WEBVTT
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(Gina) Welcome, everyone,
welcome to our webinar:
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A New Distinction for Memory Care Services
in Assisted Living Communities.
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I'm Gina Zimmerman,
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and I'm Executive Director
for the Nursing Care Center
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in Assisted Living Community
Accreditation Programs
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at The Joint Commission.
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I'll tell you a little bit more
about myself in a moment.
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But why don't we go ahead
and move on to the next slide
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and talk a little bit about
what we'll do today.
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We're so excited that you have joined us,
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along with, I think,
a really great panel of experts
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in the area of Memory Care
for Assisted Living.
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So, we're really excited to dig into
some of the content with you here today.
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We'll actually start out
a little bit with me in a moment
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on the making of a Memory Care
Certification Program.
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Next, we have Doug Pace
from the Alzheimer's Association.
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I think many of you know Doug,
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and he'll talk a little bit
about some interesting information
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from the Alzheimer's Association
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and Transforming Quality
through Dementia Care.
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We'll move to Debbie Holzer
from The Joint Commission.
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She'll talk with us
a little bit about eligibility
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and certification requirements
for this new offering.
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And Beverly Belton,
from The Joint Commission,
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will also talk about
the survey experience.
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I will talk a little bit about
the steps you'll take to certification
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and some resources
that are available to you.
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And we'll finally
all join together at the end
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for a Speakers Panel and a Q&A.
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So excited to share this content with you
and hope you have your questions ready.
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And definitely, as Andrea had mentioned,
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please do submit any of your questions
in the chat along the way.
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Before we dive into our agenda,
we're actually going to head into a poll.
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We sprinkled a few polls into this webinar
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to kind of break this up
a little bit for you.
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And so we'll start with Andrea
on a poll here.
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(Andrea) Thank you, Gina.
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So, first, we'd like to ask,
what services are you providing today?
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And you can select all that apply.
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We have a few options for you already:
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Assisted living;
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Home care or Hospice;
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Independent living;
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Nursing home or Skilled nursing;
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or other.
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And if you'd like to elaborate,
feel free to do so.
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If you could put that
in the question section as well,
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we'd love to know.
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This just helps us
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hone our content a little bit better,
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getting a fill, we'll just put that up
for a few more seconds.
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Thank you all so much
for your contribution.
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OK, let's see what we have here,
and let's share those results.
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Overwhelming majority,
71% with Assisted Living,
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with a nice [inaudible]
across the other types of segments.
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Thank you so much
for sharing that information.
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OK, Gina, I'm going to hand it
back to you to begin.
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(Gina) Thanks so much, Andrea.
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It's really good to know
who we have in our audience.
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And we're here to talk a lot
about Assisted Living,
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Memory Care and Assisted Living.
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So I think we're--
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we've got the right audience
and the right content
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we're delivering for y'all today.
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So let's move on to the next slide.
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And I'll tell you
a little bit about myself.
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As I mentioned, I'm Executive Director
for the Nursing Care Center
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and Assisted Living Community Services
at The Joint Commission.
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I've actually been
with The Joint Commission
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for many, many years.
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I know a lot about Joint Commission
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and the kinds of things we do
in the continuum of healthcare.
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I've actually been here
for more than 30 years.
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But I have to tell you
that I think this is--
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the launch of the Assisted Living Program,
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and now, the Memory Care Certification,
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is probably one
of the most fulfilling things
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that I have done at The Joint Commission,
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having had an opportunity
to do a number of launches
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and work within the Business
Development side
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of what we do for so long.
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This is probably got to be
the hallmark of my career here.
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So really excited to be here with you,
and the panel here today.
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So let's go ahead
and move on to the next slide,
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and let's talk about the making
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of an Assisted Living Community
Memory Care Program.
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So I don't even have to say that,
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I think we all know
that memory care needs are growing.
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It's really stating the obvious,
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but let's take a look a little bit
at the numbers.
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We know that an estimated
6.7 million Americans
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are living with Alzheimer's dementia
in 2023.
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And that does not even include
the other dementias
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that we see in the environment as well.
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We also know that the number
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and proportion of Americans
with Alzheimer's or other dementias
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is expected to continue to grow.
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Certainly, as we all age,
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and continue to live longer,
and longer every day, and every year.
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The population of Americans
age 65 and older
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is projected to grow
from 58 million back in 21
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to a whopping addition
of another 30 million
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to 88 million by 2050.
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And we want to think about,
and we have been thinking a lot about
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where these individuals
with Alzheimer's and other dementias live.
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So we do have estimates
that about 34% of residents
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in residential care facilities,
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including assisted living facilities,
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have Alzheimer's or other dementias.
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And that 58%
of residential care facilities
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offer programs for residents
with Alzheimer's or other dementias.
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And so, I'd like to back up
for just a minute here,
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and talk about Assisted Living,
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and its growing importance
in a continuum of care,
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provided to the public in the US today.
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Because I think
that we really need to think about
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the addition of the new standards
we're talking about here today,
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relating to Memory Care
within the Assisted Living Community.
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So many of you may be aware,
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we launched our Assisted Living
Community Accreditation Program
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at The Joint Commission in July of 21.
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So here we are, two years later,
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and we are now adding, really some,
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above and beyond standards
in the area of Memory Care.
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So let's talk about what's been happening
in the landscape of Assisted Living.
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I think it's fair to say
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that a case for strengthened
oversight of Assisted Living was,
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kind of suspected,
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back in January of 2018,
when the GAO report
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highlighted the lack of federal oversight
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when federal funds are directed
to coverage of Medicaid beneficiaries
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receiving Assisted Living services
under a number of Medicaid waivers
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that are out there.
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And, really, it's a significant number,
because, according to the report,
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more than $10 billion
in federal and state funds
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were spent to cover
Assisted Living services
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for a large number
of Medicaid beneficiaries
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in a number of states.
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And at the same time,
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more than half of the state
Medicaid agencies that were studied
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could not report
the number of critical incidents,
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such as abuse, neglect, or exploitation
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that occurred in the Assisted Living
Facilities located in their states.
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The GAO report also documented for us
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the wide variation
in state regs and processes
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for overseeing beneficiary
health and welfare
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in Assisted Living settings.
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And let's think a little bit about
the Medicare front as well.
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We really have been seeing Assisted Living
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playing a greater role
in CMS bundled payment initiatives.
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Most recently, hospital
and physician participants
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are looking for ways to achieve savings
by changing post acute care patterns,
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specifically by shortening
or sometimes bypassing SNF stays
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and sending residents back to their home
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or sometimes into assisted living
when they choose to live there.
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Home settings
and Assisted Living Communities
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are in turn seeking to provide
the highest quality outcomes
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and avoid unnecessary hospitalizations
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in order to participate
in some of the savings
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and share of payments
for the care episode.
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So now, more than ever,
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as we've all experienced the unimaginable,
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such as a pandemic in recent years,
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we have a much more
discriminating consumer
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as well as more discriminating
stakeholders in the worlds we live in.
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And quality really does matter,
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especially when we think about
our vulnerable elders
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with Alzheimer's disease
or other dementias.
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These individuals really need us
more than ever today,
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and now it's the time to build
Memory Care standards
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for Assisted Living Communities.
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So next slide.
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So the program
that we've built for you today
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is a Memory Care Certification
for Assisted Living Communities
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that really recognize
the provision of care for residents
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with memory impacting conditions
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such as Alzheimer's disease
or other dementias.
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The goal of our certification
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is to enable residents
with memory impacting conditions
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to remain engaged in their environment
at the highest level possible
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for as long as possible,
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and to really help those individuals
live a fulfilling and quality life
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for as long as possible.
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Next slide.
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I'm probably most excited
out of my entire history
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at The Joint Commission
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to really have had the opportunity
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to collaborate
with the Alzheimer's Association
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on this important project.
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We joined in a collaboration,
actually, several years ago,
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when we launched
a Memory Care Certification
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within the Nursing Care Center
Accreditation space.
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But we clearly see,
looking at the statistics
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and understanding where individuals
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with Alzheimer's
and other dementias are living
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that it was really important for us
to start to look at Memory Care services
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within the Assisted Living
Community setting.
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So, our goal together
with the Alzheimer's Association
00:11:28.876 --> 00:11:33.291
is really to help improve quality
and safety in dementia care,
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both in skilled nursing,
and assisted living facilities.
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And that's what we're introducing
in July of 2023,
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and we'll talk a lot more about that
as we go on.
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We also are looking to evaluate
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and continuously evolve
our standards performance measures,
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and quality improvement initiatives,
in this important space.
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And we also share a goal to educate,
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to provide education programs
and presentations,
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and share data with the public.
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Next slide.
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So, let's talk a little bit
about the benefits of certification,
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and why someone may want to commit
to Memory Care Certification.
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Well, first of all, we would suggest
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that this is a really great way
to elevate your brand
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and to align yourself
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with some of the most
respected names in health care.
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Stand out in your market
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by earning the industry's
most recognized quality distinction
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through The Joint Commission,
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as well as through
the Alzheimer's Association.
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This is truly a distinction in quality
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that can strengthen community
confidence in the services
00:12:54.674 --> 00:12:58.110
within your Assisted Living Community
or other setting.
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Accreditation from The Joint Commission
00:13:01.911 --> 00:13:05.141
certainly establishes
and reinforces relationships
00:13:05.141 --> 00:13:09.463
with other health care partners
across the continuum of care,
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and helps to differentiate
your Assisted Living Community
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from your competition.
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We also learned
in the research that we conducted,
00:13:18.751 --> 00:13:20.039
when we were launching
00:13:20.039 --> 00:13:23.217
our Assisted Living Community
Accreditation Program,
00:13:23.217 --> 00:13:26.450
as well as our Memory Care
Certification Program,
00:13:26.972 --> 00:13:30.485
that residents and caregivers
view distinctions,
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such as accreditation and certification,
as very valuable attributes.
00:13:36.458 --> 00:13:40.375
We learned through our research
that residents and prospective residents
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and their caregivers
are more willing to visit
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or tour a community
that is accredited or certified
00:13:47.151 --> 00:13:51.008
once they understand that
such awards are available to them.
00:13:51.774 --> 00:13:54.543
And another great benefit of certification
00:13:54.543 --> 00:13:58.065
is that we do provide
a number of promotional resources
00:13:58.065 --> 00:14:01.960
to help you in your promotion,
communications, and marketing efforts.
00:14:02.812 --> 00:14:05.666
We do have certificates of recognition.
00:14:06.647 --> 00:14:12.510
Accredited and certified organizations
may use the Gold Seal of Approval
00:14:12.510 --> 00:14:14.232
from The Joint Commission,
00:14:14.232 --> 00:14:18.624
as well as a joint designation mark
that we have put together
00:14:18.624 --> 00:14:20.663
together with the Alzheimer's Association,
00:14:20.663 --> 00:14:23.145
and we'll share that
with y'all in a moment.
00:14:23.969 --> 00:14:29.240
We also have available
for accredited and certified organizations
00:14:29.240 --> 00:14:32.351
the ability to be publicly recognized
00:14:32.351 --> 00:14:35.783
on The Joint Commission's
Quality Check website,
00:14:35.783 --> 00:14:39.952
which is a listing of all accredited
and certified organizations
00:14:39.952 --> 00:14:41.532
across the country,
00:14:41.532 --> 00:14:46.547
as well as the Alzheimer's Association
Community Resource Finder,
00:14:47.151 --> 00:14:51.591
which is also a widely used
database of resources
00:14:51.591 --> 00:14:56.284
that are available to the public,
providers and other key stakeholders.
00:14:56.914 --> 00:15:00.514
We're excited to know
that more than 800,000 searches
00:15:00.514 --> 00:15:04.829
were conducted on the Alzheimer's
Association Community Resource Finder
00:15:04.829 --> 00:15:06.319
over the past year.
00:15:06.936 --> 00:15:09.058
So, again, that's the database of dementia
00:15:09.058 --> 00:15:13.340
and aging relating resources
available to the public.
00:15:13.685 --> 00:15:16.692
And finally, we have promotional resources
00:15:16.692 --> 00:15:18.773
in the form of a media kit
00:15:18.773 --> 00:15:23.695
to really help you get started,
to know how to speak to your communities,
00:15:23.695 --> 00:15:25.882
speak to the public that you're serving,
00:15:25.882 --> 00:15:30.368
and really, how to get the best
and the most out of your distinction
00:15:30.368 --> 00:15:32.702
of accreditation and certification.
00:15:33.744 --> 00:15:35.783
So let's stop here for a second,
00:15:35.783 --> 00:15:38.968
and Andrea is going to share
another poll for us.
00:15:40.810 --> 00:15:42.099
(Andrea) Thank you, Gina.
00:15:42.099 --> 00:15:44.627
So, while we're talking about distinction,
00:15:44.627 --> 00:15:46.471
so we thought
it would be interesting to know
00:15:46.471 --> 00:15:50.347
if you currently hold
any distinctions today.
00:15:50.855 --> 00:15:53.762
You can choose all that apply.
00:15:53.762 --> 00:15:56.402
We've given you some suggestions,
00:15:57.659 --> 00:15:59.993
whether it be
Joint Commission Accreditation
00:15:59.993 --> 00:16:02.035
and or certification;
00:16:02.035 --> 00:16:05.000
accreditation via another provider;
00:16:05.786 --> 00:16:07.475
quality awards;
00:16:07.475 --> 00:16:10.109
maybe you don't currently have
any distinctions
00:16:10.109 --> 00:16:13.611
or if you have other avenues,
00:16:13.611 --> 00:16:16.774
awards that you think would be applicable.
00:16:20.503 --> 00:16:23.770
And thank you for being
such a participatory group.
00:16:25.671 --> 00:16:29.305
I think we'll just do a few more seconds.
00:16:31.369 --> 00:16:34.397
Thank you. So, let's go ahead
and share those results.
00:16:37.136 --> 00:16:41.860
You can see Quality Awards
and Currently having no distinctions
00:16:41.860 --> 00:16:44.129
are at the top choices there,
00:16:44.129 --> 00:16:46.226
followed by accreditation
and certification,
00:16:46.226 --> 00:16:47.852
with alternate providers.
00:16:49.374 --> 00:16:52.412
Thank you all very much
for that information.
00:16:56.758 --> 00:17:01.120
And Doug, I will now
hand it over to you to take over.
00:17:02.313 --> 00:17:04.004
(Doug) Great. Thank you so much.
00:17:06.566 --> 00:17:07.865
Go to the next slide.
00:17:09.799 --> 00:17:12.732
Hi everyone. I'm Doug Pace,
for the Alzheimer's Association.
00:17:12.732 --> 00:17:16.368
It's so nice
to be with all of you here today.
00:17:16.368 --> 00:17:19.715
I've been with the Alzheimer's Association
almost eight years,
00:17:19.715 --> 00:17:23.163
but prior to that, I'm a licensed
Nursing Home Administrator,
00:17:23.163 --> 00:17:26.314
and I worked many years for Leading Age.
00:17:26.314 --> 00:17:28.338
And when I came to the Association,
00:17:28.338 --> 00:17:30.322
one of the projects
that I've been working on
00:17:30.322 --> 00:17:32.984
along with my colleague,
Doctor Sam Fazio,
00:17:32.984 --> 00:17:37.424
was in the development of our updated
Dementia Care Practice recommendations
00:17:37.424 --> 00:17:38.857
that I'll be speaking about.
00:17:38.857 --> 00:17:40.190
Next slide.
00:17:43.320 --> 00:17:45.589
So Gina shared some
of this information with you,
00:17:45.589 --> 00:17:47.561
but I wanted to share a little bit more.
00:17:48.101 --> 00:17:53.044
I wanted to share some information
from our 2023 Facts and Figures Report.
00:17:53.495 --> 00:17:55.533
You know, this is one
of the most important reports
00:17:55.533 --> 00:17:57.719
that the Association produces annually,
00:17:57.719 --> 00:18:03.015
and you can view or download
a copy of this report at alc.org\facts.
00:18:03.478 --> 00:18:06.700
As Gina said, there's an estimated
6.7 million Americans
00:18:06.700 --> 00:18:07.948
living with Alzheimer's.
00:18:07.948 --> 00:18:11.072
And you can see this number
is expected to increase significantly
00:18:11.072 --> 00:18:12.481
in the coming years.
00:18:12.481 --> 00:18:15.173
Well, deaths from other diseases
have decreased,
00:18:15.173 --> 00:18:20.997
deaths from Alzheimer's
has increased 145% between 2000 and 2019.
00:18:21.995 --> 00:18:23.898
Something that you also may not realize
00:18:23.898 --> 00:18:27.968
is that one in three seniors dies
with Alzheimer's or another dementia,
00:18:28.496 --> 00:18:31.207
meaning it may not be always
the cause of death,
00:18:31.207 --> 00:18:33.001
but it's present at the time of death.
00:18:33.892 --> 00:18:35.714
We also know
the persons with dementia
00:18:35.714 --> 00:18:38.103
have more comorbidities
than those without,
00:18:38.103 --> 00:18:41.835
and that this disease disproportionately
affects women and minorities.
00:18:42.624 --> 00:18:46.223
And the cost associated with the disease
also continues to increase.
00:18:46.773 --> 00:18:48.685
Over 11 million Americans
00:18:48.685 --> 00:18:51.409
provide unpaid care
for people with Alzheimer's,
00:18:51.409 --> 00:18:57.117
which is over 18 billion hours annually,
rounded at $340 billion.
00:18:57.760 --> 00:19:01.303
And an additional $345 billion
will be spent this year
00:19:01.303 --> 00:19:04.504
in providing professional health
and long-term care costs.
00:19:05.014 --> 00:19:07.004
So you can see today as a nation,
00:19:07.004 --> 00:19:10.716
we're already spending over
half a trillion dollars a year
00:19:10.716 --> 00:19:12.949
on unpaid and paid caregiving.
00:19:13.770 --> 00:19:15.760
People with Alzheimer's
and other dementias
00:19:15.760 --> 00:19:18.994
make up a large proportion
of those receiving services
00:19:18.994 --> 00:19:21.661
in long term
and community based care settings.
