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Cat Selman is an educator, motivator, communicator, consultant, and author. Her dynamic personality and compelling presence provides specific messages directed to any given professional field. As a seasoned lecturer, Cat has more than 30 years of experience in management, social work, activities/recreation, education and consultation. Her presentations include: Motivational Keynotes; discipline-specific topics, detailing regulatory/compliance criteria, as well as care planning and documentation requirements; Generic/Plenary - appropriate for all settings; and designed specifically for healthcare professionals. As a speaker in all fifty states, Cat is in demand and on topic. Her sessions are one to six hours. Whether short or long, it doesn't matter - the audience is transfixed! Their attention comes not only from the impact of Cat's message but also from her qualification to deliver it.

 

What businesses and associations say...

"What can I say - Cat is absolutely outstanding, and the convention attendees adore her. They continue to beg us to bring her back. From our evaluations, it is obvious that Cat is an excellent teacher with valuable information to share. Her ratings are 'off the chart'! It appears that participants return to their jobs re-energized and full of new ideas they hope to implement. Every attendee wants to have the opportunity to attend another of Cat's classes in the future. Basically, there is nothing we wouldn't say about how wonderful Cat is. Nothing is too superlative to describe the quality of her programs and how well they are received. The programs are superb, our folks love her, and she is incredibly helpful and easy to work with. We continue to be amazed and inspired by her wealth of knowledge and experience, and her ability to communicate that to attendees." ~ Rose Hughes, Executive Director, Montana Health Care Association

 

"Cat definitely meets our expectations every time she presents to the members of LeadingAge New York.  Her programs are timely and current on issues of importance to long term care professionals. Her presentation style is engaging, upbeat and fun. She is friendly, focused and exceptionally knowledgeable.  Prior to any of her presentations, Cat takes the time to listen to the goals for the program and customizes her message to meet our needs.  As a meeting planner, she makes my job easy.  Cat Selman is a # 1 speaker. Some comments from past presentations include: 'Cat is a gifted speaker and storyteller.' 'Cat's program topics were relevant, useful, met my expectations and a whole bunch more.' 'A skilled and engaging speaker with fabulous ideas.' ~ Kathy Gormley, CMP, LeadingAge NY

 

"The Cat Selman Company is an excellent company to work with. National HealthCare Corporation has done business with Cat Selman for more than 20 years. She has been a guest speaker at many of our conferences throughout the years, speaking to Recreation, Social Work, Dietary, Nursing, Therapy, and Administration. With each speaking engagement she gets rave reviews and usually another booking for a future session. We continue to choose Ms. Selman because we always know she will provide accurate, timely information. Paying for a speaker and not knowing how they will come across is always a fear when planning a meeting. However, with Cat, we know what we are getting and we know each participant will come away from the session with tools and ideas to help them in their job. Cat Selman has the respect of CMS and stays well informed on the latest training for surveyors. Her sessions include personal stories from her years working directly with residents, as well as current information she gathers from research and conversations with those creating and enforcing the regulations. She takes what could be a very dull session and keeps everyone engaged. Her great sense of humor and willingness to share her heart with the audience creates an atmosphere that fosters learning. Participants leave her sessions feeling energized and full of new knowledge that will assist them as they continue to make a difference in the lives of their residents." ~ Cecilia Taylor, National HealthCare Corporation ~ Murfreesboro, TN

 

More references can be provided upon request.

Topics -

Our topics are driven by today's current events, while others cover long-standing truths. Some involve re-thinking old ways and offering new points of view or practice. Some are "warm and fuzzy," while others address survey regulation, process and compliance. Many topics come from consistent requests by providers across the United States. No matter what the topic, each session will captivate, educate and entertain your participants.

 

Special Note: During the COVID-19 Pandemic, these topics can be presented live, virtually, or pre-recorded. Most of the topics can be adjusted to fit a 1-hour time slot, if needed.

keynote speeches

 

COVID Anger - Should I be feeling this?? (1-1.5 hours)

Anger is part of everyone’s emotional compass. It helps us respond to the happenings and experiences of life. Anger signals that we are being threatened, injured, deprived, robbed of rewards and expectancies. It prompts us to stand up and take care of ourselves and those we love. It is an honest emotion. The COVID-19 pandemic has put us all to the test: we find ourselves drowning in negative emotions: fear, sadness, contempt, and yes, anger. What do we do with this forceful emotion, calling us to act on our behalf? Can it be managed to limit disruption to our well-being, or harnessed for a positive outcome? Anger should be one of our adaptive tools to deal with the most difficult circumstances. Sometimes it becomes an obstacle to our struggles, especially when it results in aggression, abuse, despondency, and doubts about who we really are as a person. But far more often, it energizes and motivates us to fix what is broken. In this session Cat will address: identifying the sources of COVID Anger; recognizing the manifestations within each person; and providing effective coping strategies for dealing with this particular emotion. If we are ALL feeling angry, shouldn’t we use that emotion to influence a positive change?

