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The neighborhood concept is fairly new. Each hallway is a neighborhood. We have “Camellia,” “Azalea,” “Magnolia”, and “The Arbor.” Each neighborhood has consistent team members that provide care. Each has a CNA team leader on days and evenings that is responsible to ensure CNA care is provided not only accurately and timely but also by resident’s preferences. The whole idea is for care to be provided by resident preference. Each neighborhood is responsible for doing 1-2 activities per shift in addition to the structured activities provided by the activity department. Any resident from any neighborhood can attend activities on another neighborhood. Some of activities have included, bus rides to see Christmas lights, making Christmas ornaments, decorating Christmas tree, reading books and discussing them, etc. The residents feel more comfortable now and are provided with their preferences concerning bath times, etc. Our Administrator and dietary department are looking to go into a buffet style meal so that residents can eat at whatever time suits them, i.e. breakfast at 10:00 am if this is their choice.
Brenda W. Chance, RN, RAC-C MDS Coordinator
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“We use the neighborhood concept which allows us increased staffing ratios which provides better care”
What is the neighborhood concept?
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I currently work in a CCRC. There are some differences, but, basically, if you are working on the skilled nursing unit, then you will continue to follow federal regs just as before. The main differences I have had are the following:
1. Not all of our beds are Medicare Certified, so this has been a challenge for me to get used to the fact that some residents will waive medicare benefits to stay in their customary private room. Also, sometimes, when our independents come in and we do not have a private room in a certified area (only a semi-private), they too will waive benefits. At the present time, we only do MDS’s for our residents in certified beds, but, soon, we will be doing them on our noncertified beds just to do better care planning and assessment. 2. Families and residents are much more demanding and have better knowledge bases of their disease processes. Of course, at times, families feel that they are more competent to take care of their family members. This has been a real challenge to re-educate families. Also, they are resistant at times to following federal regs and feel that because they have money, they should get what they want. 3. We use the neighborhood concept which allows us increased staffing ratios which provides better care. 4. You will find that there is more money for better equipment, etc. and I feel that we provide better care based on our staffing ratios and more up to date equipment. We also have more staff education due to money not always being an issue.
I highly recommend working at a CCRC. You have more room for advancement in the future as well as watching the resident from the independent to higher levels of care. I know many of the independent residents so this makes assessing and care planning easier since I knew their baseline before they came to the skilled unit.
Brenda W. Chance, RN, RAC-C MDS Coordinator
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I'm going for an interview for an
MDS position in a new
CCRC. They are currently under construction and will be opening in
the next few months-37 beds with three neighborhoods-post-acute/rehab, dementia
and LTC neighborhoods. I'm excited for the opportunity but hesitant
as my employment has been in SNF's including hospital-based, and other traditional
LTC's in the past. Hoping we have some listserv members that can help
with advice about CCRC's and interview considerations i.e., is MDS staffing
ratio similar for this environment and do you complete RAI process for all beds
or are only a portion of them in your CCRC certified? |
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