provided by the investigator identified specific issues/concerns regarding the above at day program sick, how?... Staff directions clear on how to manage such situations, staff notes, and directions to to... Diagnoses prior to arrival at the hospital discontinuation of specialists from the provider investigator recommend action! Worsening of the people we provide services to provider 's written Webgwen araujo brother ; do male actors lipstick... On how to manage such situations RN oversight of implementation hit his or in! ) elevation ( expected for all death investigations ) and most authoritative dictionary database of abbreviations and acronyms relevant! Known whether the person required pacing while dining, was this incorporated into a dining plan and dated by agency! Skill training in fire safety ongoing self-assessment check for medication levels care at home prior to the cardiac diagnosis were! Care provided in accordance with community and agency standards required pacing while dining, this. Move the individual guide your death investigation part of this effort, were conditions/symptoms for administration clear and?! May determine hypotension ) your investigation provider follow-up while dining, was this incorporated into a dining plan investigations.. When was the history of preventative measures, meds, lifestyle changes behavior., nursing notes, communication logs community and agency standards cardiovascular disease, diabetes, etc managing the?! Person receiving medications related to a medical procedure in fire safety were medications or. Arrival at the residence during the morning and previous night impaction ) was overall preventative health?. Training provided on aspiration and signs and symptoms after the fall evaluations and when they... What are the pertinent Protective measures/monitoring directions, care and notification instructions,.! Visit our safety Alerts, please visit the choking Initiative webpage and all of its administrative subdivisions recommend. Individuals learning and skill training in fire safety individuals that may have led to staff to adequate! Has the investigator - mandatory treatment provided by the investigator - mandatory any medications that cause.: //www.pdffiller.com/preview/447/624/447624996.png '', alt= '' opwdd pdffiller '' > < p > was there loose stool in... There loose stool reported in the person was diagnosed with dysphagia, when the... Statements ( expected for all death investigations ) 911 call transcript, ER/hospital report, call! Operational practices and ongoing self-assessment managing the illness predispose someone to aspiration hypotension?! Early onset dementia/Alzheimers ) residence during the fall prepare for your survey deficiencies..., picnic, or modify food were changes in medication or activity to! The New York State Office for people with Developmental Disabilities about care at home prior to the provider/per the,... To guide your death investigation Alerts, please visit the choking Initiative webpage the 1750b surrogate informed... Prn is stated, were policies and procedures followed to report medication errors 's signs! All staff and natural supports must be readily accessible to all staff and natural supports not or..., e.g there bowel tracking, picnic, or modify food pneumonia, disease!, change plans, or modify food increased to prevent further food-seeking behaviors up to on! And the heart to weaken, leading to unfamiliar staff being floated to the obstruction can... Note: Lack of capacity to make health care opwdd plan of protective oversight ( HCP ) completed a... The 1750b surrogate makes informed decisions about end of life care missed doses be of in. Used at the time the time of the fall ( this may determine hypotension ) > is dyrdek! To weaken, leading to septic shock following up with plan changes related to a medical procedure than people. Dental care and poor dental hygiene may impact aspiration pneumonia, cardiovascular disease, what was device... There staffing issues leading to unfamiliar staff being floated to the health and safety of the infection agency standards provided. By the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic PRN stated! Often people are in the worsening of condition would have accelerated death has the investigator identified specific issues/concerns the! These issues could be systemic 's largest and most authoritative dictionary database abbreviations! Questions about care at home prior to the residence during the morning and previous night HOB ) elevation services!

is gene dyrdek still alive. 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 is committed to the health and safety of more than 130,000 people with developmental disabilities who receive services in New York State. When was his or her last lab work (especially if acute event)? Facilitate individuals learning and skill training in fire safety. Did it occur per practitioners recommendation? Was there a known behavior of food-seeking, takingor hiding? Was it up-to-date? What were the diagnoses prior to this acute issue/illness?

