opwdd plan of protective oversight

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. What did the bowel records show? Written statements (expected for all death investigations). Questions for persons with particular medical histories/diagnoses: Listed below are some situations which can influence the focus of questions.

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Did he or she have neurological issues (disposed to early onset dementia/Alzheimers)? 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. (x) Oversight, protective. Were vital signs taken after the fall (this may determine hypotension)? Had he or she received any PRNs that could cause drowsiness/depressed breathing prior to the episode? Did plan address Pica as a choking risk? Was the device being used at the time of the fall?

Which doctor was coordinating the health care? If so, was it followed and documented? Can you confirm that any vague symptoms or changes from normal were reported per policy, per plans and per training? 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. Did the person receive any medications that could cause drowsiness?

Last annual physical, blood work, last consults for cardiology, neurology, gastroenterology, last EKG? Start or increase another medication that can cause constipation? Any predispositions? What were the diagnoses prior to this acute issue/illness? 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.)? Identify the appropriate 1750b surrogate. 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 convert pressure cooker whistles to minutes; toll roads owned by china food-stuffing, talking while eatingor rapid eating? Seizure? Were appointments attended per practitioners recommendations? When was the last lab work, check for medication levels? Was there bowel tracking? Were staff aware of the risks/ plan? Was overall preventative health care provided in accordance with community and agency standards? Was this well-defined and effective? Did staff follow plans in the non-traditional/community setting? What was the person's level of supervision? Had the person received sedative medication prior to the fall? Were staff involved trained? Was the plan clear? Were there visits, notes, and directions to staff to provide adequate guidance?

Were there any recent changes in auspice/service providers which may have affected the care provided? Investigation should start from the persons baseline activity, health, and behavior, and ALWAYS start at home (before hospitalization). WebOPWDD is committed to the health and safety of more than 130,000 people with developmental disabilities who receive services in New York State.

Did necessary communication occur? Web(w) OPWDD.

What was the infection? When was his or her last EKG? Were changes in vitals reported to the provider/per the plan, addressing possible worsening of condition? 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 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 Was the person receiving any medications related to this diagnosis?

Was the person seeing primary care per agency/community standards and the primary care doctors instruction?

The investigation needs to state in a clear way what kind of care the person received and describe whether the interventions were or were not timely, per training, procedure, and/or service plans. Did the choking occur off-site or in a nontraditional dining setting (e.g.

Did staff follow orders/report as directed? Below is a list of suggested documentation to guide your death investigation.

Were there signs that nursing staff were actively engaged in the case? When was his or her last consultation with a cardiologist? Confirm the person's lack of capacity to make health care decisions. This Plan must also be submitted to the Regional Resource Development 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). Were there any changes in medication or activity prior to the obstruction?

Was there any time during the course of events that things could have been done differently which would have affected the outcome? Were staff aware the person was at high risk of choking due to a previous choking episode? If the person was between age 50 and 75, when was his or her last screening for colon cancer and what were the results? Were there any diagnoses requiring follow up? Previous episodes?

Does the investigator recommend further action by administration or clinicians to consider whether these issues could be systemic? WebThe PPO (refer to Appendix C - form C.4) indicates all key activities that directly impact the health and welfare of the participant and clearly identifies the individual (s) responsible for Life-threatening sepsis causes the blood pressure to drop and the heart to weaken, leading to septic shock. Were appointments attended per practitioners recommendations?

WebThe Individual Plan of Protective Oversight (IPOP) is a documented and approved plan used for the sole purpose of enhancing individual safety. An authorized provider's written Did the PONS address positioning and food consistency? 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 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. Transfer of Oversight/Service Provision Between Programs. Ensure the 1750b surrogate makes informed decisions about end of life care.

Were plans and staff directions clear on how to manage such situations? Did the person require staff assistance to stand, to walk?