Intended Audience: All disciplines; all settings

 

Regaining your “ZING!” - Jump-Starting your Motivation After COVID19 (1 - 1.5 hours)

“ZING” means energy, enthusiasm, or liveliness. Due to the pandemic, many health care professionals have either temporarily “misplaced” their ZING, or have totally lost it! Let’s face it - everyone is simply exhausted and find it hard to simply place one foot in front of the other each day. Maybe no one noticed that your ZING was missing, because you put up a “good front” and didn’t let anyone know what you were going through personally. Maybe you were the community “cheerleader” and could not allow others to see the cost of the pandemic to you as an individual. Maybe even YOU weren’t aware of what was taking place within your own emotions and feelings, but now, you realize something is missing. Whatever your emotional position may be Post-COVID, professionals are finding it harder and harder to recapture that enthusiasm for the job they love, and the role they play within their community. Will it be possible to regain that enthusiasm and motivation? Do you now feel so emotionally damaged that you cannot recover? Then attend this session! Cat will share what COVID has done to us - the good, the bad, and the ugly. However, she will also be offering guidance and suggestions on how we can recapture that motivation and enthusiasm for what we do best - caring for our precious elders. If you can’t seem to find the motivation you need to return to our “new normal,” this is the session for you!

Intended Audience: All disciplines; all settings

 

"Who's taking care of you??" (1 to 1.5 hours - can be adjusted as needed)

Throughout the COVID-19 pandemic, we have witnessed increasing numbers of anxiety, depression, loneliness, and other mental health concerns. COVID-19 has had a profound negative effect on the mental health of the nation, especially among those who are faced with combatting the virus. Health care workers, expose themselves to the virus every day. They are experiencing conditions that have been compared to a war zone, continuously witnessing the direct effects of the pandemic as it has spread throughout communities. In a recent survey, 93% of health care workers experienced stress; 86% reported experiencing anxiety; 77% reported frustration; 76% reported physical exhaustion and burnout; and 75% said they were overwhelmed. So...who takes care of the health care worker while they are taking care of the residents? Many times it is being left up to the individual to take care of themselves. In this uplifting, positive session, Cat will address what we, as employers, can do to help address these issues for our staff. Suggestions/ recommendations for coping strategies to help take care of ourselves during this time will also be discussed. Let’s face it...we could all use a little help...

Intended Audience:  All disciplines; all settings

 

"Look for the helpers..."  (1 hour)

When Mister Rogers was a little boy and would see scary things in the news, his mother would say, “Look for the helpers. You will always find people who are helping.” What we are currently seeing in the news, and experiencing in our places of work and personal lives, certainly meets the definition of “scary.” It becomes increasingly hard to “look for the helpers,” when in reality, we ARE the helpers. Where do we find the strength and fierce courage to provide loving care to our precious residents? How do we keep our own fears, anxiety and concern at bay? How do we cope with the loneliness and despair that our residents are feeling? Where do we find the physical strength to simply keep “keeping on,” when we are totally exhausted? In this motivating and inspirational session, Cat shares how we can face our fears, take care of ourselves during this time, and provide the person-centered care that we have always been known to provide. We really ARE all in this together!

Intended Audience:  All disciplines; all settings

 

The Power at Hand (1 hour)

A powerfully motivating keynote session that will inspire individuals to "rethink" their approach to long-term care and interactions with not only our elders but with anyone with whom we come in contact. Power can mean the ability to act; the capacity for action or performance; or the capability of producing an effect. Each of us possesses this power; yet, many have not figured out how to "tap in" to that particular skill, much less how to use it properly. Abraham Maslow states, "We are not in a position in which we have nothing to work with. We already have capacities, talents, direction, missions, callings." The challenge comes in discovering those skills and determining how to use them to make life better for those with whom we come in contact. Each of us wants to see the difference that we can make in people's lives. Come and learn as Cat shares thought-provoking, heart-touching and emotional stories, teaching us how to "tap the power" and discover the "gifts" that lie deep within each of us.