00:19:21.661 --> 00:19:23.618
As Gina mentioned,
according to the report,
00:19:23.618 --> 00:19:25.506
49% of nursing home residents,
00:19:25.506 --> 00:19:30.784
and 34% of residents in Assisted Living
have Alzheimer's or other dementia,
00:19:30.784 --> 00:19:33.980
and we know that those numbers
will continue to increase.
00:19:34.456 --> 00:19:39.096
And in reality, we know that, since
many people don't have a formal diagnosis,
00:19:39.096 --> 00:19:42.431
that these numbers
are probably higher than reported.
00:19:43.281 --> 00:19:44.588
Next slide, please.
00:19:47.270 --> 00:19:48.680
But there's some good news.
00:19:48.680 --> 00:19:51.923
There is exciting progress
in Alzheimer's and dementia research
00:19:51.923 --> 00:19:55.820
that's creating promising new treatments
for people living with the disease.
00:19:56.436 --> 00:19:57.816
As this slide indicates,
00:19:57.816 --> 00:19:59.861
the first description
of the disease was made
00:19:59.861 --> 00:20:02.776
by doctor Alois Alzheimer in 1906.
00:20:03.258 --> 00:20:07.072
But it wasn't until 1996, 90 years later,
00:20:07.072 --> 00:20:10.438
that the FDA approved drugs
that can temporarily ease
00:20:10.438 --> 00:20:12.361
some of the symptoms of the disease.
00:20:12.842 --> 00:20:16.029
But now we're entering
into a new era of treatment,
00:20:16.029 --> 00:20:18.616
drugs that can change
the disease progression
00:20:18.616 --> 00:20:20.531
in people living with Alzheimer's.
00:20:20.531 --> 00:20:21.719
Next slide.
00:20:24.725 --> 00:20:27.257
Two of these drugs
that target amyloid in the brain
00:20:27.257 --> 00:20:30.561
have been granted
accelerated approval by the FDA.
00:20:30.561 --> 00:20:33.322
The FDA will actually
be meeting this Friday,
00:20:33.322 --> 00:20:36.296
and it's anticipated
that they will give full approval
00:20:36.296 --> 00:20:38.167
for a third drug in this class.
00:20:38.932 --> 00:20:43.163
Also, on June 1st, CMS announced
that they will cover these drugs
00:20:43.163 --> 00:20:45.125
for Medicare beneficiaries
00:20:45.125 --> 00:20:48.183
when the physician or clinical team
participates in a registry.
00:20:48.890 --> 00:20:51.774
And as you can see,
there are many more drugs in the pipeline,
00:20:51.774 --> 00:20:55.576
so it truly is an exciting time
and we are entering a new era.
00:20:56.140 --> 00:21:00.458
So, I encourage you to visit
alc.org\treatments
00:21:00.458 --> 00:21:04.165
for the latest information
on these new developments.
00:21:04.165 --> 00:21:05.292
Next slide.
00:21:07.165 --> 00:21:08.548
So now let's spend a few minutes
00:21:08.548 --> 00:21:12.131
discussing the Association's
Dementia Care Practice Recommendations,
00:21:12.131 --> 00:21:15.189
which The Joint Commission crosswalk
against their standards
00:21:15.189 --> 00:21:17.855
for this new Memory Care
Certification Program.
00:21:17.855 --> 00:21:19.008
Next slide.
00:21:20.523 --> 00:21:23.393
So, since its inception,
the Association has been a leader
00:21:23.393 --> 00:21:28.005
in outlining principles of quality care
for persons living with dementia,
00:21:28.005 --> 00:21:31.524
who receive services in long term
and community based care settings.
00:21:31.524 --> 00:21:34.655
In the late 1980s,
we had the guidelines for dignity
00:21:34.655 --> 00:21:36.891
that describe goals for quality care,
00:21:36.891 --> 00:21:40.290
followed by the key elements
for dementia care in the mid 90s,
00:21:40.290 --> 00:21:44.325
and then the updated recommendations
in 2005 to 2009
00:21:44.325 --> 00:21:46.167
as more evidence became available.
00:21:46.167 --> 00:21:47.356
Next slide.
00:21:48.611 --> 00:21:50.516
Then, in 2018, as I mentioned,
00:21:50.516 --> 00:21:53.371
the Association released
updated recommendations.
00:21:53.371 --> 00:21:56.951
In this new iteration,
we outlined 56 recommendations
00:21:56.951 --> 00:21:58.863
across 10 content areas
00:21:58.863 --> 00:22:01.443
grounded in the fundamentals
of person-centered care.
00:22:02.123 --> 00:22:04.920
They were developed
by 27 dementia care experts,
00:22:04.920 --> 00:22:06.381
convened by the Association,
00:22:06.381 --> 00:22:09.423
and based on a comprehensive review
of the current evidence,
00:22:09.423 --> 00:22:11.363
practice an expert opinion.
00:22:11.930 --> 00:22:14.899
The recommendations stick
to better define quality
00:22:14.899 --> 00:22:18.168
across all care settings
and throughout the disease course,
00:22:18.168 --> 00:22:20.920
and they're intended
for professional care providers
00:22:20.920 --> 00:22:24.268
who work with individuals
living with dementia and their families
00:22:24.268 --> 00:22:27.072
and long term
and community based care settings.
00:22:27.072 --> 00:22:28.888
You can do the field record.
00:22:28.888 --> 00:22:30.804
You can view the full recommendations
00:22:30.804 --> 00:22:33.730
at alc.org\qualitycare.
00:22:33.730 --> 00:22:35.131
Next slide.
00:22:36.175 --> 00:22:39.445
So this slide shows the tin content areas.
00:22:39.445 --> 00:22:42.811
And two new areas of focus
were added to this set of recommendations
00:22:42.811 --> 00:22:46.742
from the previous detection and diagnosis,
and medical management.
00:22:47.364 --> 00:22:49.473
But you can see that person-centeredness
00:22:49.473 --> 00:22:52.195
is at the core
of all of these recommendations.
00:22:52.195 --> 00:22:55.320
Now, let's just take a brief look
at each of the topic areas.
00:22:55.320 --> 00:22:56.610
Next slide.
00:22:58.274 --> 00:23:00.335
So, when we talk about
person-centered care
00:23:00.335 --> 00:23:02.128
or a person-centered delivery system,
00:23:02.128 --> 00:23:04.027
and long term
and community based care setting,
00:23:04.027 --> 00:23:05.382
what does that mean?
00:23:05.382 --> 00:23:09.012
A good way to think about this
is with our very first recommendation,
00:23:09.012 --> 00:23:10.432
know the person.
00:23:10.857 --> 00:23:14.730
Know the person living with dementia
is more than a diagnosis.
00:23:14.730 --> 00:23:17.651
It's important to know
the unique and complete person,
00:23:17.651 --> 00:23:20.812
including their values, beliefs,
00:23:20.812 --> 00:23:24.309
interests, abilities, likes, and dislikes
00:23:24.309 --> 00:23:26.247
both past and present.
00:23:26.247 --> 00:23:30.734
This information should inform
every interaction and experience.
00:23:31.450 --> 00:23:35.362
It's about recognizing
and accepting the person's reality,
00:23:35.362 --> 00:23:37.000
it's important to see the world
00:23:37.000 --> 00:23:39.953
from the perspective of the individual
living with dementia.
00:23:39.953 --> 00:23:43.711
Doing so recognizes behavior
as a form of communication,
00:23:43.711 --> 00:23:47.317
thereby promoting effective
and empathetic communication
00:23:47.317 --> 00:23:50.271
that validates feelings
and connects with the individual
00:23:50.271 --> 00:23:51.658
and their reality.
00:23:52.621 --> 00:23:55.053
Identifying and supporting
ongoing opportunities
00:23:55.053 --> 00:23:56.798
for meaningful engagement:
00:23:56.798 --> 00:23:59.236
It can be seen
as an opportunity for engagement.
00:23:59.236 --> 00:24:01.040
Engagement should be meaningful to
00:24:01.040 --> 00:24:03.763
and purposeful
for the person living with dementia.
00:24:04.190 --> 00:24:06.708
It should support interest
and preferences,
00:24:06.708 --> 00:24:08.643
allow for choice and success,
00:24:08.643 --> 00:24:11.984
and recognize that even
when the dementia is most severe,
00:24:11.984 --> 00:24:16.344
the person can still experience joy,
comfort, and meaning in life.
00:24:17.103 --> 00:24:19.742
And persons with dementia
should be part of relationships
00:24:19.742 --> 00:24:22.105
that treat them with dignity and respect,
00:24:22.105 --> 00:24:25.358
and where their individuality
is always supported.
00:24:25.906 --> 00:24:29.022
This type of a caring relationship
is about being present
00:24:29.022 --> 00:24:32.437
and concentrating on the interaction
rather than the task.
00:24:32.826 --> 00:24:36.024
It's about doing with,
rather than doing for,
00:24:36.024 --> 00:24:39.742
as part of the supportive
and mutually beneficial relationship.
00:24:40.927 --> 00:24:43.559
And a supportive community
allows for comfort
00:24:43.559 --> 00:24:46.131
and creates opportunities for success.
00:24:46.131 --> 00:24:49.058
It's an opportunity
that values each person
00:24:49.058 --> 00:24:53.287
and respects individual differences,
celebrates accomplishments and occasions
00:24:53.287 --> 00:24:57.602
and provides access and opportunities
for autonomy, engagement,
00:24:57.602 --> 00:24:59.059
and shared experiences.
00:25:00.007 --> 00:25:01.956
And with all of the recommendations,
00:25:01.956 --> 00:25:05.506
quality improvement
is one of two crosscutting themes.
00:25:05.506 --> 00:25:10.555
It's important to regularly evaluate
practices and models, share findings,
00:25:10.555 --> 00:25:14.942
and make changes to interactions,
programs, and practices as needed.
00:25:14.942 --> 00:25:16.258
Next slide.
00:25:18.795 --> 00:25:21.177
So, as I mentioned,
detection and diagnosis,
00:25:21.177 --> 00:25:24.730
is one of the two new topic areas
for the recommendations.
00:25:25.096 --> 00:25:27.304
It's vitally important
for staff and long term
00:25:27.304 --> 00:25:30.568
and community based care settings
to provide information about brain health,
00:25:31.154 --> 00:25:34.040
changes in cognition
that commonly occur in aging
00:25:34.040 --> 00:25:38.360
and the importance of lifestyle behaviors
and other approaches to brain health.
00:25:38.360 --> 00:25:41.863
And to work in concert
with clinicians and physicians
00:25:41.863 --> 00:25:44.813
for diagnostic evaluations
and other clinical care.
00:25:45.497 --> 00:25:47.601
So, all staff should be trained
00:25:47.601 --> 00:25:50.872
to recognize the signs and symptoms
of cognitive impairment,
00:25:51.414 --> 00:25:54.972
and if it's within the scope
of a non physician care provider,
00:25:54.972 --> 00:25:59.975
they should use a brief mental status
to test to detect cognitive impairment.
00:25:59.975 --> 00:26:03.518
And for individuals
who score below a preset score,
00:26:03.518 --> 00:26:07.333
ensure that they receive
a diagnostic evaluation by a physician
00:26:07.333 --> 00:26:08.839
who can make the diagnosis.
00:26:09.363 --> 00:26:10.555
Next slide.
00:26:12.820 --> 00:26:16.740
And then assessment and care planning
should be conducted every six months,
00:26:16.740 --> 00:26:19.829
and prioritize issues
to help the person with dementia
00:26:19.829 --> 00:26:21.185
to live fully.
00:26:21.185 --> 00:26:24.275
They should be used as an opportunity
for information gathering,
00:26:24.275 --> 00:26:27.224
relationship building,
education, and support.
00:26:27.764 --> 00:26:29.730
The assessment
and care planning process
00:26:29.730 --> 00:26:31.892
should be a collaborative team approach.
00:26:31.892 --> 00:26:34.413
The person living with dementia
and their care partners,
00:26:34.413 --> 00:26:37.198
and the caregivers
are all integral members
00:26:37.198 --> 00:26:38.567
of the care planning team.
00:26:39.218 --> 00:26:41.693
And a comprehensive person
centered care assessment
00:26:41.693 --> 00:26:43.768
should include three major areas:
00:26:43.768 --> 00:26:46.676
the experience of the person
and their care partner,
00:26:46.676 --> 00:26:48.484
their functioning behavior,
00:26:48.484 --> 00:26:50.848
and their health status,
and risk reduction.
00:26:51.584 --> 00:26:53.795
Now, I mentioned
that there's two crosscutting themes
00:26:53.795 --> 00:26:55.497
across all of the recommendations,
00:26:55.497 --> 00:26:58.239
and the second one
is around advance care planning.
00:26:59.928 --> 00:27:04.508
Advance care planning is crucial
to optimize physical, psychosocial,
00:27:04.508 --> 00:27:06.153
and physical well-being,
00:27:06.153 --> 00:27:08.968
and to increase awareness
of all care options,
00:27:08.968 --> 00:27:11.147
including palliative care and hospice.
00:27:11.787 --> 00:27:13.952
Early and ongoing discussion
of what matters,
00:27:13.952 --> 00:27:16.952
including values, quality of life,
and goals of care
00:27:16.952 --> 00:27:18.883
are essential for person-centered care,
00:27:19.244 --> 00:27:22.337
and the person living with dementia's
preferences and wishes
00:27:22.337 --> 00:27:25.172
should be honored
in all phases of the disease.
00:27:25.776 --> 00:27:26.919
Next slide.
00:27:28.840 --> 00:27:31.456
The second new topic area
is around medical management.
00:27:31.966 --> 00:27:35.167
So, non medical care providers
and family caregivers
00:27:35.167 --> 00:27:36.864
should work with medical providers
00:27:36.864 --> 00:27:39.460
towards developing a shared vision of care
00:27:39.460 --> 00:27:41.505
to support the person
living with dementia.
00:27:42.482 --> 00:27:44.914
Common comorbidities
can actively impact
00:27:44.914 --> 00:27:46.519
a person living with dementia,
00:27:46.519 --> 00:27:49.269
and conversely, a diagnosis of dementia
00:27:49.269 --> 00:27:53.097
can make the treatment
and management of comorbid conditions
00:27:53.097 --> 00:27:54.785
quite challenging.
00:27:54.785 --> 00:27:56.394
So, non medical care providers
00:27:56.394 --> 00:27:59.138
should encourage persons
living with dementia and their families
00:27:59.138 --> 00:28:01.867
to report acute changes
in health and function
00:28:01.867 --> 00:28:03.623
to the person's physician
00:28:03.623 --> 00:28:06.537
and let the physician know
about difficulties they encounter
00:28:06.537 --> 00:28:10.565
in managing acute and chronic
comorbidities in the community.
00:28:11.244 --> 00:28:13.105
An increasing evidence suggests
00:28:13.105 --> 00:28:17.574
that non pharmacological interventions
are effective at managing behavioral
00:28:17.574 --> 00:28:19.478
and psychosocial symptoms of dementia.
00:28:20.477 --> 00:28:23.549
And although non pharmacological
interventions are preferred,
00:28:23.549 --> 00:28:26.646
we know that there are times
when a pharmacological treatment
00:28:26.646 --> 00:28:30.028
may be warranted for behavioral
and psychosocial symptoms.
00:28:30.693 --> 00:28:34.366
But providers should understand
the general principles for starting,
00:28:34.366 --> 00:28:37.476
and more importantly,
ending pharmacological treatments
00:28:37.476 --> 00:28:40.831
and encourage the person
living with dementia and the caregivers
00:28:40.831 --> 00:28:44.370
to ask their medical providers
for regular medication reviews,
00:28:44.370 --> 00:28:48.926
and to consider the discontinuation
of medications as appropriate.
00:28:51.624 --> 00:28:55.280
It's also important to encourage persons
living with dementia and their families
00:28:55.280 --> 00:28:58.284
to start those end of life
discussions early.
00:28:58.793 --> 00:29:01.752
Persons living with dementia
and their caregivers
00:29:01.752 --> 00:29:03.974
should understand
options available for care
00:29:03.974 --> 00:29:06.006
during the latter stages of the disease.
00:29:06.396 --> 00:29:09.623
And having discussions early
with the person's physician
00:29:09.623 --> 00:29:13.133
and other care providers
and communicating those preferences
00:29:13.133 --> 00:29:16.571
across care settings
can make the transitions much easier
00:29:16.571 --> 00:29:19.541
as the progression of dementia continues.
00:29:19.541 --> 00:29:20.788
Next slide.
00:29:23.370 --> 00:29:25.873
Providing education
and support early in the disease,
00:29:25.873 --> 00:29:28.219
preparing for the future is so important.
00:29:28.219 --> 00:29:33.293
Intervening during the early stages
creates opportunities to identify, meet,
00:29:33.293 --> 00:29:36.175
and in turn, honor the changing
and future care needs
00:29:36.175 --> 00:29:38.502
and preferences of individuals
living with dementia
00:29:38.502 --> 00:29:41.828
and their family caregivers
and the caregivers in the community.
00:29:42.239 --> 00:29:47.099
Discussing the individuals' care values
and preferences early in the disease
00:29:47.099 --> 00:29:50.380
can aid in planning
during the moderate and advanced stages,
00:29:50.380 --> 00:29:51.892
as well as at the end of life.
00:29:52.703 --> 00:29:56.482
And it's also very important to design
effective evidence-based program
00:29:56.482 --> 00:29:59.407
that's sensitive
to the unique circumstances
00:29:59.407 --> 00:30:02.452
of persons living with dementia
and their families,
00:30:02.452 --> 00:30:07.720
such as minorities, LGBTQ population,
and socially disadvantaged populations.
00:30:08.951 --> 00:30:12.728
There's many transitional points
throughout the disease trajectory
00:30:12.728 --> 00:30:14.450
that have variable effects.
00:30:14.450 --> 00:30:18.726
For instance, transitioning from early
to middle, to late stage
00:30:18.726 --> 00:30:21.712
often introduces
new symptoms and behaviors.
