MDS Alert

Go above and beyond your facility’s official protocol to make nervous residents more comfortable.

Brush up on your facility’s disaster preparedness before the next hurricane, tropical snowstorm, or big snowstorm hits. Beyond the official plans and documentation required by CMS and your state, use these tips to make a very stressful situation and transition as smooth as possible.

Use these tips from an Emergency MDS Protocol for Texas update, prepared by Michelle nanney, Rn, RaC-Ct, MDS Clinical Coordinator for Texas Health and Human services, in Weimar, Texas, when the next dangerous forecast comes your way:

• If there’s a chance you’ll be transferring residents to another facility, print out hard copies of each resident’s current MDS and care plan. Start this process as soon as possible if the forecast suggests that your facility might have to evacuate.
• If you’re transferring residents to another facility within the same company, talk to your company’s corporate director if you can enable the electronic sharing of records and care plans for the duration of the weather event. (If this works out, you don’t need hard copies for each resident.)
• Ensure that your MDS data, clinical records, care plans, and any other pertinent information that is stored electronically is backed up with the most current versions. Back everything up again if you’re not sure.
• “Be mindful of the need for discharge assessments,” Nanney says. “If you document exactly where and when each resident was evacuated, you will be able to complete the records when the situation is more stable.”

Think about the probability that residents will be confused and might struggle with the suddenness and difference of an evacuation. CMS offers these tips for interacting with residents when planning for and experiencing emergency evacuation contingencies:

• Encourage residents to be open with expectations, anger, and disappointments.
• Focus on establishing and maintaining a high level of trust with residents
• Make sure your own attitude about a temporary relocation is optimistic when interacting with residents—  regardless of the stress you’re feeling.
• Plan for anxiety, especially if the resident already suffers from anxious episodes.
• Keep in mind, when interacting with residents, to help avoid negative interactions: do not argue, do not give orders, do not take the resident’s behavior personally during the event
• Remember to praise residents liberally, focus on being extra courteous and kind, and encourage the resident to feel part of the plans by having them help assess any issues and getting family involved.
• Start off new relationships on the right track by making sure staff at the receiving facility introduce themselves.

Make sure residents’ rights are prioritized and not forgotten, even when you and they are finding everything overwhelming. Stay attuned to these rights, in particular, per CMS’s guidelines:

• Residents should be updated and informed about the status of relocation.
• You or a team member should make sure that residents know about any options or alternatives for living arrangements during the evacuation.
• Seek out or involve an ombudsman or other resident advocate.
• Residents have the right to the same level of care and treatment/intervention.
• If a resident disagrees with anything about the relocation, produce a review of relocation changes.
• The resident (and you and staff) should expect that the resident’s rights won’t be violated regardless oflocation.

Find out more about CMS’s SNF disaster preparedness information here: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/Downloads/All-Hazards-FAQs.pdf