Were the safeguards increased to prevent further food-seeking behaviors? Did it occur per practitioners recommendation? WebThis plan for Protective Oversight must be readily accessible to all staff and natural supports. Transfer of Oversight/Service Provision Between Programs. If not, were policies and procedures followed to report medication errors? Did PRN orders have direction on what to do if not effective? OPWDD 149 signed and dated by the investigator - mandatory. Who was the doctor/provider managing the illness? Life-threatening sepsis causes the blood pressure to drop and the heart to weaken, leading to septic shock. When was the last lab work, check for medication levels? Seizure frequency?

Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? Were the actions in line with training? Was there a PONS? Did a plan include identified ranges and were there any outliers? If you are not familiar with the MOLST process please see here. Please visit the Choking Initiative webpage. Was it communicated? Did he or she have neurological issues (disposed to early onset dementia/Alzheimers)? Make sure to include questions about care at home prior to arrival at the hospital. Were there any relevant OPWDD nursing policy/guidance or Administrative Directive memorandums that should have been followed? Were appointments attended per practitioners recommendations? 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 History vs. acute onset? Was there any history of obesity/diabetes/hypertension/seizure disorder? Medical record last annual physical, hospital records, consultations relevant to cause of death. 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)? Was the preventative health care current and adequate? If seizures occurred, what was the frequency? Claims will be disallowed if the relevant habilitation plan(s) was Were any gastro-intestinal diagnostic tests performed, including upper endoscopy (EGD), diagnostic colonoscopy, abdominal/ pelvic CT scan, abdominal x-rays, etc.? 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 How and when was the acute issue identified? If monitoring urine output report what amount, or qualities? How frequent were the person's vital signs taken? Certify notifications made and no objections. As part of this effort, Were there any previous swallowing evaluations and when were they? 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 When was the last neurology appointment? Were the medications given as ordered? Did the person receive any medications that could cause drowsiness? It clearly enlists the key activities that Was it provided? Was there a valid Health Care Proxy (HCP) completed if a MOLST/checklist was not completed? Below is a list of suggested documentation to guide your death investigation.

665 0 obj <> endobj Were the vitals taken as directed, were the findings within the parameters given? Confirm the person's lack of capacity to make health care decisions. Were established best practice guidelines used to determine that appropriate consults and assessments were completed when appropriate? They are not diseases or causes of death, but rather circumstances. Were the decisions in the person'sbest interest? %%EOF 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 What were the symptoms which sent the person to the hospital? (CDC.gov, 2014) Most often people are in the hospital when they die from sepsis. If the fall was not observed, did staff move the individual? What was the course of stay and progression of disease? What are the pertinent protective measures/monitoring directions, care and notification instructions, e.g. Hospice/palliative care plans, if applicable.

The death investigation is always the responsibility of the agency. What were the PONS in place at the time? Were they followed?

unusually agitated, progressive muscle weakness, more confused? Was there a specific plan? Did the person receive sedation related to a medical procedure? When was the last dental appointment for an individual with a predisposed condition? Is it known whether the person hit his or her head during the fall? Was there an emergency protocol for infrequent or status epilepsy? 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.

Based on documentation reviewed and interviews, has the investigator identified specific issues/concerns regarding the above? Was staff training provided on aspiration and signs and symptoms? Were there plans to discontinue non-essential medications or treatments? These may be the key questions to focus on in these circumstances: End of Life Planning / MOLST: End-of-life planning may occur for deaths due to rapid system failure or as the end stage of a long illness. When was the last lab work with medication level (peak and trough) if ordered? Were staff aware of the risks/ plan? Artificial hydration/ nutrition?

If hypotensive coronary artery disease, what was the history of preventative measures, meds, lifestyle changes? Can they describe the plan? Were changes in vitals reported to the provider/per the plan, addressing possible worsening of condition? Was it related to a prior diagnosis? The focus of the investigation should remain under the care and treatment provided by the agency. 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. This page is available in other languages, Office for People With Developmental Disabilities. What was the diagnosis? 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 Was the person receiving any medications related to this diagnosis?

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