Presentation on theme: "Making the Transition from Activities to Recreational Therapy and Activities October 2010 MDS 3.0."— Presentation transcript:
1Making the Transition from Activities to Recreational Therapy and Activities October 2010MDS 3.0
2The Purpose of Activities in the Nursing Home Prior to OBRA ’87,To divert attention and fill the time.After OBRA ’87Elevated services to provide therapeutic programs to meet the physical, mental, and psychosocial needs as well as providing diversional activities to meet the interests of residents.
3New Survey GuidelinesCMS revised the interpretive guidelines for F248 which became effective June 1, 2006.These guidelines emphasize:Comprehensive assessment to determine mental, physical, and psychosocial needsIndividualized interventions to meet the identified needsAs well as the interests of each resident.
4Recreational Therapy A key component in meeting these guidelines and providing the highest qualityof care to the residentsof nursing facilities.
5What is Recreational Therapy? “Therapy ordered by a physician that provides therapeutic stimulation beyond the general activity program in a facilityandphysician ordered services which must include the frequency, duration, and scope of treatment.”-Centers for Medicare and Medicaid (CMS)
6Minimum Requirements of a Recreational Therapist State license or national certification as a Certified Therapeutic Recreation Specialist (CTRS) or Therapeutic Recreation Assistant working under the direct supervision of a CTRS.-CMS
7Recreational Therapy services are treatment services designed “to restore, remediate, or rehabilitate in order to improve functioning and independenceas well as reduce or eliminatethe effects of illness or disability.”American Therapeutic Recreation Association
8Recreational Therapy Active treatment provided: In a small group (1 to 4 staff to client ratio)or in a one-to-one settingUsed to meet a care plan goal or objectiveWith a reasonable expectation for improvementTime limited
9Benefits & OutcomesReduces falls and injuries related to falls (Buettner, 2001).Reduces disturbing behaviors exhibited by individuals with dementia which leads to decreased use of psychotropic medications and chemical restraints (Buettner & Fitzsimmons, 2003; Buettner, Fitzsimmons, & Atav, 2006; Fitzsimmons & Buettner, 2003a).
11Benefits and OutcomesImproves muscle strength and balance (Sayers, 2005; Mobily, Mobily, Raimondi, Walter, & Rubenstein, 2004; Wolf, Feys, De Weerdt, van der Meer, Noom, Aufdemkampe, 2001).Improves functional abilities whichresults in decreased use of nursing resources.allows individuals to live in lesser level of care (ATRA, n.d.)
12Benefits & OutcomesTeaches skills needed to return to the community through community reintegration programs (Lewis, 2006)Addresses clinical issues identified by the Quality Indicators offering non-pharmacological interventions (Buettner, 2000).Improves subjective well-being and quality of life (Janssen, 2004; Richeson & McCullough, 2003).
13Current & Future Implications for Recreational Therapy MDS 2.0Recreational Therapy included under Section T as a data gathering tool but does not impact RUG scores.Recreational Therapy influence RUG scores through participation in Restorative Nursing programs.
14In The Future…October 2010 and Beyond MDS 3.0Recreational Therapy is included in Section O. which includes other rehabilitative therapies (Physical Therapy, Occupational Therapy, Music Therapy and Speech Therapy).Will impact the RUG scores affecting the level of Medicare reimbursement down the road if we record minutes/days now! At this time we are included in the “bed rate”. Your MDS 3.0 minutes will be vital for future reimbursement.
15Need to Update: Policies & Procedures Staffing: roles and responsibilities should be defined.Conducting Recreational Therapy and Activity ProgramsRecreational Therapy and Activity DocumentationEmergencies
16Policies & Procedures to update: Recreational Therapy AssessmentCommunity Integration OutingsAnimal Assisted Therapy vs. Animal VisitationRecreational Therapy and Activity Program on a continuumRecreational Therapy Treatment Protocols
17Added Roles for the CTRS: Expert clinician (work with the most difficult to engage to improve QOL and function), perhaps co-treatments, or under restorative nursing.Trainer and educator: teach staff how to maintain residents active lives; aftercare depends on this.Researcher: use evidence based practices for behaviors, falls, pain, depression, functional gains, and other quality indicators.Supervisor: provide interns with RT role models and supervisor of other staff.Culture change liaison: bridge between medical care and homelike active lifestyles.
18Next step: Upgrade to Recreation Therapy (RT) and activities in LTC. Update policies & procedures manuals.Prepare protocols for RT practice when MDS 3.0 begins.Prepare referral forms and educate about RT as an option.
19It is the wave of the future! Permission to planRequesting permission to upgrade from our current activities offerings to include recreational therapy.It is the wave of the future!