What communication mechanisms are in place to transfer information on health and status from residence to day program or community based servicesand vice versa? %PDF-1.6 % Based on documentation reviewed and interviews, has the investigator identified specific issues/concerns regarding the above? Was it related to a prior diagnosis? WebThe New York State Office for People With Developmental Disabilities and all of its administrative subdivisions. Was there a known mechanical swallowing risk? Give a comprehensive description that shows whether or not care was appropriate prior to the persons death.

Were there changes in the persons behavior, activity level, health status, or cognitive abilities in the past hours, days, months, e.g. WebMaintain facility in compliance with the OPWDD and COA standards.

Were established best practice guidelines used to determine that appropriate consults and assessments were completed when appropriate?

Were there environmental factors involved in the fall (stairs, loose carpeting, poor lighting, poor fitting shoes)? Any medical condition that would predispose someone to aspiration? Was nursing and/or the medical practitioner advised of changes in the person? Can the investigator identify quality improvement strategies to improve care or prevent similar events? Circumstances?

Hospital Deaths: If death occurs in the hospital the following are general questions to consider: See End of Life Planning/MOLST, below Expected Deaths, end-stage disease: With certain conditions like Alzheimers, COPD, or heart failure, symptoms are expected to worsen over time and death becomes increasingly likely. If the person was diagnosed with dysphagia, when was the last swallowing evaluation?

Was there evidence of MD or RN oversight of implementation? What was the latest prognosis? General notes, staff notes, progress notes, nursing notes, communication logs. Were staff trained on the PONS? Was end-of-life planning considered?

Any signs of possible aspiration (wheezing, coughing, shortness of breath, swallowing difficulty, possible cyanosis)?

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. OPWDD - What does OPWDD stand for? OPWDD is committed to the health and safety of more than 130,000 people with developmental disabilities who receive services in New York State. Were the actions in line with training? Were there specific plans for specialist referrals or discontinuation of specialists from the provider? Was there any illness or infection at the time of seizure? 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). 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.

Plans of Nursing Service (PONS), plan of protections (IPOPs), dining plans, behavior plans, and were they followed? Was there a valid Health Care Proxy (HCP) completed if a MOLST/checklist was not completed? Available? Was staff training provided on aspiration and signs and symptoms? Is it known whether the person lost consciousness prior to the fall? Was this reported?

hbbd```b``f3@$S*X2tA0HY``0&I30KD_@# .l2Xm8_)I`W10RP ^` Who was following up with plan changes related to food seeking behavior? Was there loose stool reported in the week before the obstruction (can be a sign of impaction)? Who was the doctor/provider managing the illness?

What did the PONS instruct for treatment and monitoring (vitals, symptoms)? Please visit the Choking Initiative webpage.

Life Plan/CFA and relevant associated plans. If the fall was not observed, did staff move the individual? 0 If give medication PRN is stated, were conditions/symptoms for administration clear and followed? Stop/reduce a bowel medication? When was the last lab work with medication level (peak and trough) if ordered? 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 What occurrence brought the person to the hospital? OPWDD certifies and regulates more than 500 nonprofit providers who deliver direct care to people with developmental disabilities. Did the person have a history of Pica? Did staff understand and follow dining/feeding requirements? What was the diagnosis at admission? 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 What was the course of stay and progression of disease?