Intended Audience:  All disciplines: All settings

 

The 11 Things You Can Control Every Day of Your Life (1 hour)

We all know how it feels to lose control of our day. A resident has "issues" before you can even get into the door of the facility. Staff members have left messages on your voice mail and notes all over your desk. Families feel that you were hired "just for them..." And that's just at work!! What about when you get home? Feel like the world is spinning out of control? Ever said, "It's just out of my hands...?” Those thoughts can result in doubts about your abilities as a caregiver, devalue your worth as a person, foster a lack of confidence in your skills as a professional and just plain "wear you out!" Whatever the events happen to be, there is little we can do to prevent them from occurring. However, we should realize that there are some things in life that we CAN control. We can prevent life's little diversions from completely derailing us day after day. This session will offer guidance and recommendations for exercising techniques to regain "control" of your life and work.

Intended Audience:  All disciplines; All settings

 

Inspiring a Winning Team! (1 hour)
If you have direct or indirect responsibility for the performance of others — whether it’s a small group or a large group — you know it takes more than good leadership skills to develop and motivate staff. Discover how to create and employ people-focused strategies and plans that will ultimately maximize your organization's care delivery and bottom-line results. According to recent research on employee retention, happy employees stay twice as long in their jobs as their least happy colleagues. A great facility culture can make the critical difference between organizational success and dismal failure. It impacts just about every business metric we have, from customer service to productivity to profitability. It is the key to retention because employees don’t want to leave a great culture. It is the key to recruitment because applicants want to work for you. But how can you get there? Our industry is facing frustrations and challenges that have never been seen before. Join Cat as she shares “common-sense, tried and true” techniques to motivate and inspire your employees. Start building your winning team today!

Intended Audience:  All disciplines; All settings

 

Surviving the Business with Humor (1 hour)

Would you say that health care providers have a slightly "warped" sense of humor?? Let's face it! We laugh at situations that others would find horrifying! It doesn't mean that we are unprofessional, uncaring or insensitive. Those "light moments" help us get through an extremely stressful or painful time, and allow us "longevity" in this industry. This session takes a look at the humorous side of health care. Through the humor we see very real resident/client issues and what we, as providers, should have in place to meet those issues. Utilizing humor and laughter, participants will learn necessary techniques to maintain a balance in providing care that is both meaningful and realistic. Cat ends this session with a "Jeff Foxworthy-take" on the "Top 10 Ways" you can tell you work in health care. Let's face it - without humor, how else are you going to survive?

Intended Audience:  All disciplines; All settings

 

Are You Fired Up OR Just Have that Burning Sensation?! (1 hour)

"I'm quitting!! I just can't do this anymore!" Tired? Overworked? Unappreciated? Frustrated? This session will address the challenges that healthcare professionals face each day at work and at home. The session is not "just another stress management" lecture; it has been developed specifically for the long-term care professional. How do you stay "up" all the time? How do you keep your enthusiasm and energy? What motivates you to continue in this very stressful field? These questions and more will be answered at this motivating, uplifting session!

Intended Audience: All disciplines; All settings

 

Just for this Week... (1 hour)

Could you accept a challenge for "just a week?" Cat started 2013 off balance and with a heavy heart. Her Mother had reached the advanced stages of Alzheimer's, with resulting death in February. Wanting to turn a profoundly sad, life-changing event into something positive, Cat began a blog entitled, "Just for this week..." in January 2013, which can be found on this site under Cat’s Personal Vlog. The intent was to challenge herself to do something different and positive in the world each week, helping others, and in turn, helping herself through a difficult time. She got the bright idea that if she could persuade others to not only follow what she was doing, but to also "join" her each week, countless lives could be influenced in a positive way. Thousands of followers later, in over 77 countries, the blog is considered a success! The response to the blog, and the issued "challenges," has been tremendous! Join Cat as she shares some of the more memorable stories and responses. Laugh (quite a lot) and learn (quite a lot) as she challenges us to do more for ourselves and others! Won't you join us? Just for this week...

Intended Audience: All disciplines; All settings

 

Who's the Leader? (And Do They Know Where They're Going??) (1 hour)

At the most basic level, a leader is someone who leads others. What makes someone a leader? What is it about being a leader that some people understand and use to their advantage? Can you become a leader? Do you want to? A leader is a person who has a vision, a drive and a commitment to achieve that vision and the skills to make it happen. If you are the leader, do you know your vision? Do you know how to create a cohesive team that will attain your vision and organization goals? If you are not the leader, have you evaluated or assessed the ones you are following? Are they leading you in the right direction? And if not, what can be done about it? Lots of questions for the leaders, and the individuals following the leaders... 

