MEDR 4514 — Module 8 basics?? i suppose?
What three coding systems but employees of ICF/IID facilities be familiar with?
- ICD-9-CM - ICD-10-CM - DSM-5
What accreditation groups are available to facilities serving persons with intellectual or developmental disabilities?
- The Joint Commission (TJC) - Council on Quality and Leadership (CQL)
What legal issues must be considered in the ICF/IID?
- confidentiality - protection of records - written policies and procedures - record retention
In what areas may risk management be involved in the ICF/IID?
- deaths - incidents and accidents - method of correcting errors - editing documentation in records - use of technology
How are individuals referred to in the ICF/IID?
- medical model: patients - developmental model: individual, person
The publisher of Intellectual Disability: Definition, Classification, and Systems of Supports, Eleventh Edition is ________________________.
American Association on Intellectual and Developmental Disabilities (AAIDD)
_______________________ are personnel whose daily responsibility is to manage, supervise, and provide direct care to individuals in their residential living units.
Direct care staff
An ICF/IID differs from other healthcare facilities in that ICF/IID clients receive no training in activities of daily living. (T/F)
False
For security purposes, no part of the individual's record is stored on the person's living unit at any time. (T/F)
False
Reimbursement for intellectual disabilities services is usually a capitation payment, which is an easily determined amount based on services received. (T/F)
False
_______________ is the process by which a person is assisted to acquire and maintain life skills that enable the person to cope more effectively with personal and environmental demands and to raise the level of his or her physical, mental, and social efficiency.
Habilitation
standing orders
individualized forms listing medications, contraindications, allergies, etc.
The preferred term for significant limitations in both intellectual functioning and adaptive behavior expressed in conceptual, social, and practical adaptive skills and age of onset before the age of 18 is _____________________.
intellectual disability
In an ICF/IID, the individualized program plan is developed by the ___________________.
interdisciplinary (ID) team
order sheets
list every medication that the person is taking, along with a corresponding diagnosis
The Joint Commission would accredit an ICF/IID using its ________________________.
Standards for Behavioral Health Care
A qualified developmental disabilities professional (QDDP) is responsible for coordinating and monitoring each individual's active treatment program. (T/F)
True
DSM-5 recognizes four degrees of severity of intellectual disabilities: mild, moderate, severe, and profound. (T/F)
True
ICF/IID client records are often divided into three sections—administrative, health, and habilitation/training sections. (T/F)
True
Interdisciplinary team meetings may be informally referred to as staffings. (T/F)
True
Medicaid (Title XIX) provides most funding for ICF/IIDs. (T/F)
True
The Council on Quality and Leadership publishes its accreditation standards for facilities for individuals with intellectual disabilities in a document called Personal Outcome Measures. (T/F)
True
The United States Supreme Court has ruled that the Americans with Disabilities Act may require states to provide community-based services rather than institutional placements for individuals with disabilities. (T/F)
True
individual program plan (IPP)
a comprehensive written document that states the specific objectives necessary to meet the individual's needs, as identified by a comprehensive individualized assessment - the major tool in planning and implementing the care and services rendered to the individaul
active treatment
a continuous program for each recipient, which includes aggressive, consistent implementation of specialized and generic training, treatment, health services, and related services
developmental disability
a disability attributable to a mental or physical impairment that begins before age 18 and is likely to continue indefinitely, and that results in substantial functional limitation in three or more areas of major life activity
intermediate care facility for individuals with intellectual disabilities (ICF/IID)
a facility that provides care and training for persons with intellectual disabilities, to increase their adaptive skills — self-care skills, language skills, social skills, vocational skills, etc.
Home and Community Based Services (HCBS) Waiver
a federal program that allows states to use Medicaid funding to serve persons in their own homes and communities, not just in institutional settings
chronological drug regimen review
a form that is used monthly by the consultant pharmacist, who conducts a review not only of the medication and administration of drugs but also of specific protocols that staff members are required to follow in using the medications prescribed for the individual
interdisciplinary (ID) team
a group that develops an integrated habilitation or program plan that provides individualized services to the individual
qualified developmental disability professional (QDDP)
a person assigned to monitor and coordinate all activities related to the development and implementation of the individual program plan
person-centered planning
a process that focuses on the preferences of the individual who is receiving services in planning the type of future life the individual wishes to live
person-centered thinking
a set of values, skills, and tools used in person-centered planning
training objective
a single outcome expected to be achieved by the individual within one year as a result of training — measurable outcome, criteria for measuring progress, and projected completion date should be specified relative to strengths, needs, and established goals
Inventory for Client and Agency Planning (ICAP)
a standardized assessment instrument that can be used for program planning and also is used in several states as a data collection tool for case-mix reimbursement to ICF/IID organizations
Who determines whether a given individual needs the type of specialized services provided by an ICF/IIC?
a state's mental health or intellectual disability authority
medication administration record (MAR)
a tool used by nursing staffs to initial for the medication administered during their shift; the reverse side of the form is used to explain why medications were not administered (person was out on pass, NPO - nothing by mouth - prior to surgery, person refused medication) - director of nursing and pharmacist use this form in their medication reviews, to check for problem areas, for incidents in medication administration, and in guidelines when inservice training or other corrective measures are required
core team summary sheet
a tracking form used to implement the individual program plan (IPP) - as the staff identifies needs, they are added to the sheet - because it is a working tool used by the staff, there is no problem with "write-overs" and strikeouts to indicates when goals have been met or when new information is added
The effect of the Olmstead ruling on services for individuals with intellectual disabilities has been ____________________. a. an increase in community-based services b. a decrease in services available to individuals c. a decrease in individuals requiring services d. an increase in institutional-based services
a. an increase in community-based services
In an ICF/IID, the most active portion of the individual's record is ___________________. a. housed on the living unit b. maintained in original form for 21 years past the statute of limitations c. microfilmed or imaged weekly d. housed in the HIM department
a. housed on the living unit
List three administrative staff members.
