H08- 071– Procedure

October 8, 2008
TO: / Area Agency on Aging (AAA) Directors
Home and Community Services (HCS) Division Regional Administrators
Division of Developmental Disabilities (DDD) Regional Administrators
FROM: / Bill Moss, Director, Home and Community Services Division
Linda Rolfe, Director, Division of Developmental Disabilities
SUBJECT: /
Revisions to Long-term Care Manual Chapter 24, Nursing Services and Skin Observation Protocol Related to DDD Clients
Purpose: / To notify staff of updates to the Skin Observation Protocol (SOP) to include direction to DDD Case Resource Managers.
Background: / In June 2007, all DDD clients began to be assessed using the Comprehensive Assessment Reporting Evaluation (CARE) tool. Embedded within the CARE assessment is the Skin Observation Protocol and its associated data elements. Clients who had not previously been assessed in CARE, and have no access to usual Nursing Services resources, are now triggering the Skin Observation Protocol.
The directions and revisions to the Skin Observation Protocol specifically address the needs of DDD clients who do not have access to Medicaid Personal Care or Waiver Personal Care nursing resources (e.g. Nursing Services or Nurse Delegation) for completion of the Skin Observation Protocol.
What’s new, changed, or
Clarified / The following has been added to the Skin Observation Protocol:
  1. A Skin Observation Protocol Referral Tree for DDD clients.
  2. A client letter describing the Skin Observation Protocol and suggestions for follow-up care.
  3. Educational materials for clients and caregivers.
The Long-term Care Manual, Nursing Services Chapter, is currently being updated to include these changes.
ACTION: / Effective immediately:
  1. Use the Updated Nursing Services Chapter
  2. DDD Case Resource Managers will follow the instructions on the Skin Observation Protocol Referral Tree for referral and resource information.
  3. MIP and ADH program managers shall distribute SOP provider memos to contracted organizations.
  4. DDD Case Resource Managers will provide a copy of the Client Referral Letter to clients without access to nursing resources.

Related
REFERENCES: / Educational Materials (Healthy Skin 1 & 2, Taking Care of Pressure Sores)
ATTACHMENT(S): / Long-term Care Manual, Nursing Services Chapter changes:

Skin Observation Protocol Referral Tree:

MIP Provider Memo:

ADH Provider Memo:

SOP Pressure Ulcer Assessment and Documentation:

Basic Skin Assessment:

Client Letter:

CONTACT(S): / Candace Goehring, Unit Manager
Clinical Effectiveness and Performance Improvement Unit
(360) 725-2562

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