  • How to gain power & influence
  • How to use influence/persuasion strategies
  • How to diagnose poor performance & enhance motivation
  • How to effectively utilize empowerment & delegation
  • How to diagnose the need for team building

Intended Audience: All disciplines; All settings

 

What's WRONG with Being a Good Follower? (1 hour)

Absolutely nothing!! If it were not for good followers there would be no good leaders. As Aristotle once said, “He who cannot be a good follower cannot be a good leader.” Not everyone becomes (or wants to be) a leader; however, those who follow will no longer accept old-fashioned leaders, full of authoritative ideas and who impose new management techniques on others. They want leaders with deep-rooted human values and who respect the talent and contributions given by others. In this session, Cat will focus on attributes of the “follower” to emphasize contributions that are integral to the facility team’s success and provide strategies for the development of a stronger team. We would get nowhere fast if all we had were leaders.

Intended Audience: All disciplines; All settings

plenary/general sessions

 

Managing the Long-term Effects of Dealing With COVID-19 (1-1.5 hours)

A pandemic generates in human beings one of the most primitive reactions at the psychological level: fear. Fear is an emotion that allows us to react to a real or imagined event which we consider a threat, at the physical level as well as psychological or socioeconomic levels. Fear guarantees our survival; however, fear can also cripple us to inaction and “shutdown.” One of the most exposed groups to the virus and its psychosocial consequences is the healthcare professional and caregiver. Our caregivers share the increased probability of suffering different consequences, including “burnout,” as well as an overbearing feeling of sadness. Additionally, anxiety, fear of death or contagion, and quarantine/isolation, provide the foreseeable feeling of Post Traumatic Stress Disorder (PTSD) and depression. In this session, Cat will discuss symptoms and triggers that we CANNOT ignore, as well as providing effective techniques to face these psychosocial challenges. Our world is certainly going to be even more different after COVID-19. Will your team be prepared to face that new world?

Intended Audience: All disciplines; All settings

 

How to Combat Isolation and Depression for Our Residents During COVID (1-1.5 hours)
Facility lockdowns are fueling a mental health crisis that’s amplifying the devastating impacts of the pandemic in our communities. Feelings of loneliness, abandonment, despair and fear among residents — and their toll on physical and neurological health — are only pushing the pandemic's death toll higher. We are watching our residents simply “give up” and die. Even when we can have activities, the requirements of social distancing lead to less meaningful interactions and socialization. Even where physical visits can be allowed, they are more infrequent, shorter, possibly outdoors, and highly regulated. The isolation is leading to negative outcomes physically, mentally, and emotionally. In this session, Cat will discuss the strategies/interventions that have proven effective in helping our residents deal with the lack of socialization during this time. Simulated Presence Therapy, utilization of technological devices, and individual staff approaches will be addressed. We are not going to be getting additional staff for implementation, so we need to learn how to utilize the staff that we already have! Can we help turn this situation around? YES WE CAN!!

Intended Audience: All disciplines; All settings

 

Motivating Your Staff During a Pandemic (1-1.5 hours)

In order for nursing homes to succeed during the coronavirus (COVID-19) pandemic and this uncertain economic climate, it is more important than ever to focus on employee well-being and overall morale. It’s also time to help your team navigate the emotional and psychological challenges they’re currently facing because of the COVID-19 outbreak. How do you keep your staff motivated when they are physically and emotionally exhausted? How do you keep them engaged when they observe sadness and death almost daily? How do they maintain pride in the care they are giving, when news and social media have made nursing homes the “whipping post” for the nation? There is so much happening outside of our control right now, which leads to frustration, disconnection and low morale. But the lack of staff morale affects companies in more ways than expected. Overtly stressed and anxious employees result in poorer quality of work, as well as disengaged employees. And many times, it can even lead to a higher turnover rate. It is a challenging time for all of humanity, but especially for the healthcare professionals who work in long term care. HOWEVER, there is always HOPE! Come and listen as Cat shares successful tips and effective strategies on keeping your staff engaged and motivated. She continues to remind us that it is usually the “little things” that make all the difference in the world.