00:30:22.258 --> 00:30:25.113
So providing education,
information and support
00:30:25.113 --> 00:30:27.972
that honor the individual with dementia's
values and preferences
00:30:27.972 --> 00:30:31.210
during these transitions
would be re-assuring the caregivers
00:30:31.210 --> 00:30:33.403
as they make those hard choices many times
00:30:33.403 --> 00:30:36.415
on behalf of the person
living with dementia.
00:30:36.415 --> 00:30:37.615
Next slide.
00:30:40.594 --> 00:30:43.730
Support for ADL function
must recognize the activity,
00:30:43.730 --> 00:30:46.921
the person's functional ability,
and their cognitive impairment.
00:30:47.458 --> 00:30:51.476
So, not only are dignity, respect,
and choice, a common theme,
00:30:51.476 --> 00:30:54.955
but providers must attend
to those individual abilities,
00:30:54.955 --> 00:30:57.643
the likes and dislikes
of the person with dementia,
00:30:57.643 --> 00:30:59.532
and now we have even more evidence
00:30:59.532 --> 00:31:03.111
around things like dressing
and toileting, eating and nutrition.
00:31:04.066 --> 00:31:07.939
It's important to remember
that dementia is a progressive disease
00:31:07.939 --> 00:31:09.814
accompanied by the progressive loss
00:31:09.814 --> 00:31:12.789
and the ability
to independently conduct ADLs.
00:31:13.218 --> 00:31:15.734
We know that needs
will increase over time.
00:31:16.502 --> 00:31:20.221
So, for instance, evidence now shows us
that, for dressing, for example,
00:31:20.221 --> 00:31:22.073
people living with dementia
00:31:22.073 --> 00:31:24.471
are more able
to dress themselves independently,
00:31:24.471 --> 00:31:26.734
if they have a safe and comfortable area,
00:31:26.734 --> 00:31:28.663
they're provided a selective choice,
00:31:28.663 --> 00:31:31.107
and just given
a few simple verbal instructions.
00:31:32.029 --> 00:31:34.737
With toileting in general,
people living with dementia
00:31:34.737 --> 00:31:36.239
are more able to be continent.
00:31:36.239 --> 00:31:40.034
For example, if they're monitored
for signs of leakage or incontinence,
00:31:40.034 --> 00:31:42.636
or if they have regularly scheduled
bathroom visits
00:31:42.636 --> 00:31:45.869
or they have access to a bathroom
that's clearly evident.
00:31:46.512 --> 00:31:49.214
And one of the most important
times of the day is mealtime.
00:31:49.703 --> 00:31:52.445
People living with dementia
are more likely to eat
00:31:52.445 --> 00:31:53.813
if they're offered choice.
00:31:54.318 --> 00:31:56.601
Dine with others
in a home-like environment,
00:31:56.601 --> 00:31:58.443
maintain oral health,
00:31:58.443 --> 00:32:01.688
and are provided
adaptive food and utensils,
00:32:01.688 --> 00:32:05.192
and offered nutritionally
and culturally appropriate food.
00:32:05.687 --> 00:32:06.928
Next slide.
00:32:09.820 --> 00:32:13.079
So it's important to identify situations
00:32:13.079 --> 00:32:17.781
where social or the physical environment
triggers a behavioral response,
00:32:17.781 --> 00:32:22.122
produces stress, or evokes a behavior
that expresses an unmet need.
00:32:22.845 --> 00:32:25.086
You know, as I discussed earlier,
00:32:25.086 --> 00:32:28.318
it's important to implement
non pharmacological practices
00:32:28.318 --> 00:32:32.958
that are person-centered, evidenced-based
and feasible in the care setting.
00:32:34.207 --> 00:32:37.067
Anti-psychotic
and other psychotic medications
00:32:37.067 --> 00:32:40.760
are generally not indicated
to deliver dementia related behaviors.
00:32:40.760 --> 00:32:44.759
So non pharmacological practices
should be the first line of approach.
00:32:45.445 --> 00:32:48.799
And the recommendations identify
three overarching categories
00:32:48.799 --> 00:32:51.305
for evidenced based
non pharmacological approaches.
00:32:51.827 --> 00:32:55.874
And while the evidence varies,
aroma therapy, massage therapy,
00:32:55.874 --> 00:32:58.866
multi-sensory symbolization,
and bright light therapy,
00:32:58.866 --> 00:33:02.337
can be effective in reducing
episodes of dementia related behaviors.
00:33:03.187 --> 00:33:06.387
Psychosocial practices,
such as validation therapy,
00:33:06.387 --> 00:33:09.737
reminiscence therapy,
music therapy, pet therapy,
00:33:09.737 --> 00:33:12.383
and other meaningful activities
can have a positive effect
00:33:12.383 --> 00:33:14.704
on a wide range of dementia
related behaviors.
00:33:15.312 --> 00:33:18.727
And we know that technology
is making tremendous strides in this area.
00:33:19.228 --> 00:33:22.423
For instance, there's now
robotic pet therapy dogs
00:33:22.423 --> 00:33:24.567
that are showing some positive results,
00:33:24.567 --> 00:33:27.780
and music therapy programs
that have shown to be very effective.
00:33:28.651 --> 00:33:30.772
And while the evidence
is small but growing,
00:33:30.772 --> 00:33:33.726
structured care protocols
can make a huge difference
00:33:33.726 --> 00:33:35.770
in the quality of life
for someone with dementia.
00:33:36.477 --> 00:33:38.740
Anticipated resistance to daily mouth care
00:33:38.740 --> 00:33:39.808
is one of the reasons
00:33:39.808 --> 00:33:43.813
that oral hygiene tends to be neglected
for people living with dementia,
00:33:43.813 --> 00:33:46.053
especially in residential care settings.
00:33:46.557 --> 00:33:50.772
So, using mouth care protocols
that include person-centered strategies
00:33:50.772 --> 00:33:54.830
for approaching and communicating,
along with technical skills,
00:33:54.830 --> 00:33:59.083
can help reduce the threat
and thereby minimize resistive behaviors.
00:33:59.783 --> 00:34:02.727
And, from the current evidence,
we know that there's little investment
00:34:02.727 --> 00:34:05.675
that's required to implement
those structure protocols
00:34:05.675 --> 00:34:09.650
to prevent or minimize those behaviors
during mouth care.
00:34:10.142 --> 00:34:13.006
And findings suggest that care providers
00:34:13.006 --> 00:34:15.819
who've been trained
to use mouth care protocol
00:34:15.819 --> 00:34:20.254
feel more able to address
those behavioral responses during care.
00:34:21.219 --> 00:34:24.727
And bathing is a personal care tasks
associated with the frequency
00:34:24.727 --> 00:34:28.777
of behavioral expressions for distress
for many persons living with dementia.
00:34:29.120 --> 00:34:32.135
Just with mouth care,
distress during bathing,
00:34:32.135 --> 00:34:36.092
may signify a fear response
that may be potentially alleviated
00:34:36.092 --> 00:34:39.143
by implementing person-centered
strategies and skills.
00:34:39.781 --> 00:34:40.965
Next slide.
00:34:43.110 --> 00:34:46.647
We know all of the current struggles
that are out there during COVID
00:34:46.647 --> 00:34:48.768
and Post-COVID with workforce.
00:34:49.166 --> 00:34:52.680
One of the most important components
of delivering high quality dementia care
00:34:52.680 --> 00:34:54.148
is having a trained staff.
00:34:54.815 --> 00:34:57.245
It's important to have
comprehensive orientation
00:34:57.245 --> 00:35:00.867
and training for new staff
on person-centered dementia care,
00:35:00.867 --> 00:35:04.026
as well as a dedicated plan
for ongoing education
00:35:04.026 --> 00:35:05.557
for all staff members.
00:35:06.270 --> 00:35:08.041
It's important that all staff
00:35:08.041 --> 00:35:11.004
know the person
living with dementia as individuals
00:35:11.004 --> 00:35:12.958
and procedures must be established
00:35:12.958 --> 00:35:15.325
that collects information
on their choices,
00:35:15.325 --> 00:35:17.419
preferences, and life history
00:35:17.419 --> 00:35:20.208
as a mechanism
for sharing that information.
00:35:20.968 --> 00:35:25.205
Interdepartment and interdisciplinary
collaboration is crucial,
00:35:25.205 --> 00:35:28.257
as well as ensuring that training
is provided on all [inaudible].
00:35:29.521 --> 00:35:31.928
But we know that
a person-centered delivery system
00:35:31.928 --> 00:35:35.717
is not possible without
a vision-driven leadership team.
00:35:36.217 --> 00:35:39.851
Leadership that believes
in complete system transformation,
00:35:39.851 --> 00:35:42.772
leadership that knows
that a well trained, informed,
00:35:42.772 --> 00:35:47.040
and empowered staff
who feel valued, recognized,
00:35:47.040 --> 00:35:48.647
and involved in decision making
00:35:48.647 --> 00:35:50.993
is the foundation
for person-centered care.
00:35:51.995 --> 00:35:54.226
There are many ways that staff
can get to know a person
00:35:54.226 --> 00:35:55.993
such as consistent assignment
00:35:55.993 --> 00:35:58.249
and involving residents,
staff and families
00:35:58.249 --> 00:36:00.306
to cultivate successful relationships.
00:36:00.790 --> 00:36:04.475
With all of these areas,
we know that evaluation is key.
00:36:04.475 --> 00:36:07.066
So leadership must encourage a culture
00:36:07.066 --> 00:36:10.563
that all staff welcome, serve and respond.
00:36:10.563 --> 00:36:11.780
Next slide.
00:36:14.773 --> 00:36:17.941
The next area is around supportive
and therapeutic environments,
00:36:17.941 --> 00:36:19.405
and they are so important.
00:36:19.405 --> 00:36:21.988
The environment should support
building relationships.
00:36:22.465 --> 00:36:26.125
And comfort and dignity
are at the core of person-centered care.
00:36:26.654 --> 00:36:28.666
Comfort is about how a person feels,
00:36:29.061 --> 00:36:30.886
dignity is about how they're treated.
00:36:31.458 --> 00:36:34.238
We know another essential tenant
of person-centered care
00:36:34.238 --> 00:36:35.807
is respect for others.
00:36:35.807 --> 00:36:38.824
And there are
environmental correlations as well.
00:36:39.472 --> 00:36:43.996
We know that settings should be pleasant
with visual and physical access
00:36:43.996 --> 00:36:46.595
to engaging in safe outdoor settings,
00:36:47.014 --> 00:36:49.914
supporting privacy
and the security of personal space.
00:36:50.428 --> 00:36:54.073
It's really about balancing
safety and autonomy.
00:36:54.472 --> 00:36:57.279
It's about opportunities
for meaningful engagement,
00:36:57.279 --> 00:36:59.492
both in the residential
and the home setting
00:36:59.492 --> 00:37:00.927
and in the broader community.
00:37:01.487 --> 00:37:03.034
Spaces should allow for both
00:37:03.034 --> 00:37:05.347
individual activities
and group activities.
00:37:05.691 --> 00:37:10.526
While the environment is the backdrop
in front of which real life takes place,
00:37:10.940 --> 00:37:14.000
caregivers and care partners
must be trained and understand
00:37:14.000 --> 00:37:18.485
how things like turning on a light,
or closing a curtain to reduce glare,
00:37:18.485 --> 00:37:22.870
or reducing unnecessary background noise
can make a tremendous difference
00:37:22.870 --> 00:37:26.254
in the quality of life
for someone living with dementia.
00:37:26.700 --> 00:37:27.953
Next slide.
00:37:29.210 --> 00:37:31.927
And the last topic area
is around transitions of care.
00:37:32.459 --> 00:37:34.818
It's important for persons
living with dementia
00:37:34.818 --> 00:37:36.505
and their care partners to understand
00:37:36.505 --> 00:37:39.546
their need for information
around common transitions,
00:37:39.546 --> 00:37:41.092
including across care settings,
00:37:41.092 --> 00:37:44.157
such as home to hospital
or skilled nursing facility,
00:37:44.157 --> 00:37:46.401
nursing home to emergency department,
00:37:46.401 --> 00:37:47.652
or within care settings,
00:37:47.652 --> 00:37:51.916
such as from emergency department
to an intensive care unit,
00:37:51.916 --> 00:37:55.195
or from one team of clinicians
or care providers to another.
00:37:55.849 --> 00:37:57.384
So individuals with dementia
00:37:57.384 --> 00:38:00.765
are frequently transferred
across facilities
00:38:00.765 --> 00:38:02.187
without clinical information.
00:38:02.551 --> 00:38:06.943
So careful attention is essential
to ensure a safe handoff.
00:38:08.656 --> 00:38:13.117
Revisiting preferences and goals of care,
including treatment preferences,
00:38:13.117 --> 00:38:16.187
advanced directives,
social and living situations
00:38:16.187 --> 00:38:19.354
while the person living with dementia
can participate is essential
00:38:19.354 --> 00:38:20.788
during transitions of care.
00:38:21.355 --> 00:38:23.587
And after any hospitalization
00:38:23.587 --> 00:38:26.672
or other significant change
requiring a transition in care
00:38:26.672 --> 00:38:28.427
or any level of care,
00:38:28.427 --> 00:38:31.295
a review and assessment
of the preferences and goals
00:38:31.295 --> 00:38:33.301
of the person living with dementia
00:38:33.301 --> 00:38:36.787
should include an assessment
of safety, the health needs,
00:38:36.787 --> 00:38:39.582
and the community's ability
to manage the needs
00:38:39.582 --> 00:38:41.241
of the person living with dementia.
00:38:41.989 --> 00:38:45.565
And, finally, it's important to initiate
or use evidence-based models
00:38:45.565 --> 00:38:48.934
to avoid, delay,
or plan transitions of care.
00:38:49.419 --> 00:38:53.151
And our recommendations include
seven evidence-based models of [inaudible]
00:38:53.151 --> 00:38:54.287
that are included,
00:38:54.287 --> 00:38:57.882
that are focused on avoiding
unnecessary transitions,
00:38:57.882 --> 00:39:01.010
such as hospitalization
or emergency room visits.
00:39:01.764 --> 00:39:03.044
Next slide.
00:39:06.018 --> 00:39:08.008
It's important to put it all together,
00:39:08.008 --> 00:39:11.256
and that's just another advantage you have
in working with The Joint Commission
00:39:11.256 --> 00:39:13.350
on the Memory Care Certification Program.
00:39:13.834 --> 00:39:16.806
To be able to provide
the highest quality of dementia care,
00:39:16.806 --> 00:39:19.197
it's important to develop a plan,
00:39:19.197 --> 00:39:20.903
think about what you want to accomplish.
00:39:21.585 --> 00:39:23.495
Great short-term and long-term goals.
00:39:23.495 --> 00:39:27.486
What's the most important to begin with
and what are some easy wins you can have?
00:39:28.261 --> 00:39:31.243
It's so important
to include all staff in the process,
00:39:31.243 --> 00:39:33.957
to gain everyone's perspective
and begin support.
00:39:34.688 --> 00:39:36.043
And take small steps,
00:39:36.043 --> 00:39:39.552
one step at a time,
everything doesn't have to happen at once.
00:39:39.837 --> 00:39:41.003
And get help if needed.
00:39:41.003 --> 00:39:43.532
That's one of the places
that The Joint Commission can help you.
00:39:43.532 --> 00:39:46.944
Ask for help, not only inside
but outside of your organization.
00:39:47.360 --> 00:39:50.940
And build a support system
to help one another through change.
00:39:50.940 --> 00:39:54.133
And one thing that's so important today
that a lot of times we forget to do
00:39:54.133 --> 00:39:57.187
is to recognize and celebrate
our accomplishments,
00:39:57.187 --> 00:40:00.082
and reward good work
and steps in the right direction.
00:40:00.955 --> 00:40:04.303
So thank you for the opportunity
to share this information with you.
00:40:04.303 --> 00:40:08.348
And thanks to The Joint Commission
for collaborating with us
00:40:08.348 --> 00:40:11.320
on this exciting new
Memory Care Certification initiative.
00:40:16.498 --> 00:40:19.295
(Debbie) Great. Thank you so much, Doug,
for that great information.
00:40:19.295 --> 00:40:21.296
You can go on to the next slide, please.
00:40:22.731 --> 00:40:25.321
So my name is Debbie Holzer,
and I'm a Project Director
00:40:25.321 --> 00:40:28.108
in the department
of Standards and Survey Methods,
00:40:28.108 --> 00:40:29.143
and the team lead
00:40:29.143 --> 00:40:31.723
for the Assisted Living Community
Accreditation Program.
00:40:32.316 --> 00:40:33.874
Today I'll be discussing the standards
00:40:33.874 --> 00:40:37.078
for our new Assisted Living
Memory Care add-on Certification.
00:40:37.979 --> 00:40:39.122
Next slide.
00:40:40.881 --> 00:40:42.640
So The Joint Commission currently offers
00:40:42.640 --> 00:40:45.980
an Assisted Living Community
Accreditation Program.
00:40:46.857 --> 00:40:50.139
An Assisted Living Community
is defined as an organization
00:40:50.139 --> 00:40:54.707
that provides housing, meals,
and a combination of supervision
00:40:54.707 --> 00:40:56.472
and personal care services.
00:40:57.147 --> 00:40:58.463
Other services may include:
00:40:58.463 --> 00:41:02.928
nursing care, dementia care,
medication management,
00:41:02.928 --> 00:41:05.656
rehabilitation, and palliative care.
00:41:06.693 --> 00:41:08.895
Care can be provided
in a number of settings,
00:41:08.895 --> 00:41:11.075
including freestanding communities
00:41:11.704 --> 00:41:15.252
near or integrated
with skilled nursing homes or hospitals,
00:41:15.768 --> 00:41:18.590
as components of continuing care
retirement communities,
00:41:18.590 --> 00:41:22.753
or life plan communities,
or independent housing complexes.
00:41:23.756 --> 00:41:25.069
In order for an organization
00:41:25.069 --> 00:41:28.362
to be eligible for Assisted Living
Community Accreditation,
00:41:28.362 --> 00:41:33.212
they must be US based,
operational and providing care,
00:41:33.212 --> 00:41:36.832
satisfy state law
or licensing requirements,
00:41:36.832 --> 00:41:39.465
and engage
in process improvement activities.
