The Power of Care Planning

The person-centered care plan has always been the guide with which successful facilities provide quality care to their residents. Updates to the Quality Reporting Program, implementation of the Patient-Driven Payment Model (PDPM) in October, and phase three of the Requirements of Participation (RoP) scheduled for implementation November 28th, ensure the person-centered care plan will continue its prevalence in the spotlight.

Care planning involves assessing the resident’s needs, health status, personal preferences, religious and cultural beliefs and discharge destination in order provide the best possible individualized care. Trauma-informed care focuses on reducing triggers and re-traumatization. The goal of care planning is to develop a comprehensive plan that the interdisciplinary team (IDT) can then implement. Ensuring receipt of all relevant medical records is vital in determining how to best care for the individual. Additionally, the IDT members must be involved early in the process to identify areas of risk and interventions that are specific to their discipline or department and enhance quality of care for the individual. The goal is for each team member to bring those elements to the table for the IDT meeting in order to determine service provision under the PDPM and to accurately care plan person-centered, trauma-informed services for seamless implementation.

Therapists are uniquely qualified to assess the needs of the resident and identify individualized intervention strategies specific to their discipline; therefore, in most cases, therapy should highly influence the care planning process so that patients and facilities experience successful outcomes. Notification of admission, staff scheduling, and medical record availability is imperative to gathering accurate information for the MDS, baseline care plans and IDT education. Providing trauma-informed care is yet another aspect of care planning that is vital to patient success. Ensure processes are in place to promote IDT collaboration to determine the best approaches for each individual.

This month take opportunities to assess and refine these processes. Ensure all team members have influence at the IDT table as each person’s input is invaluable to identification of service provision under the PDPM and person-centered treatment strategies for the care planning process in order to safeguard positive patient outcomes and satisfaction.

Click here to access the final rule regarding the Requirements of Participation.

Texting and Protected Health Information

Did you know basic text messaging of Protected Health Information (PHI), including texting pictures of patients, is not HIPAA compliant?  People sometimes think the main reason texting is not compliant is because texts are sent without any encryption.  However, the biggest reason is we cannot guarantee or prove who will be accessing this information. 

HIPAA also mandates other technical safeguards when it comes to the electronic transmission of PHI1.  Here are some other reasons why text messaging is not compliant:

  • Access to PHI should be limited to authorized users who require the information to do their jobs.  With text messaging, we cannot guarantee who is accessing this information.
  • A system should be implemented to monitor the activity of authorized users when accessing PHI.  Cell phones do not provide the capability of logging all activity, especially when it comes to inappropriate access. 
  • Those with authorization to access PHI should authenticate their identities with a unique, centrally issued username and PIN.  Personal cell phones can be set without a PIN to access them, and, when utilized, PIN numbers do not indicate which user was using the phone.
  • Policies and procedures should be introduced to prevent PHI from being inappropriately altered or destroyed based on regulations.  Text messages can be altered or deleted, preventing the ability for retrieval.
  • Data transmitted beyond an organization´s internal firewall should be encrypted to make it unusable if it is intercepted in transit.  Simple Messaging Services (SMS) is the normal text messaging service and it transmits unencrypted, making it easy for others to gain access to this information. 

It is very important not to use text messaging to discuss any patient care, especially in providing PHI or pictures of patients. 

Reliant’s Use of E-mail and Text Messaging Policy (3.8) provides guidance to employees, contractors, volunteers, and trainees in proper use and safeguarding of electronic communications.