I have decided to create a blog on some of the current problems relative to Long Term Care (LTC) facilities. It is my hope that discussing these issues will provide a helpful tool for caregivers. We are all aware that the acuity levels of residents’ illnesses have escalated dramatically and residents that are presently discharged very quickly post acute stage to LTC facilities.

All LTC employees should be aware of the federal regulations and state agency guidelines required to enable the facility be certified by Centers for Medicare and Medicaid (CMS) and licensed by the state.  This certification and licensure enables the facility participate in the Medicare and Medicaid reimbursement programs.

State and/or federal surveyors visit LTC  facilities at least annually to determine if these standards are maintained and to ensure the residents are receiving appropriate care.

I have worked in many areas of LTC over the past 40 years. Having concentrated on the overall  of resident care needs I have developed the Ten Commandments of LTC:

1. Admission, transition and assessment of a new resident.
2. Observation and reporting and Team work.
3. Complaints and Communication.
4. Falls, Incidents and  Accidents.
5. End of Life care POLST.
6. Psychotropic medication reduction.
7. Diabetic management.
8. Infections including UTI problems
9. Hospital readmission avoidance.

     (10) Dehydration and weight variance.     

These are not listed in any order of importance and are frequently interrelated. I will discuss these issues in future blogs.