00:41:40.495 --> 00:41:41.592
Next slide.
00:41:43.437 --> 00:41:46.791
In addition, to be eligible
for Assisted Living Accreditation,
00:41:46.791 --> 00:41:49.934
organizations must meet
the minimum requirement
00:41:49.934 --> 00:41:51.837
of three residents served,
00:41:51.837 --> 00:41:53.693
and at least two active.
00:41:54.248 --> 00:41:58.752
For communities, up to 18 beds,
or five residents served,
00:41:58.752 --> 00:42:01.454
and at least two active
for communities with 19 beds or more
00:42:01.454 --> 00:42:04.156
at the time of survey.
00:42:04.972 --> 00:42:09.278
In order to qualify for the new
add-on Memory Care Certification,
00:42:09.278 --> 00:42:13.218
an organization must be ALC accredited,
00:42:13.218 --> 00:42:16.320
or simultaneously seeking
that accreditation
00:42:16.320 --> 00:42:18.223
with Memory Care Certification.
00:42:18.616 --> 00:42:21.081
And have served
a minimum of five residents
00:42:21.081 --> 00:42:23.315
and two active at the time of survey.
00:42:24.654 --> 00:42:28.577
It is not required that organizations
have a separate memory care unit.
00:42:28.577 --> 00:42:31.196
Residents receiving memory care services
00:42:31.196 --> 00:42:34.310
can be integrated
within the Assisted Living Community.
00:42:35.138 --> 00:42:39.001
The certification is awarded
for a three-year period.
00:42:39.856 --> 00:42:41.039
Next slide.
00:42:42.755 --> 00:42:45.353
The standards for the Memory Care Program
00:42:45.353 --> 00:42:47.717
are based on
the Alzheimer's Association's
00:42:47.717 --> 00:42:50.145
Dementia Care Practice Recommendations,
00:42:50.145 --> 00:42:53.755
and focus on areas
critical to quality, safety,
00:42:53.755 --> 00:42:55.351
and the resident experience.
00:42:55.830 --> 00:42:58.943
So you will recognize
a lot of what Doug talked about
00:42:58.943 --> 00:43:00.703
are reflected in our standards.
00:43:01.680 --> 00:43:02.837
The standards were developed
00:43:02.837 --> 00:43:05.181
in collaboration
with the Alzheimer's Association
00:43:05.181 --> 00:43:06.998
and rigorously vetted,
00:43:06.998 --> 00:43:10.478
which involves research,
drafting the standards,
00:43:10.478 --> 00:43:15.124
collecting feedback, testing,
and a final approval process.
00:43:15.864 --> 00:43:19.846
We also used the information collected
from the learning visits we conducted
00:43:19.846 --> 00:43:22.151
when developing
the Assisted Living Program
00:43:22.151 --> 00:43:23.816
to inform our research.
00:43:23.816 --> 00:43:27.867
Since all of the ALCs that we visited
did have a memory care component.
00:43:28.790 --> 00:43:32.458
We elicited internal feedback
on the standards
00:43:32.458 --> 00:43:34.235
from subject matter experts.
00:43:34.701 --> 00:43:39.460
We conducted a public facing
and a targeted expert panel field review.
00:43:40.368 --> 00:43:43.040
And to assist in developing
our survey process,
00:43:43.040 --> 00:43:46.436
we conducted a pilot test
with a surveyor experienced
00:43:46.436 --> 00:43:48.839
in Assisted Living and Memory Care,
00:43:48.839 --> 00:43:50.396
at an Assisted Living Community
00:43:50.396 --> 00:43:53.262
exclusively focused
on Memory Care services.
00:43:53.953 --> 00:43:56.902
And finally, the standards
were reviewed and approved
00:43:56.902 --> 00:44:00.669
by The Joint Commission Leadership
and the Alzheimer's Association.
00:44:01.753 --> 00:44:03.167
Next slide.
00:44:05.211 --> 00:44:10.875
The Memory Care Program
has 54 Elements of Performance or EPs
00:44:10.875 --> 00:44:13.570
that fall within 27 standards.
00:44:14.315 --> 00:44:17.058
The standards define
the performance expectations
00:44:17.058 --> 00:44:20.344
and the structures or processes
that must be in place.
00:44:20.841 --> 00:44:23.499
And the EP is the language
that surveyors will use
00:44:23.499 --> 00:44:25.222
to evaluate compliance.
00:44:26.059 --> 00:44:28.481
There is a Memory Care
Certification Chapter
00:44:28.481 --> 00:44:30.438
in the ALC Accreditation Manual
00:44:30.438 --> 00:44:33.531
that lists all of the Memory Care
standards separately.
00:44:34.178 --> 00:44:36.525
The Memory Care standards
are also integrated
00:44:36.525 --> 00:44:40.067
within the Assisted Living standards
throughout the manual
00:44:40.067 --> 00:44:44.191
and are highlighted by a leading header
for the requirement
00:44:44.191 --> 00:44:48.159
that states for organizations
that elect The Joint Commission
00:44:48.159 --> 00:44:50.235
Memory Care Certification option,
00:44:50.235 --> 00:44:52.211
as you see it highlighted
here on the slide.
00:44:53.232 --> 00:44:55.550
There is an example
of a standard on the slide
00:44:55.550 --> 00:44:58.242
from the provision
of care, treatment, and services,
00:44:58.242 --> 00:44:59.742
or PC chapter.
00:45:00.257 --> 00:45:05.760
PC.02.01.01 is the standard
which requires that organizations
00:45:05.760 --> 00:45:08.659
provide care, treatment, and services
to each resident.
00:45:09.294 --> 00:45:13.100
EP 31 is what the surveyor
is going to be assessing for.
00:45:13.486 --> 00:45:16.572
It requires that organizations
certified in memory care
00:45:16.572 --> 00:45:19.831
supervise residents
based on their individual needs.
00:45:21.053 --> 00:45:22.116
For the remaining slides,
00:45:22.116 --> 00:45:24.949
I'll provide an overview of the standards
within each chapter.
00:45:25.548 --> 00:45:27.259
The standards that I'm referencing
00:45:27.259 --> 00:45:30.001
will be listed at the bottom left
of each slide
00:45:30.001 --> 00:45:33.160
and the yellow highlighted box,
as it's demonstrated here.
00:45:34.200 --> 00:45:35.301
Next slide.
00:45:37.538 --> 00:45:40.339
Standards
in the Environment of Care chapter
00:45:40.339 --> 00:45:43.901
require visual cues
or landmarks in the environment
00:45:43.901 --> 00:45:46.245
to assist residents with wayfinding.
00:45:47.141 --> 00:45:51.442
Minimizing noises
that may overstimulate or cause distress,
00:45:51.442 --> 00:45:54.124
such as alarms or maintenance activities.
00:45:54.930 --> 00:45:57.331
Minimizing confusing visual stimuli,
00:45:57.331 --> 00:46:01.132
such as harsh shadows,
busy fabric patterns,
00:46:01.132 --> 00:46:03.095
or the lack of color contrast.
00:46:03.827 --> 00:46:07.079
Access to a safe
and secure outdoor space,
00:46:07.079 --> 00:46:10.381
or if unavailable,
assimilated outdoor space.
00:46:11.046 --> 00:46:14.624
There is no specific requirement
for the size of the space
00:46:14.624 --> 00:46:16.275
or the amount of seating,
00:46:16.275 --> 00:46:18.751
but it should be sufficient
for the number of residents
00:46:18.751 --> 00:46:19.881
that you serve.
00:46:20.670 --> 00:46:23.731
Paths must be free
from obstructions or barriers
00:46:23.731 --> 00:46:25.962
to allow for walking and exploring.
00:46:26.865 --> 00:46:29.974
Limiting paging systems
to minimize distress.
00:46:30.446 --> 00:46:34.062
And the organization
should provide interests points
00:46:34.062 --> 00:46:37.276
to encourage visual
and tactile stimulation
00:46:37.276 --> 00:46:42.278
such as fish tanks, colorful tapestry,
or textured objects.
00:46:42.974 --> 00:46:45.972
We're not prescriptive on the types
or numbers of items
00:46:45.972 --> 00:46:48.991
because each facility will have
their own unique considerations
00:46:48.991 --> 00:46:52.784
as to available space,
resident needs, and budgets.
00:46:53.713 --> 00:46:54.812
Next slide.
00:46:57.220 --> 00:47:00.268
There is a requirement in the Emergency
Management Chapter
00:47:00.268 --> 00:47:01.736
that requires organizations
00:47:01.736 --> 00:47:04.872
include the special needs
of residents with dementia
00:47:04.872 --> 00:47:07.358
into the Emergency Operations Plan.
00:47:07.906 --> 00:47:12.851
The plan must include how supervision
will be maintained during evacuations,
00:47:13.292 --> 00:47:16.013
how agitation or anxiety will be managed
00:47:16.013 --> 00:47:18.577
when the environment
or circumstances change
00:47:19.131 --> 00:47:22.916
and how staff will maintain access
to the resident's medical history,
00:47:23.236 --> 00:47:26.667
current medication orders,
physician information,
00:47:26.667 --> 00:47:28.733
and family contact information.
00:47:29.660 --> 00:47:31.145
This is the minimum criteria
00:47:31.145 --> 00:47:34.455
expected to be covered
in the Emergency Operations Plan,
00:47:34.455 --> 00:47:37.127
but organizations can expand on this list.
00:47:38.315 --> 00:47:39.658
Next slide.
00:47:41.551 --> 00:47:44.232
The standards
in the Human Resource Chapter
00:47:44.232 --> 00:47:47.546
require that organizations
have a process for recruiting
00:47:47.546 --> 00:47:49.435
and retaining qualified staff.
00:47:50.094 --> 00:47:51.747
We know how challenging it can be
00:47:51.747 --> 00:47:54.425
to acquire staff
in Assisted Living settings
00:47:54.425 --> 00:47:57.593
and what an impact
that can have on quality and safety.
00:47:57.988 --> 00:47:59.224
So it's important to know
00:47:59.224 --> 00:48:01.500
that organizations
are investing in this effort.
00:48:02.594 --> 00:48:05.580
Staff and licensed practitioners
must be oriented
00:48:05.580 --> 00:48:09.548
about psychotropic medications
based on their responsibilities.
00:48:10.230 --> 00:48:14.167
The orientation topics listed
in the EP are required.
00:48:14.167 --> 00:48:17.853
However, the education for each topic
should be addressed in a way
00:48:17.853 --> 00:48:20.728
that's appropriate for the staff
receiving the training,
00:48:20.728 --> 00:48:24.839
whether it's a very high level instruction
or much more detailed.
00:48:25.710 --> 00:48:29.367
And staff and licensed practitioners
who provide dementia care,
00:48:29.367 --> 00:48:35.259
participate in annual training that aligns
with best practices in dementia care,
00:48:35.259 --> 00:48:39.407
and it must include team building,
therapeutic environments,
00:48:39.407 --> 00:48:44.538
pain management, palliative care,
and transitions in resident care.
00:48:45.354 --> 00:48:48.448
These topics are required
for the annual training,
00:48:48.448 --> 00:48:51.414
however, organizations
may develop education
00:48:51.414 --> 00:48:54.622
that goes beyond this list
to meet their individual needs.
00:48:55.622 --> 00:48:56.768
Next slide.
00:48:58.592 --> 00:49:00.640
The Information Management standards
00:49:00.640 --> 00:49:05.025
require that the organization
stay current on dementia care practices
00:49:05.025 --> 00:49:08.433
by participating in nationally
sponsored activities.
00:49:09.315 --> 00:49:12.931
Nationally recognized dementia care
leaders or authorities,
00:49:12.931 --> 00:49:16.641
will often sponsored activities
through funding, research,
00:49:16.641 --> 00:49:18.315
and resource allocation.
00:49:19.136 --> 00:49:22.145
Activities must be from reliable sources,
00:49:22.145 --> 00:49:24.128
like the Alzheimer's Association
00:49:24.128 --> 00:49:26.834
or the American Medical
Directors Association.
00:49:27.465 --> 00:49:31.443
And examples of activities
include webinars, conferences,
00:49:31.443 --> 00:49:33.946
and task force or committee attendance.
00:49:34.829 --> 00:49:35.911
Next slide.
00:49:37.371 --> 00:49:40.939
The Leadership standards require
that there is a medical director
00:49:40.939 --> 00:49:43.039
or other physician designated
00:49:43.039 --> 00:49:45.766
to oversee the care, treatment,
and services.
00:49:46.566 --> 00:49:51.136
The designee must either have
the necessary specialty expertise,
00:49:51.136 --> 00:49:54.129
or identify a qualified physician
00:49:54.129 --> 00:49:57.229
with the expertise
to direct a Memory Care program.
00:49:58.227 --> 00:50:01.754
The physician assigned
directs medical care,
00:50:01.754 --> 00:50:06.819
creates policies, participates
in provision of staff training,
00:50:06.819 --> 00:50:10.356
provides recommendations
for practitioners who provide care,
00:50:11.221 --> 00:50:14.264
monitors the performance
of medical services,
00:50:15.136 --> 00:50:16.639
considers the impact
00:50:16.639 --> 00:50:19.973
that public health agencies
have on resident care
00:50:20.686 --> 00:50:22.823
represents the organization
in the community
00:50:23.252 --> 00:50:28.390
and monitor psychotropic medications
to minimize misuse or overuse.
00:50:29.156 --> 00:50:30.324
Next slide.
00:50:32.403 --> 00:50:34.782
Leadership must evaluate and modify
00:50:34.782 --> 00:50:37.296
their organization's
dementia care practices
00:50:37.296 --> 00:50:41.889
based on current evidence,
best practices, resident need,
00:50:41.889 --> 00:50:45.022
and changes to the care,
treatment, or services.
00:50:45.801 --> 00:50:48.208
And the program must use
clinical practice guidelines
00:50:48.208 --> 00:50:50.242
and evidence-based practices
00:50:50.242 --> 00:50:53.236
to guide the provision of care,
treatment, and services.
00:50:53.920 --> 00:50:56.508
These can be nationally
recognized guidelines,
00:50:56.508 --> 00:51:01.533
as well as organizational guidelines
used to address specific circumstances.
00:51:02.673 --> 00:51:03.773
Next slide.
00:51:06.326 --> 00:51:11.027
For the Medication Management chapter,
an interdisciplinary team
00:51:11.027 --> 00:51:15.169
consisting of a physician,
pharmacist, nurse,
00:51:15.169 --> 00:51:17.758
and others from the healthcare team
as needed,
00:51:17.758 --> 00:51:20.823
monitor each resident's
psychotropic medications.
00:51:21.393 --> 00:51:24.503
This can be demonstrated
by notes in the resident's records
00:51:24.503 --> 00:51:26.463
and in the resident's plan for care.
00:51:27.154 --> 00:51:29.151
Interdisciplinary team meeting minutes
00:51:29.151 --> 00:51:31.352
may also be used
to demonstrate compliance.
00:51:32.333 --> 00:51:37.148
Psychotropic medications are prescribed
if there is a medical necessity
00:51:37.148 --> 00:51:42.010
after non pharmacological interventions
have been used or considered
00:51:42.010 --> 00:51:44.917
and at the lowest effective
therapeutic dose.
00:51:45.421 --> 00:51:48.946
And the resident and family,
or legal representative,
00:51:48.946 --> 00:51:50.985
to the extent possible,
00:51:50.985 --> 00:51:55.570
must be involved in any decision
to prescribe anti-psychotic medications.
00:51:56.538 --> 00:51:57.733
Next slide.
00:51:59.398 --> 00:52:03.509
When a resident is admitted
on a psychotropic medication,
00:52:03.509 --> 00:52:07.002
the physician and pharmacist review
00:52:07.002 --> 00:52:09.285
the clinical indication
for the medication,
00:52:09.929 --> 00:52:12.222
whether it's necessary moving forward,
00:52:12.740 --> 00:52:17.376
and considerations for dose reduction
and any alternative interventions.
00:52:18.120 --> 00:52:21.698
There's no specific requirement
for where this information is documented
00:52:21.698 --> 00:52:25.125
as long as the organization
can present evidence
00:52:25.125 --> 00:52:28.919
of the physician or pharmacist review
and their conclusions.
00:52:29.944 --> 00:52:32.842
The organization must monitor
the use of PRN,
00:52:32.842 --> 00:52:35.994
or as needed
psychotropic medication orders
00:52:35.994 --> 00:52:40.354
to ensure they are appropriate
and effective, and to reduce their use.
00:52:40.992 --> 00:52:44.630
And the organization must also
evaluate compliance with his process
00:52:44.630 --> 00:52:47.276
for monitoring
psychotropic medication use.
00:52:48.265 --> 00:52:49.534
Next slide.
00:52:51.292 --> 00:52:55.011
The standards in the Provision of Care,
Treatment, and Services chapter
00:52:55.011 --> 00:52:58.306
require that organizations
provide a disclosure form
00:52:58.306 --> 00:53:00.147
to all residents with dementia
00:53:00.147 --> 00:53:02.625
that include the items
listed on this slide.
00:53:03.372 --> 00:53:07.244
The document must be signed
by the resident or responsible party.
00:53:07.903 --> 00:53:10.415
Many states require
that Assisted Living residents
00:53:10.415 --> 00:53:13.071
receive and sign a disclosure form,
00:53:13.071 --> 00:53:14.665
and some states require it
00:53:14.665 --> 00:53:18.312
specifically when the organization
offers dementia care services.
00:53:19.342 --> 00:53:20.478
Next slide.
00:53:23.196 --> 00:53:27.034
The PC Chapter also addresses
resident assessments.
00:53:27.525 --> 00:53:32.037
Residents without a dementia diagnosis
exhibiting symptoms of dementia
00:53:32.037 --> 00:53:37.366
must be evaluated by a neurologist,
psychiatrist, geriatrician,
00:53:37.366 --> 00:53:41.010
or other qualified physician
to establish a diagnosis.