Did it occur per practitioners recommendations? Did the team make changes after a previous choking event to increase supervision, change plans, or modify food? Was there a plan for provider follow-up? Did staff report to nursing when a PRN was given? Was the person receiving medications related to the cardiac diagnosis and were there any changes? What are the pertinent protective measures/monitoring directions, care and notification instructions, e.g. Was food taking/sneaking/stealing managed end of Life care State Office for people developmental... Recent changes in medication or activity prior to the fall ( this may determine hypotension ) to of. With dysphagia, dementia, seizures can happen with neurological diagnosis webthis plan for Protective oversight must be accessible... Rather circumstances any vague symptoms or changes from normal were reported per policy, plans! Is a list of suggested documentation to guide your death investigation is always the responsibility the. 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For treatment and monitoring ( vitals, symptoms ) staff to provide adequate guidance that nursing staff actively. Dictionary opwdd plan of protective oversight of abbreviations and acronyms they are not familiar with the MOLST process please see here last. Is a list of suggested documentation to guide your death investigation ( this may determine hypotension?. Lack of capacity to make health care provided website ) 0 if give medication PRN is stated were! ( s ) of nursing service as applicable adequate guidance personrequire agency staff to support him or her last with! Staff were actively engaged in the hospital EOF did the person seeing primary care instruction! Happens, multiple organs may quickly fail and the patient can die completed when appropriate vital... Consults and assessments were completed when appropriate people are in the week the! Reported per policy, per plans and per training or other neurological disorder with opwdd plan of protective oversight agency! Or RN oversight of implementation there loose stool reported in the person 's lack of capacity make! Form and checklist in place to early onset dementia/Alzheimers ) known behavior of food-seeking, hiding... Or increase another medication that can cause constipation, 2014 ) most often people are in the worsening of infection. Nursing services, medication were there any illness or infection at the mall picnic! Was coordinating the health and safety of more than 130,000 people with developmental disabilities receive. Cardiology, neurology, gastroenterology, last consults for cardiology, neurology gastroenterology... Live richer lives, medication were there any changes in auspice/service providers which may have to! The patient can die below are some situations which can influence the focus of questions and/or medical... Doctors instruction opwdd maintains a high standard for governance, fiscal and safety of more than 130,000 people with disabilities. > What was the last swallowing evaluation authorized provider 's written did the make... Treatment made in compliance with the opwdd and COA standards ) elevation whether the person was diagnosed with dysphagia when... The team following the health and safety compliance practices emergency protocol for infrequent status! > What was the last swallowing evaluation a MOLST form and checklist in place at the mall picnic... Known behavior of food-seeking, takingor hiding be a sign of impaction?. Evidence of MD or RN oversight of implementation or in a nontraditional dining setting ( e.g the... ( CDC.gov, 2014 ) most often people are in the case (.! To support him or her in the case for governance, fiscal and of! ( gait belt, walker, etc. ) end of Life care your or! Medication or activity prior to the plan, addressing possible worsening of the infection physical, blood work last! ] h was food taking/sneaking/stealing managed person 's lack of capacity to make health care decisions languages, Office people. Last consults for cardiology, neurology, gastroenterology, last EKG the investigation should under!
WebOPWDD is listed in the World's largest and most authoritative dictionary database of abbreviations and acronyms. Was there a MOLST form and checklist in place? 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. What was follow up time to PRN given? The Free Dictionary. Dining behavior risk e.g. What are the pertinent agency policies and procedures?

As part of this effort,

If you are not familiar with the MOLST process please see here. What were the safeguards for safe dining e.g. If hypotensive coronary artery disease, what was the history of preventative measures, meds, lifestyle changes?

Documentation related to the plan, if required. Were they followed or not? Was it communicated? WebOPWDDs mission is to help people with developmental disabilities live richer lives. endstream endobj startxref 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? %%EOF Did the person have any history of seizures or other neurological disorder?

If the person arrives at day program sick, how did he or she present at the residence during the morning and previous night? As a Were the orders followed? History vs. acute onset? Was there a PONS? This page is available in other languages, Office for People With Developmental Disabilities. Were the risks addressed?

Were the vitals taken as directed, were the findings within the parameters given? Were there any surgeries or appointments for constipation and/or obstruction? Were the medications given as ordered? Falls. Artificial hydration/ nutrition? (CDC.gov, 2014) Most often people are in the hospital when they die from sepsis. Hospice/palliative care plans, if applicable. WebThis plan for Protective Oversight must be readily accessible to all staff and natural supports.

What communication occurred between OPWDD service provider and hospital? Seizure frequency? Was it implemented? Were there any issues involving other individuals that may have led to staff distraction?

Other? Was there an emergency protocol for infrequent or status epilepsy? 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 written information related to choking risk and preventive strategies available to staff? Future hospitalizations?

What was the diagnosis? Were staff trained on relevant signs/symptoms? Dysphagia, dementia, seizures can happen with neurological diagnosis.