administrator, finance officer, and human resources staff.
the updating worksheet
an electronic application used by the interdisciplinary (ID) team at the full-team meetings for updating the person's record in specific service areas - captures the services rendered and the staff member responsible for providing each service - provides the capability of immediately making these changes in the person's individual program plan (IPP)
annual staffing
an informal term for the annual meeting of the interdisciplinary (ID) team during which the individual program plan (IPP) is reviewed and revised for the coming year - not to exceed 365 days from the previous annual or initial staffing
How is reimbursement to the ICF/IID handled in most states? a. The ICF/IID receives payment for each item of service provided according to a statewide fee schedule. b. The ICF/IID receives a capitation payment for each individual in its geographic region. c. The ICF/IID receives a per diem payment for each day of service to each individual resident. d. The ICF/IID receives a DRG payment for each episode of care.
c. The ICF/IID receives a per diem payment for each day of service to each individual resident.
medication worksheet
computerized summary used by the nursing staff to assist in the review and audit of medication administration
The Scales of Independent Behavior-Revised (SIB-R), the Vineland Adaptive Behavior Scales, the AAIDD Diagnostic Adaptive Behavior Scales (DABS), and the Inventory for Client and Agency Planning (ICAP) are ____________________. a. used to document the services planned to achieve program goals b. electronic health record products for the ICF/IID setting c. flowsheets maintained by nursing staff d. standardized assessments
d. standardized assessments
draft referral to staffing
form used throughout the year to provide updates to the current individual program plan (IPP) - eventually becomes a part of the permanent record as an addendum to the current staffing, which illustrates that program updates have been initiated and approved by appropriate staff members
The ____________-centered approach to habilitation has been instrumental in improving the services rendered to individuals with intellectual disabilities and identifying the least restrictive program alternative.
person
direct care staff
personnel whose daily responsibility is to manage, supervise, and provide direct care to individuals in their residential living unit
seizure chart
provides documentation on individuals with convulsive disorders - allows recording of the frequency, time of day, and kinds of seizures, and can assist the staff in adjusting medication for the control of seizures
Name three types of caregivers that help individuals with intellectual disabilities
psychologist, speech language pathologist, and special education staff.
restraint documentation
required in the tracking of restraint use and become valuable in addressing such issues on a timely basis, such as in quarterly summary reviews
Studying incident and accident reports to identify patterns and reduce hazards is a function of ______________________.
risk management
influenza vaccine authorization and administration record
serves a dual purpose - sent to the family to obtain permission or refusal for giving the person the flu vaccine - if response is affirmative, used to document administration of the vaccine
One difference in the way that services rendered to an ICF/IID client differ from those in other settings is that in the ICF/IID setting, __________________.
services must include training
intellectual disability
significant limitations in both intellectual functioning and adaptive behavior expressed in conceptual, social, and practical adaptive skills, and having an onset before the age of 18
With regard to placement of an individual in an ICF/IID setting, _____________________.
such placements should not be considered permanent, because the goal of training is to move the individual to a less restrictive setting
What is cited as the source of definitions of intellectual disability in the Code of Federal Orgainzations?
the Manual on Terminology and Classification in Mental Retardation, published in 1983 by the American Association on Mental Retardation, now the American Association on Intellectual and Developmental Disabilities (AAIDD)
habilitation
the process by which a person is assisted to acquire and maintain life skills that enable the person to cope more effectively with personal and environmental demands and to raise the level of their physical, mental, and social efficiency - include, but is not limited to, programs of structured education and training
assessment
the process of identifying an individual's functional level, strengths, needs, causes of disabilities, and conditions that hinder development
A ___________________is a single outcome expected to be achieved by the individual within one year, as a result of training. Measurable outcome, criteria for measuring progress, and projected completion date should be specified relative to strengths, needs, and established goals.
training objective
individual medication and chart audit review summary
used on a monthly basis to audit services provided to the person, such as medications and behavior monitoring activities
transportation request form
used when the individual must obtain healthcare services in the community - not only a request but actually is required for accounting purposes
medication destruction record
used when the medication becomes outdated or unused quantities of medication must be destroyed
self-administration of medication progress form
valuable for recording an individual's skill in self-medication administration
discharge from facility release of responsibility and medication form
vital when individuals leave the facility and medication is being administered - often, medication issues can be addressed and the staff alerted to possible medication problems through use of this form - the medication count can reveal if the individual was overdosed, underdosed, or the medication was not given correctly
24-hour active treatment schedule
works in conjunction with the individualized program plan and the summaries - specifically sets into timeframes the who, what, why, when, and where of the individual's treatment program - often used by surveyors to ensure that a service or activity si being followed by the direct care staff
my quiz questions and answers
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my ~notes~ of chapter content
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questions i found online that relate to the chapter content
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The ______________________ is a standardized assessment instrument that can be used for program planning and is also used in several states as a data collection tool for case mix reimbursement to ICF/IID organizations.
Inventory for Client and Agency Planning (ICAP)
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is mainly used by _____________________.
psychologists and psychiatrists
With regard to development of forms for the ICF/IID record, _____________________.
the health information director should be an active participant in the establishment of standardized forms
Which accrediting agency for organizations that provide services to individuals with intellectual disabilities is sponsored by the American Association on Intellectual and Developmental Disabilities, American Network of Community Options and Resources, The Arc, Autism Society of America, Mosaic, National Association of QDDPs, Self Advocates Becoming Empowered, and United Cerebral Palsy Associations, Inc.?
Council on Quality and Leadership (CQL)