00:53:41.851 --> 00:53:46.112
Residents must be assessed
by a qualified clinician every six months
00:53:46.112 --> 00:53:48.468
and when there's a change
in the resident's condition.
00:53:49.403 --> 00:53:51.611
The resident's decision-making capacity
00:53:51.611 --> 00:53:54.651
must be assessed
by a qualified licensed practitioner.
00:53:55.840 --> 00:53:57.577
When there's a change in condition,
00:53:57.577 --> 00:54:01.325
evidence-based cognitive
and functional assessment tools are used.
00:54:01.858 --> 00:54:04.736
Examples include
the Global Deterioration Scale
00:54:04.736 --> 00:54:06.917
and the Functional
Activities Questionnaire.
00:54:07.704 --> 00:54:10.575
And quarterly behavioral
health assessments
00:54:10.575 --> 00:54:14.546
must be completed
by a qualified licensed practitioner
00:54:14.546 --> 00:54:17.157
for residents
taking psychotropic medication.
00:54:18.216 --> 00:54:19.849
And just to clarify,
00:54:19.849 --> 00:54:24.135
a licensed practitioner is an individual
who is licensed and qualified
00:54:24.135 --> 00:54:28.179
to direct or provide care,
treatment, and services,
00:54:28.179 --> 00:54:30.775
in accordance
with state law and regulation,
00:54:31.300 --> 00:54:33.516
applicable federal law and regulation,
00:54:33.881 --> 00:54:35.848
and organization policy.
00:54:37.001 --> 00:54:38.369
Next slide.
00:54:40.400 --> 00:54:42.276
Resident assessments should be used
00:54:42.276 --> 00:54:45.751
as an opportunity to get to know
the person living with dementia,
00:54:45.751 --> 00:54:49.373
and develop a therapeutic relationship
with that resident,
00:54:49.373 --> 00:54:51.416
not only for clinical decisions.
00:54:52.171 --> 00:54:55.889
The resident and family
should be involved in assessments
00:54:55.889 --> 00:54:58.142
to whatever degree possible,
00:54:58.142 --> 00:55:01.472
when assessing the items
listed on the slide.
00:55:02.435 --> 00:55:05.110
The best sources of information
are the resident
00:55:05.110 --> 00:55:07.412
and, to a large degree,
those closest to them.
00:55:07.976 --> 00:55:10.687
Oftentimes, family members
have also been caregivers
00:55:10.687 --> 00:55:13.296
prior to the resident
moving into Assisted Living,
00:55:13.296 --> 00:55:15.219
and may also be decision makers.
00:55:16.137 --> 00:55:17.312
Next slide.
00:55:26.146 --> 00:55:27.933
One moment. OK.
00:55:28.351 --> 00:55:31.506
A plan for care must be developed
for each resident,
00:55:31.506 --> 00:55:35.441
sometimes referred to as a Service Plan
in Assisted Living settings.
00:55:36.077 --> 00:55:38.215
An interdisciplinary team,
00:55:38.215 --> 00:55:40.060
other staff as appropriate,
00:55:40.060 --> 00:55:44.057
the resident, and the family
develop the plan for care.
00:55:45.649 --> 00:55:48.267
The plan reflects
the resident's personal goals:
00:55:48.267 --> 00:55:53.028
preferences, lifelong interests,
routines for daily activities,
00:55:53.028 --> 00:55:54.550
and freedom of choice.
00:55:55.797 --> 00:55:58.600
When necessary,
the organization supervises residents
00:55:58.600 --> 00:56:00.482
based on their individual needs.
00:56:01.100 --> 00:56:04.090
The interdisciplinary team
then collaboratively reviews
00:56:04.090 --> 00:56:06.298
and revises the plan as appropriate.
00:56:06.987 --> 00:56:08.107
Next slide.
00:56:10.638 --> 00:56:13.556
Assisting a family member
transition a loved one
00:56:13.556 --> 00:56:18.333
to a memory care program
can be uncertain times for families.
00:56:18.333 --> 00:56:21.190
Providing them with education
can help alleviate
00:56:21.190 --> 00:56:22.793
some of that uncertainty.
00:56:23.518 --> 00:56:27.385
At a minimum, organizations
must provide family education
00:56:27.385 --> 00:56:32.066
that includes dementia progression
and related behavioral expressions
00:56:32.066 --> 00:56:33.766
of unmet needs.
00:56:33.766 --> 00:56:36.026
Because the resident's behavior
will change
00:56:36.026 --> 00:56:39.298
and it's less alarming and confusing
if families are prepared.
00:56:40.044 --> 00:56:41.573
Communication techniques
00:56:41.573 --> 00:56:43.876
because the resident's
perceptions may change,
00:56:43.876 --> 00:56:47.276
and there are things families can do
to adapt their communication.
00:56:48.289 --> 00:56:51.701
Personalized approaches to care
for the resident with dementia.
00:56:51.701 --> 00:56:56.037
Because each resident is unique
and not defined by their diagnosis
00:56:56.542 --> 00:57:01.206
and the use of psychotropic medications,
including the reasons for use,
00:57:01.206 --> 00:57:05.782
risks versus the benefits,
and any potential side effects.
00:57:06.409 --> 00:57:07.447
Next slide.
00:57:09.798 --> 00:57:12.954
The organization must also meet
the resident's health care needs
00:57:12.954 --> 00:57:16.481
by communicating any consultative reports
00:57:16.481 --> 00:57:19.057
and evaluations
to the resident's physician.
00:57:19.888 --> 00:57:23.061
Aligning physician visits
with the resident's needs,
00:57:23.061 --> 00:57:27.510
including at least one physician visit
during the first 30 days following moving.
00:57:28.318 --> 00:57:32.508
Co-ordinating the resident's
comorbidities and dementia care,
00:57:32.508 --> 00:57:35.450
because treatments
for other healthcare conditions
00:57:35.450 --> 00:57:38.118
can be contraindicated
with dementia treatments
00:57:38.118 --> 00:57:40.503
or exacerbate dementia symptoms.
00:57:41.182 --> 00:57:43.953
The interdisciplinary team
and others as needed
00:57:43.953 --> 00:57:47.628
must conduct resident care
conferences regularly
00:57:47.628 --> 00:57:50.593
to discuss resident-centered
goals of care,
00:57:50.593 --> 00:57:53.496
disease prognosis,
and advanced care planning.
00:57:54.218 --> 00:57:58.482
This can be accomplished, face to face,
and through remote technologies.
00:57:59.331 --> 00:58:00.410
Next slide.
00:58:02.327 --> 00:58:04.745
Coordination of resident care must be led
00:58:04.745 --> 00:58:08.097
by those with experience
and training in dementia care.
00:58:08.097 --> 00:58:11.902
Either a single individual
or multiple people can be assigned.
00:58:12.494 --> 00:58:15.451
Coordination includes planning activities
00:58:15.451 --> 00:58:18.193
that are tailored to the resident's
needs and interests;
00:58:18.617 --> 00:58:20.628
monitoring staff performance
00:58:20.628 --> 00:58:24.160
regarding communication techniques
and resident interactions;
00:58:24.890 --> 00:58:27.158
fostering an authentic
learning environment
00:58:27.158 --> 00:58:29.076
through coaching and modeling;
00:58:29.902 --> 00:58:33.125
coordinating internal
and external resources
00:58:33.125 --> 00:58:34.821
for family support needs;
00:58:36.304 --> 00:58:39.522
communicating
the quality and safety needs
00:58:39.522 --> 00:58:41.409
of the program to leadership;
00:58:42.136 --> 00:58:46.745
and assisting with evaluating
cognitive devices and equipment
00:58:46.745 --> 00:58:48.852
to support resident care and treatment.
00:58:49.856 --> 00:58:50.988
Next slide.
00:58:53.853 --> 00:58:55.936
So mealtime and food consumption
00:58:55.936 --> 00:58:58.770
should be more
than just sustenance for the resident.
00:58:58.770 --> 00:59:02.715
It can also promote social,
cognitive, and functional activities.
00:59:03.336 --> 00:59:06.549
Organizations should engage
with residents during mealtime
00:59:06.549 --> 00:59:08.953
by allowing them to assist in the process
00:59:08.953 --> 00:59:11.017
according to their abilities
and interests.
00:59:11.486 --> 00:59:15.229
For instance, they can help
with planning a menu
00:59:15.229 --> 00:59:17.105
or decorate a common space.
00:59:18.009 --> 00:59:22.256
And in order to promote independence
and minimize confusion during mealtime,
00:59:22.256 --> 00:59:24.455
organizations should serve food
00:59:24.455 --> 00:59:29.671
in a manner that offers a visual contrast
between the plate food and plate setting.
00:59:30.539 --> 00:59:33.255
Limit the amount of food choices
at one time.
00:59:34.073 --> 00:59:37.536
Provide finger foods if cutlery
becomes challenging for the resident
00:59:38.209 --> 00:59:41.856
and provide methods of assistance
when needed,
00:59:41.856 --> 00:59:44.154
such as a cup with a lid and a straw.
00:59:45.145 --> 00:59:46.337
Next slide.
00:59:48.262 --> 00:59:52.338
The organization must offer opportunities
for residents to participate in social
00:59:52.338 --> 00:59:53.867
and recreational activities.
00:59:54.521 --> 00:59:58.578
Programs must adapt to the ability
and the interests of the residents.
00:59:59.033 --> 01:00:02.076
An activity should provide
cognitive stimulation,
01:00:02.076 --> 01:00:04.515
and facilitate or enhance communication.
01:00:05.380 --> 01:00:08.152
This can include
technology-based activities.
01:00:09.054 --> 01:00:12.863
The organization must offer opportunities
for residents to go on outings,
01:00:12.863 --> 01:00:14.265
when it's safe to do so.
01:00:14.918 --> 01:00:18.035
Programming must include
inter-generational activities.
01:00:18.761 --> 01:00:23.133
And organizations must also offer
daily physical activities,
01:00:23.133 --> 01:00:26.929
such as dance or exercise,
which can improve balance
01:00:26.929 --> 01:00:30.008
and may decrease the need
for assistive devices
01:00:30.008 --> 01:00:31.548
and reduce fall risk.
01:00:32.274 --> 01:00:33.601
Next slide.
01:00:34.949 --> 01:00:37.697
The organization must determine
the education needs
01:00:37.697 --> 01:00:39.298
and the abilities of the resident,
01:00:39.691 --> 01:00:41.737
the support needs of the family,
01:00:41.737 --> 01:00:45.179
and evaluate the resident's
understanding of any education
01:00:45.179 --> 01:00:46.592
or training that they provide.
01:00:47.449 --> 01:00:50.476
It's important to inform the resident
how they can express
01:00:50.476 --> 01:00:55.435
any concerns they may have before,
during, and after care is received.
01:00:56.268 --> 01:00:58.397
The organization
must also provide information
01:00:58.397 --> 01:01:03.531
to residents, families and caregivers
on brain health and cognitive aging,
01:01:04.105 --> 01:01:09.185
disease stages and progression,
person-centered dementia care strategies,
01:01:09.632 --> 01:01:13.440
transfer protocols,
and end of life considerations.
01:01:14.374 --> 01:01:17.643
This is the minimum requirement
for education content,
01:01:17.643 --> 01:01:19.680
but it can definitely be expanded on.
01:01:21.602 --> 01:01:23.979
And the program must offer
support to families
01:01:23.979 --> 01:01:26.071
by either providing a support group
01:01:26.071 --> 01:01:29.212
or offering a list of support
groups in the community.
01:01:29.726 --> 01:01:32.153
The Alzheimer's Association
is a good resource
01:01:32.153 --> 01:01:34.349
for searching local support groups.
01:01:35.055 --> 01:01:36.096
Next slide.
01:01:38.460 --> 01:01:41.912
There are times when transfers
in care may be necessary,
01:01:41.912 --> 01:01:44.351
the organization must document the process
01:01:44.351 --> 01:01:47.849
for transitioning the responsibility
for a resident's care
01:01:47.849 --> 01:01:52.847
from one clinician, organization,
program, or service to another.
01:01:53.716 --> 01:01:55.675
The process must include:
01:01:55.675 --> 01:01:59.057
identification of potential causes
of behavioral symptoms;
01:01:59.610 --> 01:02:02.437
successful personalized
approaches to care;
01:02:02.871 --> 01:02:05.139
successful communication techniques;
01:02:05.594 --> 01:02:09.069
the resident's cognitive, sensory
and physical capabilities;
01:02:09.613 --> 01:02:11.098
and advanced care planning.
01:02:11.878 --> 01:02:13.396
And the organization must discuss
01:02:13.396 --> 01:02:16.139
the resident's transfer plan
with the family
01:02:16.139 --> 01:02:19.298
and any relevant practitioners
across care settings.
01:02:20.009 --> 01:02:21.142
Next slide.
01:02:24.364 --> 01:02:26.576
And finally,
the resident's clinical record
01:02:26.576 --> 01:02:29.352
must have information
regarding medical care
01:02:29.352 --> 01:02:31.647
and changes in the resident's condition,
01:02:32.080 --> 01:02:35.287
including the provision
of medical care and treatment;
01:02:35.746 --> 01:02:38.474
the resident's response
to medical care and treatment;
01:02:39.308 --> 01:02:42.126
medical observations
and recommendations made
01:02:42.126 --> 01:02:44.168
after the initial medical assessment;
01:02:44.942 --> 01:02:48.790
progress notes recorded
by the physician at each visit;
01:02:49.478 --> 01:02:52.927
and any significant changes
in the resident's condition,
01:02:52.927 --> 01:02:56.514
care, treatment, and services,
as determined by the organization.
01:02:57.652 --> 01:02:58.830
Next slide.
01:03:00.660 --> 01:03:03.629
So there will be an opportunity
to ask the panel questions
01:03:03.629 --> 01:03:05.233
at the end of our presentation.
01:03:05.689 --> 01:03:09.436
However, should you have
any unanswered standards questions
01:03:09.436 --> 01:03:11.037
after we conclude today,
01:03:11.037 --> 01:03:15.725
you can submit them using the online form
that I've linked here on the slide,
01:03:15.725 --> 01:03:17.670
and we will respond with an answer.
01:03:18.296 --> 01:03:22.278
There's also a link here
to Frequently Asked Questions
01:03:22.278 --> 01:03:23.852
on The Joint Commission website
01:03:23.852 --> 01:03:26.592
that provides additional
information and resources.
01:03:27.559 --> 01:03:29.232
That concludes my presentation.
01:03:29.232 --> 01:03:30.420
Thank you for your attention.
01:03:30.420 --> 01:03:33.379
I'll now turn it over to my colleague,
Beverly Belton.
01:03:34.784 --> 01:03:38.684
(Andrea) Well, thank you.
And though I'm not Beverly, Debbie,
01:03:38.686 --> 01:03:40.894
I appreciate all
of the content you presented.
01:03:40.894 --> 01:03:44.679
And before Beverly begins,
we're actually going to have a quick poll.
01:03:46.633 --> 01:03:49.716
We've certainly talked a lot
about the benefits of certification,
01:03:49.716 --> 01:03:51.252
but wanted to ask you:
01:03:51.252 --> 01:03:55.724
What is the primary reason
you would pursue certification?
01:03:56.335 --> 01:03:59.939
So we're going to ask you
to choose just one of the options.
01:03:59.939 --> 01:04:05.552
Again, we've given you some ideas here,
that be for standards and guidance;
01:04:05.552 --> 01:04:07.354
market distinction;
01:04:07.354 --> 01:04:09.085
staff recruitment;
01:04:09.085 --> 01:04:11.939
meeting other regulations;
or other reasons,
01:04:11.939 --> 01:04:15.847
and feel free
to share those other reason's with us.
01:04:16.488 --> 01:04:18.000
We would appreciate it.
01:04:25.006 --> 01:04:29.564
OK, We'll go just a few more seconds.
Thank you again, all.
01:04:32.925 --> 01:04:33.951
That's great.
01:04:33.951 --> 01:04:37.387
So I'm going to go ahead
and share those results.
01:04:38.420 --> 01:04:42.890
So the majority are choosing certification
for the market distinction,
01:04:42.890 --> 01:04:46.088
followed by the standards
and guidance that it would provide,
01:04:46.735 --> 01:04:49.953
as well as helping
to meet other regulations.
01:04:53.369 --> 01:04:56.081
I'm sorry.
I'll just show those results here.
01:04:59.522 --> 01:05:04.000
And thank you all again
so much for participating.
01:05:04.343 --> 01:05:07.970
We will have another opportunity
in just a few slides.
01:05:09.186 --> 01:05:13.807
And with that, now I will hand it over
to Beverly to begin.
01:05:13.807 --> 01:05:14.954
Thank you.
01:05:16.168 --> 01:05:19.817
(Beverly) Oh, thank you, Andrea.
Next slide, please.
01:05:23.755 --> 01:05:28.343
So my name is Beverly Belton,
and I'm a Field Director
01:05:28.343 --> 01:05:32.255
at The Joint Commission
in our supervision of Accreditation
01:05:32.255 --> 01:05:34.782
and Certification Operations,
01:05:35.370 --> 01:05:38.286
and in that role...
01:05:42.095 --> 01:05:47.167
I am responsible for the surveyors
who come out to your patients,
01:05:47.167 --> 01:05:51.978
as well as the clinical operations
associated with the survey process.
01:05:52.506 --> 01:05:53.796
Next slide, please.
01:05:57.289 --> 01:06:02.953
First, the surveyors you will meet
during the survey process
01:06:02.953 --> 01:06:08.837
are experts with broad experience
across the senior care portion
01:06:08.837 --> 01:06:11.956
of both the wellness
and healthcare continuum.
01:06:12.590 --> 01:06:16.599
And you see three of them pictured
on the screen in front of you.
01:06:17.255 --> 01:06:22.073
In addition, our surveyors are all
employed by The Joint Commission.
01:06:22.745 --> 01:06:28.705
They are all masters prepared
registered nurses.
01:06:29.748 --> 01:06:33.244
They are experienced
in providing leadership
01:06:33.244 --> 01:06:38.113
as well as expert clinical
and wellness services for individuals
01:06:38.113 --> 01:06:42.062
with memory care needs
in the Assisted Living setting.