Intended Audience: All disciplines; All settings

 

Care Planning for the Resident Who Has Dementia (1.5 hours)

Care planning is an essential part of healthcare, and provides guidance/direction to every care team member who is responsible for a resident's care. Since the introduction of CMS’ National Partnership to Improve Dementia Care in Nursing Homes, this area of resident care has been a major focal point of the survey process. The introduction of the CMS RoP, designating the resident who has dementia as “vulnerable,” has placed the care and delivery of services to these residents under much closer scrutiny. We are seeing more and more deficiencies involving residents who have dementia. How do you write a plan to meet the individualized needs of this resident? How do you allocate staff and their time? And how do you provide the staff training that is necessary to implement these care plans and programs? Come to this session to learn CMS and surveyor’s expectations, as well successful techniques for writing truly individualized, person- centered care plans for the resident who has dementia.

Intended Audience:  All disciplines; All settings

 

Effective Care Plan Interventions for the Resident Who Is Depressed (1-1.5 hours)

This session will examine depression in the elderly and how it is commonly presented in nursing homes among elderly residents. CMS indicates that mood distress, a serious condition that is under-diagnosed and under-treated in the nursing home.. They further state that between 40%-60% of our residents experience depression. Studies indicate that when “any interventions” are used, they are “almost, always EFFECTIVE!” If depression is so common in nursing homes, why does it go unnoticed and untreated? With the implementation of PDPM, “mood state” becomes an even more important factor in the reimbursement process. COVID-19 has presented a different “face” to the depression and mood state of our residents. The lockdowns and isolation have caused numerous residents to simply "give up" on living. It’s time to develop realistic care plans that address this area of care. We need to move beyond the standard “provide emotional support” care plans, and develop individualized, person-centered interventions.

Intended Audience: All disciplines; All settings

 

Effective Interventions for Behavioral & Emotional Health (1.5 hours)

CMS has placed much more survey focus on facility interventions for behavioral challenges and dementia care, as well as utilization of non-pharmacologic interventions for the reduction of antipsychotics. Alleviating the symptoms of the behavior becomes an increasing challenge for the healthcare professional, especially as the percentage of nursing home and assisted living residents with dementia steadily increases. Oftentimes the activity department merely becomes a "dumping ground" for residents who exhibit the more challenging behaviors for facility staff. This session will identify causal factors and provide valid, interdisciplinary, interventions for a variety of behaviors. Surveyors have been given examples of successful interventions and expect to find these when they assess facility programs. Shouldn't your staff have this information also?

Intended Audience: All disciplines; All settings

 

You Know My Name - NOT My Story! (1-1.5 hours)

Now, more than ever, our staff need to know a resident’s story! From the moment we meet a new “admit,” the “facts” begin pouring in! Birth date, marriages, education, occupation, children, significant health issues, finance...and on and on it goes...Our records for the individual are “jam-packed” with DATA!!! However, we usually don’t “discover” the “person” until they die, and we read their obituary. This one document is filled with such insight and “stories,” that we think, “I wish I had known that.” And here’s the sad reality: we should have known that information!! We should have met the PERSON, not the RESIDENT! Once we discover a person’s “real story,” the story of their lives, we can begin to meet needs, preferences, and interests on a more individualized basis. The key is for staff toknow those personal stories. When an individual loses their memory, they are not able to find (recall) those memories on their own. They need help from someone who knows “their” story. Additionally, CMS continues to stress and focus on “person-centered care” during surveys. Come and learn as Cat teaches
us the role we play in developing an elder’s story; a process that ultimately helps staff better meet the needs of elders who have dementia, and helps us provide true, person-centered care. By doing so, we can truly impact an elder’s quality of life in a positive way. Together we can learn the real story!

Intended Audience: All disciplines; All settings

 

Coping with Grief and Loss - Facing the Changes Brought by COVID-19 (1-1.5 hours)

Grief is a natural response to loss, and feelings of loss can be compounded during a crisis like the COVID-19 pandemic. Sometimes, grief-related pain and symptoms— which can be emotional, physical, cognitive, and spiritual—can feel overwhelming, especially for those who are caring for the elderly and see these losses on a daily basis. Bereavement is a painful, stressful, and difficult journey at the best of times. But grieving the loss of a loved one, or grieving lost “moments,” and your “normal way of life,” may be especially challenging during the COVID-19 pandemic. During this crisis it is important to grieve what has been lost, and it is also important to find meaning and hope in how life has changed. So, how do we do that? How do we face, and adjust to, all the losses that COVID-19 has presented us with? In this session, Cat will give compassionate guidance in the grief process, as well as suggestions for finding hope and joy through the process. This is an issue that ALL of us are facing - let’s do it together.