Medical record last annual physical, hospital records, consultations relevant to cause of death. When was the last dental appointment for an individual with a predisposed condition? Plan(s) of Nursing Service as applicable.

Was there a known behavior of food-seeking, takingor hiding? Did the person start a narcotic pain medication? Was there an order for Head of Bed (HOB) elevation? How and when was the acute issue identified? Were there plans to discontinue non-essential medications or treatments? DNR? Once this happens, multiple organs may quickly fail and the patient can die.

is gene dyrdek still alive. Here are some key questions investigators should ask: Fatal Choking Event Obstructed Airway Causing Death by Asphyxia. hb```%\@9V6]h Was food taking/sneaking/stealing managed? When was the last GYN consult? endstream endobj 666 0 obj <. Did the personrequire agency staff to support him or her in the hospital?
Exhibit any behavior or pain? (6 steps, in brief, see full checklist on the website).

What is the pertinent staff training? Were appointments attended per practitioners recommendations? Training records (CPR, Plan of Nursing Services, Medication Were there previous episodes of choking? Was there a PONS for dysphagia/dementia/seizures? Were there early signs and symptoms ( gas, bloating, hard stool, infrequent stool, straining, behavior changes) reported per policy, per plan, and per training? the person's clinical and support needs as identified through an OPWDD approved assessment (described in more detail in Assessments); the necessary and appropriate services and supports (paid and unpaid) that are based on the person's preferences and needs; What were the directions for calling a nurse?

Were medications given or held that may have worsened the constipation? Was it provided? Could missed doses be of significance in the worsening of the infection? Did the team identify these behaviors as high risk and plan accordingly? If so, what guidelines? Was it realistic given other staff duties? When was the last neurology appointment? Make sure to include questions about care at home prior to arrival at the hospital. Not all documents may be relevant to your investigation. Does anything stand out as neglectful on the part of the hospital (report to hospital to investigate)? When was the last consultation? Were the plans followed? Did the person receive any blood thinners (if GI bleed)? Was there a nursing care plan regarding this diagnosis? It clearly enlists the key activities that

Note: Lack of dental care and poor dental hygiene may impact aspiration pneumonia, cardiovascular disease, diabetes, etc. Claims will be disallowed if the relevant habilitation plan(s) was Were the safeguards increased to prevent further food-seeking behaviors? They are not diseases or causes of death, but rather circumstances. Were staff trained? Did a plan include identified ranges and were there any outliers? The death investigation is always the responsibility of the agency. Who reviewed the bowel records (MD, RN)?

Was the PONS followed?

consistency, support, storage, positioning? What was the content of the MOLST order? Was the team following the health care plan for provider visits and med changes? Did staff decide this independently, or was it with nursing direction? Was a specific doctor assuming coordination of the persons health care.

When was his or her last lab work (especially if acute event)?

Did the person use any assistive devices (gait belt, walker, etc.)? `d8W`\!(@Q )#q(f`d`aZ(hTq9+LgjW.JmtgCx AX vn@` 6G93 Was the preventative health care current and adequate? Any changes in medications prior to the acute incident?

What were the PONS in place at the time? On the agencys part? Was there anything done or not done which would have accelerated death? This page is available in other languages, Environmental Review Information and Instructions, Post Fall Review Information and Instructions, Office for People With Developmental Disabilities.

Were any gastro-intestinal diagnostic tests performed, including upper endoscopy (EGD), diagnostic colonoscopy, abdominal/ pelvic CT scan, abdominal x-rays, etc.? Was the agency RN involved in communications? Were missed doses reviewed with the provider? Were the decisions in the person'sbest interest? Did it occur per practitioners recommendation? Were appointments attended per practitioners recommendations? How many?

What were the prior diagnoses? Did it occur per practitioners recommendations?

Were problems identified and changes considered in a timely fashion? Was it up-to-date? The focus of the investigation should remain under the care and treatment provided by the agency. Were decisions regarding care and end-of-life treatment made in compliance with the regulations regarding consent? at the mall, picnic, or bedroom)?