01:06:43.125 --> 01:06:46.542
They are experts in the evaluation
and application
01:06:46.542 --> 01:06:48.623
of Joint Commission standards,
01:06:49.593 --> 01:06:53.492
and they receive continuous
training and education
01:06:53.492 --> 01:06:58.203
to provide consistent, current,
and relevant insights to you.
01:06:59.059 --> 01:07:01.164
But most importantly,
01:07:01.568 --> 01:07:06.291
they are your partners
in providing safe quality services
01:07:06.291 --> 01:07:08.746
and care to your residents.
01:07:09.012 --> 01:07:10.323
Next slide, please.
01:07:14.745 --> 01:07:19.908
So our survey process
is designed to be collaborative.
01:07:21.735 --> 01:07:26.743
We provide you with an in-depth,
real-time analysis
01:07:26.743 --> 01:07:29.359
of your organization's compliance
01:07:29.359 --> 01:07:31.325
with Joint Commission standards.
01:07:32.826 --> 01:07:34.509
During this process,
01:07:34.941 --> 01:07:39.196
you will be involved
in every step of the process.
01:07:40.467 --> 01:07:43.309
The appropriate member of your staff
01:07:43.309 --> 01:07:46.928
or leadership team
will accompany the surveyor
01:07:46.928 --> 01:07:52.387
and the surveyor will show you
what they're looking at, what they see,
01:07:52.387 --> 01:07:55.942
and they will explain the why behind it.
01:07:57.694 --> 01:08:01.796
During the survey,
our surveyors identify your strengths,
01:08:01.796 --> 01:08:05.540
as well as your opportunities
for improvement.
01:08:06.478 --> 01:08:08.700
They verbally acknowledge
01:08:10.221 --> 01:08:13.493
your strengths and the things
that you're doing well.
01:08:14.259 --> 01:08:19.080
They will provide you
with a thorough written evaluation
01:08:19.080 --> 01:08:21.958
of your opportunities for improvement.
01:08:23.024 --> 01:08:29.261
In addition, they will also share
practical evidence-based strategies
01:08:29.261 --> 01:08:35.169
and better practices gleaned
from our extensive survey experience.
01:08:36.639 --> 01:08:37.898
Next slide, please.
01:08:43.250 --> 01:08:48.112
The survey process is made up
01:08:48.112 --> 01:08:54.323
of two primary methodologies.
01:08:55.620 --> 01:08:59.001
We have our Tracer methodology
01:08:59.001 --> 01:09:02.570
which is the cornerstone of our process
01:09:03.041 --> 01:09:06.697
and is also unique
to The Joint Commission.
01:09:09.922 --> 01:09:16.812
Our individual tracer
literally traces your interactions
01:09:16.812 --> 01:09:21.569
with the individual
through your organization.
01:09:22.280 --> 01:09:26.650
This includes looking
at activities of daily living,
01:09:27.070 --> 01:09:29.038
general activities,
01:09:29.610 --> 01:09:35.577
participating in any key
care activities as well.
01:09:38.241 --> 01:09:39.707
Next slide, please.
01:09:46.282 --> 01:09:49.310
The system tracers
01:09:49.310 --> 01:09:55.598
are intended to look at more depth
01:09:56.086 --> 01:09:59.891
at how your policies and procedures
01:10:00.213 --> 01:10:02.971
related to the physical environment
01:10:03.406 --> 01:10:07.029
support individuals
with memory care issues,
01:10:08.048 --> 01:10:13.075
how your policies and procedures
address support of the population
01:10:13.075 --> 01:10:15.407
during emergency situations,
01:10:16.964 --> 01:10:22.761
how you ensure that your clinical teams
have the knowledge and skills
01:10:22.761 --> 01:10:25.112
to support this population,
01:10:25.511 --> 01:10:28.398
and that you have processes in place
01:10:28.398 --> 01:10:34.305
to ensure that knowledge and skill
is maintained over time.
01:10:35.727 --> 01:10:40.760
Finally, in our leadership
and data management system tracers,
01:10:41.426 --> 01:10:44.983
we'll be evaluating
how your policies and procedures
01:10:44.983 --> 01:10:47.872
support your facility leadership
01:10:48.402 --> 01:10:50.389
and for writing oversight
01:10:50.389 --> 01:10:52.837
and resources to your team
01:10:53.179 --> 01:10:59.056
so that they can provide
quality safe services to your residents.
01:11:00.151 --> 01:11:02.988
In addition, they will be evaluating
01:11:02.988 --> 01:11:07.300
how you use data
to identify opportunities
01:11:07.300 --> 01:11:11.674
to improve the services
and supports you provide.
01:11:12.584 --> 01:11:17.700
The system tracers are facilitated dialogs
01:11:17.700 --> 01:11:20.719
where the surveyor sits down with you
01:11:20.719 --> 01:11:25.202
and designated members of your team
01:11:25.202 --> 01:11:30.478
to talk about these three areas
that I've mentioned.
01:11:31.381 --> 01:11:32.803
Next slide, please.
01:11:37.320 --> 01:11:41.011
An important part
of our written survey report
01:11:41.011 --> 01:11:46.513
is our survey analysis
for evaluating risk matrix,
01:11:46.829 --> 01:11:50.059
which is also known as the SAFER Matrix.
01:11:50.979 --> 01:11:55.232
This matrix provides you
with a visual representation
01:11:55.232 --> 01:11:58.473
of the risks identified by the surveyor.
01:11:59.666 --> 01:12:01.847
A completed SAFER Matrix
01:12:01.847 --> 01:12:04.855
will have the specific
Joint Commission standard
01:12:05.414 --> 01:12:07.595
that you are not in compliance with,
01:12:08.076 --> 01:12:11.291
listed in one of the boxes on the matrix,
01:12:11.291 --> 01:12:14.764
allowing you to see
what the likelihood of risks
01:12:14.764 --> 01:12:18.768
to residents, staff, or visitors is.
01:12:19.638 --> 01:12:25.184
In addition, allowing you
to see the scope of the problem,
01:12:25.550 --> 01:12:30.405
so that you can easily see
where you need to focus your efforts.
01:12:31.171 --> 01:12:35.539
One of the most important things
to remember about the SAFER Matrix
01:12:35.539 --> 01:12:38.870
is the number of items on the matrix
01:12:38.870 --> 01:12:43.414
is less important
than the degree of risk identified.
01:12:45.023 --> 01:12:49.790
For example, if you have
ten requirements for improvement
01:12:49.790 --> 01:12:51.298
in the yellow box,
01:12:51.298 --> 01:12:54.065
which represents issues
that are low risk
01:12:54.065 --> 01:12:55.698
and with limited scope
01:12:56.634 --> 01:13:03.049
versus one item in the red box
on the top right,
01:13:03.607 --> 01:13:06.939
which represents an issue
that is high risk
01:13:06.939 --> 01:13:09.904
with widespread scope.
01:13:11.022 --> 01:13:12.878
Clearly, in this case,
01:13:13.276 --> 01:13:19.185
the one is more of a concern than the ten.
01:13:21.018 --> 01:13:22.445
Next slide, please.
01:13:25.073 --> 01:13:29.617
I'm going to spend the next few minutes
sharing a few tips with you
01:13:29.617 --> 01:13:33.636
about getting ready
for your first Joint Commission Survey.
01:13:34.853 --> 01:13:37.597
First, take a look.
01:13:38.299 --> 01:13:43.073
Get to know the standards,
take a look at the accreditation manual.
01:13:43.860 --> 01:13:47.905
Add it to your reading list
but, of course, don't read alone,
01:13:47.905 --> 01:13:52.131
invite others,
divide the chapters and discuss.
01:13:53.753 --> 01:13:57.517
Use the self assessment prompts
and checklists
01:13:57.517 --> 01:14:01.041
to identify any gaps in compliance.
01:14:02.611 --> 01:14:06.635
And, as Debbie mentioned
at the end of her presentation,
01:14:06.635 --> 01:14:09.836
reach out to us with any questions.
01:14:11.030 --> 01:14:13.390
Next, have the right mindset.
01:14:14.192 --> 01:14:18.487
One of the goals of the survey process
is to inspire you
01:14:18.487 --> 01:14:23.701
to make a focus on quality and safety,
01:14:24.063 --> 01:14:27.063
the foundation
of the services you provide.
01:14:28.066 --> 01:14:31.571
So, as you begin your journey
to accreditation,
01:14:31.571 --> 01:14:36.810
don't prepare for a single
accreditation survey event,
01:14:37.267 --> 01:14:39.745
prepare to make quality and safety
01:14:39.745 --> 01:14:43.869
a tangible part of your residents,
their families,
01:14:43.869 --> 01:14:46.911
and your entire team's daily routine
01:14:47.557 --> 01:14:51.533
so you never have to prepare for a survey.
01:14:52.696 --> 01:14:58.164
And you can do this
by talking about the standards
01:14:58.471 --> 01:15:01.523
and the expectations of the standards
01:15:01.523 --> 01:15:07.007
during your daily team routines,
01:15:07.728 --> 01:15:14.279
talking about it when having discussions
with the families of your residents,
01:15:14.279 --> 01:15:16.486
and with your residents as well.
01:15:18.109 --> 01:15:21.634
Next, as I mentioned,
you want to involve your team.
01:15:22.191 --> 01:15:26.607
Discuss the standards
and certification process with your team
01:15:27.078 --> 01:15:29.185
so they understand it.
01:15:32.035 --> 01:15:35.557
Get creative.
Have fun with the process.
01:15:36.164 --> 01:15:41.128
Make it a growth opportunity
for individuals on your team
01:15:41.128 --> 01:15:44.767
that are looking for something new
and innovative to do.
01:15:45.766 --> 01:15:47.332
In some cases,
01:15:47.814 --> 01:15:50.915
individuals will make a game out of
01:15:50.915 --> 01:15:53.913
becoming familiar with the standards.
01:15:54.184 --> 01:15:59.081
They will literally write
important items on the wall
01:15:59.081 --> 01:16:02.563
and post them in places where your staff
01:16:02.563 --> 01:16:05.668
and other members of your team
01:16:06.836 --> 01:16:09.681
spend significant amounts of time.
01:16:11.121 --> 01:16:12.852
Next, get organized.
01:16:13.360 --> 01:16:18.508
Organize your documents and the tools
that you're using on this journey,
01:16:18.508 --> 01:16:20.901
so that they're easy to find,
01:16:20.901 --> 01:16:24.279
and store them
where they're easily accessible.
01:16:24.781 --> 01:16:27.120
So, when the surveyor does arrive,
01:16:27.120 --> 01:16:33.008
you can go and pull out the items
that you need during the process,
01:16:33.395 --> 01:16:37.107
but again, these items
are readily accessible
01:16:37.107 --> 01:16:39.388
to any member of your team.
01:16:41.630 --> 01:16:46.044
Now, during the survey process,
be engaged.
01:16:46.517 --> 01:16:50.212
It is not meant to be a process
where we come in
01:16:50.212 --> 01:16:52.815
and find all the things
that you're doing wrong,
01:16:52.815 --> 01:16:54.614
and, "Oh, gotcha."
01:16:55.014 --> 01:16:59.004
It's really meant to be
a collaborative process,
01:16:59.440 --> 01:17:02.999
where you can learn about
01:17:02.999 --> 01:17:07.558
how to be in compliance
with the standards,
01:17:07.923 --> 01:17:10.839
but also where you can ask questions.
01:17:11.525 --> 01:17:17.754
Yes, the surveyor will be asking you,
your team, your residents,
01:17:17.754 --> 01:17:20.761
and, if their families are available,
01:17:22.422 --> 01:17:23.766
their families.
01:17:23.766 --> 01:17:25.481
many questions,
01:17:25.481 --> 01:17:31.447
but you and your team
can also ask the surveyor questions.
01:17:32.144 --> 01:17:33.709
It's important
01:17:34.522 --> 01:17:38.908
that you understand
what the surveyor's seeing,
01:17:38.908 --> 01:17:41.703
and if you have questions,
01:17:41.703 --> 01:17:46.243
that you ask those questions
while the surveyor is present.
01:17:46.243 --> 01:17:49.552
It really is OK to talk to the surveyor.
01:17:52.990 --> 01:17:59.683
We want the survey to be meaningful,
and we also want it to be inspirational.
01:18:02.675 --> 01:18:08.544
And after the survey is completed
and you've received your report,
01:18:08.987 --> 01:18:12.989
make sure that you share
your findings with your team,
01:18:13.429 --> 01:18:18.928
it's important for them to understand
the opportunities for improvement,
01:18:18.928 --> 01:18:20.936
That were identified
01:18:20.936 --> 01:18:27.807
because they will be important in helping
to resolve those issues as well.
01:18:29.374 --> 01:18:32.384
Develop the improvement plan
with your team,
01:18:32.384 --> 01:18:34.792
and make sure they understand it.
01:18:35.360 --> 01:18:39.936
One of the challenges
that we find many times
01:18:39.936 --> 01:18:46.050
is the improvement plan
is written by someone else,
01:18:46.050 --> 01:18:49.502
and the team has no idea what it says.
01:18:49.887 --> 01:18:54.125
As a result, they don't know what to do
01:18:54.125 --> 01:18:58.835
to actually address the opportunities
that were identified.
01:18:59.553 --> 01:19:05.014
And if you remember, earlier on,
I talked about the fact
01:19:05.014 --> 01:19:11.380
that the survey process
is really not about a single event.
01:19:11.380 --> 01:19:16.153
It's out a journey in which we come in,
01:19:17.734 --> 01:19:19.864
provide the evaluation,
01:19:20.686 --> 01:19:23.998
the meaningful assessment
of your compliance,
01:19:23.998 --> 01:19:30.111
but really inspire you to continue
to improve over time,
01:19:30.580 --> 01:19:36.426
so we use that post survey
process to do that.
01:19:36.801 --> 01:19:42.796
And remember that there are
a variety of Joint Commission resources
01:19:42.796 --> 01:19:46.472
that are available to assist you
with that process.
01:19:46.472 --> 01:19:51.396
Written documents,
that are available on our extranet,
01:19:51.396 --> 01:19:54.832
as well as the public website,
01:19:54.832 --> 01:20:00.286
and also access to members
of our Standards Interpretation Group.
01:20:01.042 --> 01:20:02.340
Next slide, please.
01:20:07.502 --> 01:20:11.862
By the way, I want to share with you
01:20:11.862 --> 01:20:15.346
that your opinions
are really important to us
01:20:15.346 --> 01:20:17.788
when it comes to the survey process.
01:20:18.520 --> 01:20:23.666
At the end the survey process,
or after the survey process is over
01:20:23.666 --> 01:20:26.965
and that surveyors
have left your facility,
01:20:26.965 --> 01:20:31.807
you will receive a post survey evaluation,
01:20:32.264 --> 01:20:37.727
where we ask you to rate
your experience with the surveyor
01:20:37.729 --> 01:20:39.491
during the survey process.
01:20:40.448 --> 01:20:43.698
You may also receive a call
01:20:43.698 --> 01:20:46.776
from a member
of The Joint Commission team
01:20:46.776 --> 01:20:48.674
to gather feedback as well.
01:20:49.371 --> 01:20:52.396
This feedback is important to us
01:20:52.396 --> 01:20:57.544
because we use this
to help make our survey process
01:20:58.046 --> 01:21:00.623
meet our expectation
01:21:01.781 --> 01:21:03.622
of helping you
01:21:04.006 --> 01:21:08.717
to be inspired and excel
01:21:08.717 --> 01:21:12.564
in providing safe
and effective services
01:21:12.564 --> 01:21:16.200
and care of the highest quality and value.
01:21:17.056 --> 01:21:22.165
I use the feedback to coach
and develop our surveyors
01:21:22.165 --> 01:21:25.043
and we appreciate the time
01:21:25.043 --> 01:21:29.043
that it takes for you
to complete the survey.
01:21:31.039 --> 01:21:33.802
So that is my final slide.
01:21:33.802 --> 01:21:37.709
I will turn the presentation over to Gina,
01:21:37.709 --> 01:21:41.472
who will be talking about
the steps to certification.
01:21:42.814 --> 01:21:47.432
(Gina) Well, thanks so much, Beverly,
and thank you, Doug and Debbie,
01:21:47.432 --> 01:21:50.323
for such great information,
01:21:50.323 --> 01:21:55.706
and Andrea, for such entertaining
and informative polls,
01:21:55.706 --> 01:21:58.959
I really appreciate all your work on this.
01:21:58.959 --> 01:22:01.011
So let's go on to the next slide
01:22:01.011 --> 01:22:03.991
and talk about
maybe some of the practical steps
01:22:03.991 --> 01:22:07.895
to going about and achieving
Memory Care Certification
01:22:07.895 --> 01:22:10.320
within your Assisted Living Community.
01:22:10.891 --> 01:22:15.337
So I want to talk a little bit
about two different buckets
01:22:15.337 --> 01:22:18.547
of people that are joining us here today.
01:22:19.774 --> 01:22:23.368
We certainly know that, within our group,
01:22:23.368 --> 01:22:26.823
we have a number
of Assisted Living Communities
01:22:26.823 --> 01:22:31.339
that haven't taken the step
towards accreditation just yet.
01:22:32.191 --> 01:22:36.429
So, for you, you absolutely are able
01:22:36.429 --> 01:22:39.949
to achieve Assisted Living
Community Accreditation,
01:22:40.381 --> 01:22:43.052
while you're planning
for your initial survey,
01:22:43.052 --> 01:22:46.700
and you can pursue
the Memory Care Certification
01:22:47.003 --> 01:22:52.256
at the same time as you're pursuing
initial accreditation for your community.
01:22:52.928 --> 01:22:55.574
We also have a number of organizations
01:22:55.574 --> 01:23:00.061
that have already achieved accreditation
as an Assisted Living Community.
01:23:00.431 --> 01:23:04.402
So, you're wondering,
"I've got three years to go, perhaps,
01:23:04.402 --> 01:23:09.546
until I do for my triennial resurvey
for accreditation."
01:23:09.546 --> 01:23:12.426
So, is this an option for you?
