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Legal Issues for Social Workers October 5, 2007

Legal Issues for Social Workers October 5, 2007. By: Susan M. Voigt VOIGT, KLEGON, and ROD É Law Firm (651) 209-6161. Increase in Responsibility for Social Services in L-T-Care. How many residents do you serve? What happens when you drop the ball? Why is the licensing Board calling you?

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Legal Issues for Social Workers October 5, 2007

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  1. Legal Issues forSocial WorkersOctober 5, 2007 By: Susan M. Voigt VOIGT, KLEGON, and RODÉ Law Firm (651) 209-6161

  2. Increase in Responsibility for Social Services in L-T-Care • How many residents do you serve? • What happens when you drop the ball? • Why is the licensing Board calling you? • Why do you need legal advice before you speak to the family? • Who wants to be conservator? • Where is the resident going? • Another new regulation?

  3. ADMISSION • Admission pressures • Financial information • Assessment – care and financial • PPS and payment on admission issues • Predatory offender law changes • DNR/DNI policies, PSDA procedures/Advance directives

  4. LEGAL AND PRACTICAL ASPECTS OF DOCUMENTATION • New documentation requirements - resident advocate/psycho social services, activities • Changes in nursing home rules and regs and areas of survey focus: - activities, unnecessary meds, anxiety, family and physician notification of significant change, F323, OHFC incidents/accidents; psycho-social requirements

  5. DOCUMENTATION CONTINUED • Resident and family interview relied upon for deficiencies (F241) Dignity; MI issues • New social service staff – no such response as “I don’t know.” • Progress notes critical – follow up after psych eval and recommendations must be timely’ • New focus on suicidal ideation and safety plans • Medication review and effectiveness documented

  6. KNOW THE REGULATIONS AND USE TERMINOLOGY • Appendix PP in state operations manual at www.cms website • MDH website at www.health.state.mn.us • Know your residents and families and connect with nursing • F323 – “identify risk”; “evaluate”; “implement interventions”; “monitor and modify” magic words

  7. THE VULNERABLE ADULTS ACT • Unexplained incidents – bruising – determine a reasonable explanation • Falls elopements, smoking risks new focus • Reporting requirements – is it abuse or neglect? Is it an error? An accident? Is it financial exploitation? • OHFC appeals increasing due to more investigations and serious level deficiencies • Vulnerable adult neglect and abuse are connected to wrongful death cases

  8. HEALTH CARE DIRECTIVES • DNR/DNI • Comfort care measures policy • Directive for Health Care and POA for financial are not the same • Informed consent and patient right to refuse • Medication administration issues • Risk management vs. legal decision making

  9. DISCHARGE AND TRANSFER REQUIREMENTS • Social service documentation regarding discharge and transfer - guidelines • Commitment process for behaviors • New conservator/guardianship process for behaviors and nonpayment • Role of Ombudsman and Adult Protection • Medical Assistance application and social service role

  10. Predatory Offender Changes • 2006 – You can decide NOT to admit an offender or violent person • Abuse prevention/assessment/individual plans • Notification requirements • HIPAA release • To admit or not admit?

  11. Why do you do this? • Grace moments • Mission and paycheck • For the residents • Because you can – and you do it well

  12. Legal Issues UpdateSocial WorkersOctober 5, 2007 By: Susan M. Voigt Attorney Voigt, Klegon and Rode Law firm (651) 209-6161

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