01:23:12.840 --> 01:23:17.131
So, you do have a couple of options
if you're already accredited,
01:23:17.131 --> 01:23:21.982
you can actually pursue
Memory Care Certification
01:23:21.982 --> 01:23:26.460
as soon as the new offering
becomes available in July.
01:23:27.339 --> 01:23:30.245
This would be called an extension survey
01:23:30.245 --> 01:23:35.934
if it occurs sometime
within that triennial accreditation cycle
01:23:35.934 --> 01:23:37.843
over the next three years.
01:23:38.403 --> 01:23:43.179
Or you can choose to pursue
Memory Care Certification
01:23:43.179 --> 01:23:48.246
at the next full triennial survey
that you would be expecting
01:23:48.246 --> 01:23:50.326
for your Assisted Living Community.
01:23:50.628 --> 01:23:56.752
And we would actually advise
that you delay the certification
01:23:56.752 --> 01:23:59.226
to the full triennial survey
01:23:59.226 --> 01:24:03.854
If you're approaching
the nine-month resurvey window
01:24:03.854 --> 01:24:06.134
before your next survey is due.
01:24:06.513 --> 01:24:09.788
Because our Accreditation Program
is fairly new,
01:24:09.788 --> 01:24:14.816
we have a couple of years to wait
until that time comes
01:24:14.816 --> 01:24:17.685
so we do have some options
for you to go ahead
01:24:17.685 --> 01:24:21.727
and achieve this market distinction
much sooner
01:24:21.727 --> 01:24:24.238
if you're interested in doing that.
01:24:24.979 --> 01:24:26.857
So next slide please.
01:24:27.209 --> 01:24:32.106
Let's go on and talk then
about some of the steps to certification
01:24:32.106 --> 01:24:33.580
and what are the things
01:24:33.580 --> 01:24:36.590
that you really need
to put on your process map
01:24:36.590 --> 01:24:39.082
or work plan to get there.
01:24:39.082 --> 01:24:43.415
So first of all, we would recommend
connecting with us.
01:24:43.859 --> 01:24:47.474
Certainly, connecting with
the Business Development team
01:24:47.474 --> 01:24:48.887
that I work with
01:24:48.887 --> 01:24:52.317
to kind of give you
some of the process steps
01:24:52.317 --> 01:24:54.109
and a little bit more detail
01:24:54.109 --> 01:24:57.612
and help to guide you through the process.
01:24:58.436 --> 01:25:01.180
As Beverly mentioned,
it certainly is very important
01:25:01.180 --> 01:25:05.886
to review the accreditation
and certification requirements
01:25:06.526 --> 01:25:12.384
to kind of understand
what your readiness is for certification,
01:25:12.384 --> 01:25:17.288
what that gap might be for you
to prepare for certification.
01:25:18.070 --> 01:25:22.117
A next step we would recommend
is complete the application
01:25:22.710 --> 01:25:26.386
for those communities
that are not yet accredited.
01:25:26.862 --> 01:25:32.674
It's a one stop application
where you can apply for accreditation
01:25:32.674 --> 01:25:38.115
for your Assisted Living Community,
as well as Memory Care Certification.
01:25:38.890 --> 01:25:42.163
For those of you
that are already accredited,
01:25:42.854 --> 01:25:45.651
by the time we hit July 1st,
01:25:45.651 --> 01:25:49.607
we should have available
in that online application
01:25:49.607 --> 01:25:51.818
that you're already familiar with
01:25:51.818 --> 01:25:54.753
the checkbox for you to complete
01:25:54.753 --> 01:25:58.913
to indicate that you'd like to achieve
Memory Care Certification.
01:25:59.488 --> 01:26:04.895
And because that application
is open to you throughout the year,
01:26:04.895 --> 01:26:07.469
you can actually go into that application
01:26:07.469 --> 01:26:11.114
and update it
at any point that you are ready.
01:26:12.096 --> 01:26:16.483
And then finally,
Beverly gave us a lot of great tips
01:26:16.483 --> 01:26:19.477
as to how to participate in the survey
01:26:19.477 --> 01:26:23.977
and have your entire team
participate in the experience.
01:26:23.977 --> 01:26:27.059
So, you really want to get
all hands on deck,
01:26:27.059 --> 01:26:29.031
get everybody, you know, really involved
01:26:29.031 --> 01:26:34.012
and understanding what it means
to implement compliance
01:26:34.012 --> 01:26:37.886
with all of the standards
that are required for certification.
01:26:38.406 --> 01:26:41.362
And once you have achieved
the certification,
01:26:41.362 --> 01:26:45.039
we definitely recommend
promoting your achievement,
01:26:45.039 --> 01:26:49.392
certainly within your community,
and externally, as well.
01:26:49.758 --> 01:26:51.498
And at the bottom of this slide,
01:26:51.498 --> 01:26:56.555
we have included a link
to our program information,
01:26:56.555 --> 01:27:00.734
and access to the Memory Care
Certification standards.
01:27:00.734 --> 01:27:03.034
So once you receive this handout,
01:27:03.034 --> 01:27:06.842
you'll be able to link right
into this information
01:27:06.842 --> 01:27:08.644
that will be important to you.
01:27:09.589 --> 01:27:11.093
Next slide, please.
01:27:12.703 --> 01:27:14.418
So let's talk a little bit, too,
01:27:14.418 --> 01:27:17.577
about some of the resources and tools
01:27:17.577 --> 01:27:22.146
and communication vehicles
that you receive
01:27:22.758 --> 01:27:26.974
to become certified
through The Joint Commission.
01:27:27.371 --> 01:27:32.589
So first, as I've already mentioned,
you have as an accredited organization,
01:27:32.589 --> 01:27:35.733
or once you do apply
to The Joint Commission
01:27:35.733 --> 01:27:38.213
for accreditation and certification,
01:27:38.213 --> 01:27:42.443
you have access year-round
to the application,
01:27:42.443 --> 01:27:47.306
you can apply for certification
at any point on your timetable
01:27:47.306 --> 01:27:51.406
and you can certainly apply
to accreditation and certification
01:27:51.406 --> 01:27:53.999
at any time that is convenient,
01:27:55.163 --> 01:27:58.148
and logical for your organization.
01:27:59.235 --> 01:28:05.301
We provide you with our standards,
which we really feel are,
01:28:05.301 --> 01:28:07.927
and I hope you've seen
through the presentation,
01:28:07.927 --> 01:28:10.854
we would describe them
as non-prescriptive.
01:28:10.854 --> 01:28:15.411
We're really giving you a guideline
of what you should do.
01:28:16.284 --> 01:28:21.823
We give you a lot of room
to color outside the lines, if you will,
01:28:21.823 --> 01:28:25.327
and really create
how you implement
01:28:25.327 --> 01:28:27.401
that standard and guide
01:28:27.401 --> 01:28:30.258
through our very
non-prescriptive standards.
01:28:30.258 --> 01:28:34.640
So you have a lot of ways
that you can actually accomplish the goal
01:28:34.640 --> 01:28:38.907
by the standard based
on your own resources and capabilities
01:28:38.907 --> 01:28:41.686
and the types of services
that you're providing.
01:28:42.900 --> 01:28:48.618
We give you the opportunity to tell us
when you're ready for survey,
01:28:48.618 --> 01:28:53.378
and certainly identify some blackout dates
for any on-site survey activities
01:28:53.378 --> 01:28:58.429
so that you can have
that survey occur at your convenience.
01:28:58.943 --> 01:29:01.447
When your organization is available,
01:29:01.447 --> 01:29:05.364
not necessarily
having key staff out on vacation
01:29:05.364 --> 01:29:07.511
or important life events,
01:29:07.511 --> 01:29:11.518
or important company all-hands meetings.
01:29:11.980 --> 01:29:15.174
So, you're able to, you know,
kind of identify for us
01:29:15.174 --> 01:29:18.196
when the survey
would be convenient for you.
01:29:19.005 --> 01:29:22.036
All of our communications
and the interactions
01:29:22.036 --> 01:29:24.885
occur through Joint Commission Connect.
01:29:24.885 --> 01:29:28.075
And that is a customized extranet portal
01:29:28.075 --> 01:29:33.049
that has all of the resources
that you will need to be successful
01:29:33.049 --> 01:29:35.602
in accreditation and certification.
01:29:35.602 --> 01:29:40.605
Including your application,
your standards, your invoicing,
01:29:41.234 --> 01:29:43.656
the SAFER Matrix that Beverly described,
01:29:43.656 --> 01:29:46.815
and all of the other tools
that will help you
01:29:46.815 --> 01:29:48.981
through the accreditation process.
01:29:49.802 --> 01:29:54.441
You do have dedicated representatives
for streamline navigation
01:29:54.441 --> 01:29:55.711
through the process,
01:29:55.711 --> 01:29:58.614
that starts with the Business
Development Team.
01:29:58.614 --> 01:30:01.207
And once an organization applies,
01:30:01.207 --> 01:30:04.583
you're in the capable hands
of an Account Executive
01:30:04.583 --> 01:30:06.570
who will help you through the process.
01:30:06.965 --> 01:30:08.161
And finally, I'll note
01:30:08.161 --> 01:30:11.063
that there are no progressive levels
to achieve.
01:30:11.535 --> 01:30:16.227
Accreditation is accreditation,
and certification is certification.
01:30:16.837 --> 01:30:21.224
So, organizations can achieve
accreditation and certification,
01:30:21.738 --> 01:30:25.878
even the very first time,
through the process.
01:30:26.447 --> 01:30:30.011
So, it's not an advanced accreditation,
01:30:30.548 --> 01:30:34.534
or a certain plus tier level.
01:30:34.534 --> 01:30:39.229
It's simply accredited and certified,
or not accredited, not certified.
01:30:40.173 --> 01:30:41.768
Next slide, please.
01:30:42.602 --> 01:30:45.998
I want to talk a little bit more
about some of the other customer support,
01:30:46.889 --> 01:30:49.848
pieces and resources
that are available to you.
01:30:50.519 --> 01:30:53.101
Again, I've mentioned
the Business Development staff,
01:30:53.101 --> 01:30:55.342
we're here to answer initial questions
01:30:55.342 --> 01:30:58.935
and give you access
to standards and the application,
01:30:58.935 --> 01:31:01.307
and a lot of the other tools you'll need.
01:31:01.701 --> 01:31:04.286
Next, once applied,
01:31:04.286 --> 01:31:07.854
the Account Executive
is your dedicated point of contact
01:31:08.307 --> 01:31:10.616
from that application onwards.
01:31:10.852 --> 01:31:15.079
And we all have talked a little bit
about the Standard Interpretation Group
01:31:15.079 --> 01:31:19.264
to help with any questions
you might have on standards compliance.
01:31:19.264 --> 01:31:23.777
And we have provided you with a link
to that group with any questions.
01:31:24.236 --> 01:31:27.422
And we also want to let you know
about resources available
01:31:27.422 --> 01:31:31.396
through our State and Federal
and Payer Relations teams.
01:31:32.184 --> 01:31:34.514
These individuals here
at The Joint Commission
01:31:35.156 --> 01:31:39.494
have daily contact
and interface with stakeholders
01:31:39.494 --> 01:31:43.720
at the state and Federal levels
and, certainly, with payers as well,
01:31:43.720 --> 01:31:48.104
on reimbursement, policy issues, etc.
01:31:48.996 --> 01:31:54.090
And we are happy
to help pursue any recognitions
01:31:54.090 --> 01:31:57.352
you might be interested in
or you think might be available.
01:31:57.352 --> 01:32:00.772
We certainly would love to work with you
on any of these issues
01:32:00.772 --> 01:32:04.567
and these resources
are available to you as well.
01:32:05.376 --> 01:32:10.134
On your Joint Commission Connect
personalized portal,
01:32:10.134 --> 01:32:14.537
I have mentioned, we do provide you
with access to the E-dition,
01:32:14.537 --> 01:32:17.955
which is the electronic version
of our standards manuals.
01:32:17.955 --> 01:32:22.212
That includes all of the standards
you need for both accreditation
01:32:22.212 --> 01:32:24.433
of your Assisted Living Community
01:32:24.433 --> 01:32:28.054
as well as the certification
we've been discussing today.
01:32:28.609 --> 01:32:33.464
On Joint Commission Connect,
you'll also find a Survey Activity Guide
01:32:33.464 --> 01:32:36.389
that describes
all of the various activities
01:32:36.389 --> 01:32:39.113
that the surveyors are involved in,
01:32:39.113 --> 01:32:41.920
and that your staff and your leaders
01:32:41.920 --> 01:32:44.803
would need to be involved in
during a survey.
01:32:44.803 --> 01:32:48.962
And we also have a subscription
to the Joint Commission Perspectives,
01:32:48.962 --> 01:32:52.020
which is our official monthly e-periodical
01:32:52.020 --> 01:32:55.361
that gives you updates
on standards changes,
01:32:55.361 --> 01:32:57.289
survey process changes,
01:32:58.475 --> 01:33:01.847
standards that are most frequently scored,
01:33:01.847 --> 01:33:05.578
and a lot of other nice information
that's good to know
01:33:05.578 --> 01:33:07.802
when you're engaged
with The Joint Commission.
01:33:07.802 --> 01:33:11.383
And then finally, we do have
some supplemental resources
01:33:11.383 --> 01:33:13.735
across the enterprise
of The Joint Commission.
01:33:13.735 --> 01:33:16.928
We have publications, software, tools,
01:33:17.599 --> 01:33:19.266
seminars, webinars.
01:33:19.266 --> 01:33:22.275
We often conduct webinars like this one
01:33:22.275 --> 01:33:27.164
that are sort of like
a lunch-and-learn type of webinar
01:33:27.164 --> 01:33:29.075
that we provide for free.
01:33:29.751 --> 01:33:35.834
We do have some other educational courses
on topics such as Environment of Care,
01:33:35.834 --> 01:33:37.408
Infection Control.
01:33:38.138 --> 01:33:41.838
We can also provide
custom education services
01:33:42.471 --> 01:33:47.102
for your organization,
and advisory services, as well.
01:33:47.102 --> 01:33:50.227
And none of those tools
are actually required
01:33:50.227 --> 01:33:55.351
in order for your community
to receive accreditation or certification,
01:33:55.707 --> 01:33:59.489
but they're certainly there
to support your journey on the way.
01:34:00.531 --> 01:34:02.448
And let's go on to the next slide.
01:34:04.131 --> 01:34:06.928
So, we also have
several tools and resources
01:34:06.928 --> 01:34:08.736
to help you raise awareness,
01:34:08.736 --> 01:34:12.479
once you've actually achieved
your distinction.
01:34:12.958 --> 01:34:16.492
First of all, we have two marks
01:34:16.492 --> 01:34:19.958
that accredited
and certified organizations
01:34:19.958 --> 01:34:24.293
can use to display
to their public and stakeholders.
01:34:24.293 --> 01:34:28.528
And the first on the left is the Gold Seal
from The Joint Commission
01:34:28.528 --> 01:34:32.873
indicating national quality approval
from our organization.
01:34:33.403 --> 01:34:36.929
And then the second logo
and mark that you see
01:34:36.929 --> 01:34:40.382
to sort of more of the middle,
in the right of your screen
01:34:40.382 --> 01:34:43.131
is actually the combined logo
01:34:43.131 --> 01:34:47.749
that communities that do achieve
Memory Care Certification
01:34:47.749 --> 01:34:50.018
for their Assisted Living Community
01:34:50.018 --> 01:34:52.940
would be able to use
to demonstrate to your public
01:34:52.940 --> 01:34:56.944
that you are Joint Commission
certified for Memory care
01:34:56.944 --> 01:35:00.222
and that there is Alzheimer's Association
01:35:00.222 --> 01:35:04.178
that is working in collaboration
on this particular product.
01:35:04.178 --> 01:35:06.747
And we think that's especially important,
01:35:06.747 --> 01:35:12.134
because the Alzheimer's Association mark
01:35:12.134 --> 01:35:14.666
is very recognizable to the public
01:35:14.666 --> 01:35:18.295
and we think that there's going to be
a lot of interest in knowing
01:35:19.010 --> 01:35:21.460
by your residents
and prospective residents
01:35:21.460 --> 01:35:25.678
that the Alzheimer's Association
and The Joint Commission are inside there.
01:35:26.477 --> 01:35:29.853
In addition to use of the logos and marks,
01:35:30.495 --> 01:35:35.047
we will be listing accredited
and certified organizations
01:35:35.047 --> 01:35:38.370
on The Joint Commission's
own quality-check website.
01:35:39.547 --> 01:35:43.289
And I mentioned previously
that you will be included
01:35:43.289 --> 01:35:48.177
in the Alzheimer's Association
Community Resource Finder listing as well.
01:35:48.704 --> 01:35:50.688
And we also provide tools
01:35:50.688 --> 01:35:53.256
such as a media kit
with guidelines and tips
01:35:53.256 --> 01:35:55.567
that you might want to take advantage of
01:35:55.567 --> 01:35:58.855
to promote your accreditation
and certification,
01:35:58.855 --> 01:36:02.848
including some sample news
and press releases
01:36:02.848 --> 01:36:04.769
that you might be able to use.
01:36:06.183 --> 01:36:07.561
So, next slide.
01:36:09.249 --> 01:36:13.645
Let's just go over the dates
that are quickly approaching,
01:36:13.645 --> 01:36:17.705
and we are super excited
about these launch dates
01:36:17.705 --> 01:36:19.045
that we have coming.
01:36:19.045 --> 01:36:21.332
So we'd recommend, if you're interested
01:36:21.332 --> 01:36:23.631
in pursuing accreditation
and certification
01:36:23.631 --> 01:36:25.103
that you contact us.
01:36:25.393 --> 01:36:29.372
We can provide you, as I mentioned,
access to the standards,
01:36:29.997 --> 01:36:32.122
we can provide you with access
01:36:32.122 --> 01:36:36.598
to the application for survey
that is available today.
01:36:37.275 --> 01:36:41.603
We are expecting that on
or about July 1st,
01:36:41.603 --> 01:36:45.193
the application
in the system will be updated
01:36:45.193 --> 01:36:49.540
to allow you to make the choice
of Memory Care Certification.
01:36:49.896 --> 01:36:52.554
That's the one button
that's missing today,
01:36:52.554 --> 01:36:55.350
but we do believe
that that will be available
01:36:55.350 --> 01:36:57.870
on or around July 1st.
01:36:57.870 --> 01:37:01.502
You'll be able to access
and complete the online application
01:37:01.502 --> 01:37:04.133
to include Memory Care Certification,
01:37:04.634 --> 01:37:09.526
if you are an initial applicant
01:37:09.526 --> 01:37:12.573
to the accreditation
and certification process,
01:37:12.941 --> 01:37:17.355
we would require you
to submit an initial survey deposit
01:37:17.355 --> 01:37:19.299
along with that application.
01:37:19.602 --> 01:37:21.950
We have all of the instructions,
01:37:21.950 --> 01:37:27.956
and links and tools available online
for you to know how to do that.
01:37:28.473 --> 01:37:32.973
And we suggest,
start preparing for your survey.
01:37:32.973 --> 01:37:36.325
Really, in the July-August timeframe,
01:37:36.325 --> 01:37:41.976
we do anticipate that we will be ready
to deploy surveyors into the field
01:37:42.894 --> 01:37:48.306
probably around early to mid August
for the Memory Care Certification.
01:37:48.306 --> 01:37:50.978
So we'd suggest that you take the time,
01:37:50.978 --> 01:37:55.409
and around the July-August timeframe,
to really be preparing for your survey.
01:37:55.409 --> 01:37:57.499
There's certainly no time,
like the present,
01:37:57.499 --> 01:38:01.048
we do have the standards,
and a lot of the tools available to you,
01:38:01.048 --> 01:38:06.796
So you are able to begin
that preparation process as early as now,
01:38:06.796 --> 01:38:10.185
just a couple of weeks
before we get to July 1.
01:38:11.862 --> 01:38:15.118
So I hope all this information
has been really helpful to you.
01:38:15.118 --> 01:38:21.963
We would actually like to do
our final poll for the webinar
01:38:21.963 --> 01:38:25.595
before we turn our attention
to some of the questions that y'all have.
01:38:25.595 --> 01:38:26.977
So, Andrea.
01:38:27.688 --> 01:38:29.408
(Andrea) Thank you so much, Gina.
01:38:29.408 --> 01:38:32.781
And, yes, before we do launch
our final poll,
01:38:32.781 --> 01:38:37.755
just, we'd like to invite you all
to submit your questions at this time
01:38:37.755 --> 01:38:40.003
in the Questions section
of the control panel.
01:38:40.554 --> 01:38:44.238
And we'll answer that
right after the poll answers here.
01:38:44.238 --> 01:38:48.079
But first, here is our final poll.
01:38:48.079 --> 01:38:53.951
And we'd like to know: what would be
your timeline to pursue certification?
01:38:53.951 --> 01:38:56.321
If you could please choose
one of those options,
01:38:56.321 --> 01:38:58.432
whether it be within three months,
01:38:58.432 --> 01:39:02.460
3 to 6 months, 6 to 12 months,
1 to 2 years,
01:39:02.460 --> 01:39:05.057
or if you're just not sure.
01:39:05.955 --> 01:39:07.492
We'd like to know when you think
01:39:07.492 --> 01:39:10.543
you would pursue this certification
in your future.
01:39:14.224 --> 01:39:16.319
And thank you all again.
01:39:16.319 --> 01:39:20.100
You are a wonderful participatory group.
01:39:20.623 --> 01:39:24.195
And I think we have
most of our answers here.
01:39:25.095 --> 01:39:27.819
So let's go ahead and share those results.
01:39:28.912 --> 01:39:30.981
So the majority is not really sure
01:39:30.981 --> 01:39:33.291
when they are ready
to pursue certification.
01:39:33.291 --> 01:39:35.537
Followed by 6 to 12 months,
01:39:36.430 --> 01:39:38.851
3 to 6 months,
and then within three months,
01:39:38.851 --> 01:39:43.353
with the last group
in the 1 to 2 year section there.
01:39:43.831 --> 01:39:46.542
Well, thank you so much
for sharing that information.
01:39:47.620 --> 01:39:52.710
And, with that, we're going to go
and jump on to the questions section
01:39:52.710 --> 01:39:54.594
of this presentation.
01:39:56.230 --> 01:39:58.477
So, let me start with the first question.
01:39:58.477 --> 01:40:02.857
It is really quite basic
but a great question.
01:40:03.464 --> 01:40:06.361
And Gina, you touched
a little bit about this,
01:40:07.124 --> 01:40:09.465
and this came a little bit earlier
but you touched on this,
01:40:09.465 --> 01:40:10.728
about the timeline.
01:40:11.492 --> 01:40:15.772
What's the average amount of time
an organization should expect
01:40:15.772 --> 01:40:18.321
from when they submit the application
01:40:18.321 --> 01:40:21.434
to when they would have
their first survey?
01:40:21.434 --> 01:40:25.701
What's the timeframe
that that would occur?
01:40:25.701 --> 01:40:27.371
(Gina) Yeah, that's a great question.
01:40:27.371 --> 01:40:32.360
And I just wanted to say that we thought
we'd personalize the webinar a little bit
01:40:32.360 --> 01:40:36.032
by coming on camera
where we are able, with our panel,
01:40:36.662 --> 01:40:39.234
so, you can actually see
who you're talking to.
01:40:39.705 --> 01:40:43.395
So, yeah,
so what's that timeline look like?
01:40:43.395 --> 01:40:48.952
So, we really allow you
to sort of create that timeline,
01:40:48.952 --> 01:40:53.772
and some of that depends, though,
on your preparation activities,
01:40:53.772 --> 01:40:56.325
you know, what kinds of gaps
you may identify
01:40:56.325 --> 01:40:58.289
once you review the standards,
01:40:59.206 --> 01:41:01.668
if you need a longer timeframe
01:41:01.668 --> 01:41:05.711
to get to the point
of being ready for survey.
01:41:06.459 --> 01:41:11.129
So, I would say on average,
we probably see most organizations
01:41:12.147 --> 01:41:17.816
requesting surveys probably
about 6 months to 12 months,
01:41:17.816 --> 01:41:21.578
after they've submitted
an application to The Joint Commission.
01:41:23.454 --> 01:41:27.723
But if you wanted that survey sooner,
it's possible.
01:41:28.188 --> 01:41:30.610
You let us know
when you'll be ready
01:41:30.610 --> 01:41:34.860
and we're able to deploy
those resources to help you.
01:41:36.090 --> 01:41:39.345
I guess, you know,
most people sort of feel
01:41:39.345 --> 01:41:43.671
they want to prepare
for a gap that they might identify.
01:41:43.671 --> 01:41:49.201
I will also mention that your application
is good in our offices,
01:41:49.201 --> 01:41:51.483
in our house for a year,
01:41:51.483 --> 01:41:54.707
so you don't have to commit
to a survey date
01:41:54.707 --> 01:41:56.671
within a very short period of time.
01:41:56.671 --> 01:42:00.866
You actually do have up to a year
to commit to a day
01:42:00.866 --> 01:42:06.222
and to determine
that you're ready for an actual survey.
01:42:08.435 --> 01:42:11.571
(Andrea) Thank you so much, Gina,
appreciate that.
01:42:12.839 --> 01:42:14.770
And I do have some questions.
01:42:14.770 --> 01:42:17.660
I think this might be
more appropriate for Debbie,
01:42:18.175 --> 01:42:22.382
and they're going to be more specific
about the standard requirement.
01:42:23.583 --> 01:42:28.777
So, the first one asks:
Our home holds 805 license,
01:42:30.170 --> 01:42:33.805
meaning we no longer are required
to have a medical director.
01:42:34.337 --> 01:42:36.821
We do have a visiting APRN.
01:42:37.272 --> 01:42:39.779
Would that meet the requirement?
01:42:44.276 --> 01:42:45.754
(Debbie) Thanks for that question.
01:42:45.754 --> 01:42:48.908
So, oversight of the program
has to be a physician.
01:42:50.372 --> 01:42:53.531
There are instances
where you may have assessments
01:42:53.531 --> 01:42:55.771
or visits to the residents.
01:42:55.771 --> 01:42:59.030
That can be an advanced practice nurse,
01:42:59.030 --> 01:43:01.640
a nurse practitioner,
physician's assistant,
01:43:01.640 --> 01:43:04.951
but the program oversight
has to be a physician.
01:43:05.515 --> 01:43:06.891
Does that answer the question?
01:43:09.067 --> 01:43:12.916
(Andrea) I think that does, Debbie,
thank you so very much.
01:43:12.916 --> 01:43:16.788
And if there is a need...
Yes, we did get confirmation that it does.
01:43:16.788 --> 01:43:18.136
Thank you so much.
01:43:18.835 --> 01:43:22.609
And while I have you here,
there is another clarifying question
01:43:22.609 --> 01:43:26.465
regarding the training
that would be required.
01:43:26.901 --> 01:43:31.605
This one says, would the certified
Dementia Practitioner Certification
01:43:31.605 --> 01:43:37.455
through NCCDP be acceptable
for the type of training that's required?
01:43:40.508 --> 01:43:46.348
(Debbie) If they can demonstrate
that all of the criteria and the EP
01:43:46.348 --> 01:43:48.484
is mapped through that program,
01:43:49.321 --> 01:43:52.833
if it's annual training,
it would have to be done annually,
01:43:52.833 --> 01:43:55.555
if it's an orientation process
that it would be covered
01:43:55.555 --> 01:43:57.558
under the orientation EP.
01:44:00.451 --> 01:44:01.991
(Andrea) Thank you so much.
01:44:03.370 --> 01:44:08.156
I have a question that may be appropriate
for the larger panel.
01:44:09.044 --> 01:44:12.426
And simply it's asking,
where can I find resources
01:44:12.426 --> 01:44:16.818
for evidence-based strategies
/best practices?
01:44:22.374 --> 01:44:25.626
I know we've shared
a lot in this presentation.
01:44:25.626 --> 01:44:28.118
(Gina) Yeah, I'll actually maybe kick off
01:44:28.118 --> 01:44:31.358
and suggest that
some of those you can find
01:44:31.358 --> 01:44:34.160
through our resources
at The Joint Commission.
01:44:34.630 --> 01:44:38.881
And we do have some links
and notes to the standards
01:44:38.881 --> 01:44:40.960
and the Elements of Performance
01:44:41.661 --> 01:44:44.330
that kind of direct you to some places
01:44:44.330 --> 01:44:49.221
where you can find best practices
and evidence-based guidelines.
01:44:49.541 --> 01:44:54.046
We certainly would also recommend
a lot of the tools and resources
01:44:54.046 --> 01:44:56.897
that are available
through the Alzheimer's Association.
01:44:57.383 --> 01:44:59.750
And I think Doug probably concur with that
01:44:59.750 --> 01:45:02.431
but I'll definitely turn
to Doug and Debbie
01:45:02.431 --> 01:45:05.099
for, you know, any additional ideas
01:45:05.099 --> 01:45:07.981
of where to find
some of the best practice resources.
01:45:09.030 --> 01:45:10.307
(Doug) Sure. Thanks, Gina.
01:45:10.920 --> 01:45:13.893
And again, our Dementia Care
Practice Recommendations
01:45:13.893 --> 01:45:18.542
are open access on our website
at alc.org\qualitycare.
01:45:18.542 --> 01:45:20.577
You can download the recommendations
01:45:20.577 --> 01:45:22.268
as well as the full articles
01:45:22.268 --> 01:45:25.874
that we published in a special
supplement of The Gerontologist
01:45:25.874 --> 01:45:28.066
that includes all of the evidence.
01:45:30.557 --> 01:45:32.077
(Andrea) Thank you very much.
01:45:33.580 --> 01:45:36.347
I do have a really wonderful,
compelling question,
01:45:36.347 --> 01:45:39.715
and I would like to approach this
to the full panel.
01:45:40.106 --> 01:45:43.656
If there had to be one or two focus areas
01:45:43.656 --> 01:45:47.650
that providers
should be concerned of the most,
01:45:48.508 --> 01:45:53.709
what would that be as they are considering
Memory Care Certification?
01:45:58.073 --> 01:46:02.386
(Gina) I'm going to say
that it's probably a standards issue
01:46:02.898 --> 01:46:07.113
that maybe Debbie, Beverly
might be able to comment on
01:46:07.113 --> 01:46:10.614
as, you know, what do we expect
might be the greatest challenges
01:46:10.614 --> 01:46:14.194
that Assisted Living Communities
and Memory Care providers
01:46:14.194 --> 01:46:16.637
might experience.
01:46:19.714 --> 01:46:23.327
(Doug) I would say quickly
before Debbie breaks in,
01:46:23.327 --> 01:46:25.395
and I would say, you know, for us,
01:46:25.395 --> 01:46:30.435
two of the overarching things
that we believe are most important,
01:46:30.435 --> 01:46:32.502
and, again, I've already spoken of those,
01:46:32.502 --> 01:46:37.407
but really is around that concept
of a person-centered delivery system,
01:46:37.407 --> 01:46:41.547
and making sure that the community
knows the person
01:46:41.547 --> 01:46:44.527
and has the process to identify that.
01:46:44.527 --> 01:46:47.677
And then the second piece would be
that quality improvement piece.
01:46:47.677 --> 01:46:54.539
Having a way to make sure that you are...
as you are trying new areas,
01:46:54.539 --> 01:46:56.778
to make sure that you have
a way to evaluate that,
01:46:56.778 --> 01:46:58.483
and to make changes as necessary.
01:46:58.483 --> 01:47:02.288
So I would say two overarching areas
are a person-directed care
01:47:02.288 --> 01:47:03.685
and quality improvement.
01:47:06.705 --> 01:47:09.126
(Debbie) Yeah, and I think that's great.
I agree with that.
01:47:09.126 --> 01:47:14.251
And I think communication
is really key with these residents.
01:47:14.251 --> 01:47:17.591
So I think working on that
and making sure your interactions
01:47:17.939 --> 01:47:22.199
are person-centered and get to the goals
01:47:22.199 --> 01:47:24.941
and the needs of each individual resident.
01:47:25.984 --> 01:47:28.166
I think I'm going to have Beverly.
01:47:29.424 --> 01:47:32.903
(Beverly) This is Beverly.
Yeah, I'm not pictured.
01:47:33.514 --> 01:47:35.788
But one of the things that I think,
01:47:36.558 --> 01:47:38.889
in addition to what's
already been shared
01:47:39.345 --> 01:47:43.830
is looking at the standards
that relate to the physical environment
01:47:43.830 --> 01:47:46.800
at the Environment of Care chapter,
01:47:46.800 --> 01:47:49.728
because that is an area
01:47:49.728 --> 01:47:53.982
that many facilities struggle with.
01:47:53.982 --> 01:47:56.809
And when you look at the standards,
01:47:57.657 --> 01:48:02.495
many of them, you will find,
you meet with your current practice.
01:48:02.969 --> 01:48:05.725
But there are others
that may require you
01:48:05.725 --> 01:48:07.693
to think a little bit about
01:48:09.718 --> 01:48:12.446
the current organization
of your environment,
01:48:12.446 --> 01:48:15.475
and address those prior
to the survey process.
01:48:18.011 --> 01:48:21.832
(Andrea) Excellent. Thank you, panel,
for your very insightful comments.
01:48:22.635 --> 01:48:25.432
And at this time,
I think we've come to the conclusion
01:48:25.432 --> 01:48:28.898
of the questions section
from the audience.
01:48:28.898 --> 01:48:34.985
So, with that, I would like
to just remind everyone,
01:48:35.516 --> 01:48:38.112
just some of the other information
that we have.
01:48:38.707 --> 01:48:40.955
When we conclude today's webinar,
01:48:41.457 --> 01:48:45.843
we are going to pose to you
a very brief survey,
01:48:45.843 --> 01:48:48.249
and we do ask that
if you could please take the time,
01:48:48.249 --> 01:48:51.217
there are only about
five questions very short.
01:48:51.505 --> 01:48:53.000
If you could fill that out for us,
01:48:53.000 --> 01:48:57.596
that really helps give us insight
as to the content that we presented today,
01:48:57.596 --> 01:49:00.992
and as well as future presentations.
01:49:01.335 --> 01:49:04.407
If you could let us know,
that would really help us out.
01:49:05.227 --> 01:49:07.455
And as I stated earlier,
01:49:07.455 --> 01:49:11.206
we will be sending a recording
of today's presentation
01:49:11.206 --> 01:49:16.941
along with the slide deck in an email
to all of the attendees today,
01:49:16.941 --> 01:49:18.704
as well as registrants,
01:49:18.704 --> 01:49:23.542
and I would expect that
to be sent within one to three days.
01:49:24.351 --> 01:49:26.905
And finally,
we do have contact information.
01:49:26.905 --> 01:49:30.876
If you do have some additional questions
that might arise,
01:49:30.876 --> 01:49:33.239
please don't hesitate to reach out to us
01:49:33.239 --> 01:49:37.467
either via phone, email,
or through the web.
01:49:38.934 --> 01:49:42.728
And finally, I'd like to thank you all
for taking your time to join us
01:49:42.728 --> 01:49:44.477
for this presentation today,
01:49:44.477 --> 01:49:48.147
as well as my esteemed
colleagues and presenters
01:49:48.147 --> 01:49:50.778
for presenting this webinar deck.
01:49:50.778 --> 01:49:52.580
I really appreciate your efforts.
01:49:53.169 --> 01:49:54.728
But most importantly,
01:49:54.728 --> 01:49:58.226
we really look forward
to continuing the conversation with you,
01:49:58.226 --> 01:50:02.998
as well as launching
our new program come July 1st.
01:50:04.009 --> 01:50:08.561
So, with that, I'd like to thank you all
again for your time,
01:50:08.561 --> 01:50:13.520
and wish you the best of everything
for the rest of this afternoon.
01:50:14.139 --> 01:50:17.013
Hope you have a great
rest of the week as well.
01:50:17.744 --> 01:50:19.980
Take care, everyone. Bye bye.