Intended Audience: All disciplines; All settings

 

CMS Guidance for Immediate Jeopardy (1.5 hours)

CMS issued new surveyor guidance for assessing Immediate Jeopardy last year. The guidance included four major areas of change that took effect immediately. This session will cover the changes that went into effect, and how the changes are going to impact your next survey. One of the changes involves recognizing and citing “psychosocial harm” for IJ concerns. Added to this new guidance/policy change is the emphasis that the CMS RoP has placed on surveyor’s use of the “Psychosocial Negative Outcome” Guide. CMS states that IJ situations "must be accurately identified by surveyors, thoroughly investigated, and resolved by the entity as quickly as possible. In addition, noncompliance cited at IJ is the most serious deficiency type, and carries the most serious sanctions for providers, suppliers, or laboratories (entities). An immediate jeopardy situation is one that is clearly identifiable due to the severity of its harm or likelihood for serious harm and the immediate need for it to be corrected to avoid further or future serious harm.” We have already seen an increase in IJ citations during the past two years, and feel certain that there will be more IJ citations as a result of this new policy change. Give your professional staff the information needed to be prepared for this new survey focus!

Intended Audience: All disciplines; Long Term Care

 

The Common Sense Approach to Abuse and Neglect (1.5-3 hours, or 6-hour intensive)

With the implementation of the CMS RoP, “abuse and neglect” has been a topic of concern and frustration for long term care centers. In October, 2019, federal officials announced that nursing homes given certain abuse, neglect or exploitation citations would have a red open-hand “stop” icon placed next to their name on the Nursing Home Compare website. And if that was not enough, the GAO recently reported that the Centers for Medicare & Medicaid Services (CMS) had yet to enforce several of its recommendations after a GAO report found oversight gaps in abuse reporting requirements for nursing homes. The GAO found that abuse deficiencies cited in nursing homes more than doubled from 2013 to 2018. To say that this area is going to be a major focus of the survey process would be an understatement! How do we train our staff in this area? How do we recognize and report abuse and neglect? How do we investigate? Let’s take a deep breath and do what we do best...provide the best possible person-centered care to our residents! In this session, Cat will discuss the regulatory side of abuse and neglect, as well as “common-sense” strategies and training techniques to address this specific area.

Intended Audience: All disciplines; Long term care

 

Trauma-Informed Care: What Your Staff NEED to Know! (1.5 hours) This session can also be adapted for a discipline-specific session, such as nursing, activities or social services.
CMS states "The facility must ensure that residents who are trauma survivors receive culturally competent, trauma-informed care in accordance with professional standards of practice and accounting for residents’ experiences and preferences in order to eliminate or mitigate triggers that may cause re- traumatization of the resident.” In the current climate of COVID-19, trauma- informed care has become a primary focus of the survey process. Every employee delivering care or service to any resident should have training and competency skills in this area. The requirement addresses much more than just PTSD! This session will address aspects of trauma-informed care as it relates to the CMS requirements: physical trauma, mental/emotional/psychosocial trauma, survey focus, documentation/care planning, as well as training issues. This is a session that every employee in your facility needs - taught in a manner that everyone can understand!

Intended Audience: All disciplines; All settings

 

Quality Initiatives - Reducing Staff Turnover (1-1.5 hours)
Staff turnover rates in long-term care and senior living are at a crisis level. In nursing facilities, employee turnover is 35%, while CNA turnover is at 43%. Social Services and Activity staff fall at 23%, and Food Services is at a rate of 34%. Conservative estimates of turnover across the long-term care sector range from 45 to at least 66 percent. One in 4 nursing assistants are actively looking for another job. Numerous facilities are experiencing a much higher rate of turnover. Often facilities are "left in the lurch," attempting to fill those positions, either temporarily or permanently. The amount of time, money, and training lost due to staff turnover runs into the thousands. Excessive turnover rate is not something that our industry should have to accept and live with. Join Cat as she shares proven strategies and techniques to improve staff "satisfaction and retention.”

Intended Audience: All disciplines; All settings

 

CMS Phase 3: The Nuts & Bolts of Cultural Competency (3 hours; can be divided into two 1.5 hour sessions)
In the new CMS Requirements of Participation, a concentrated focus has been placed on the provision of “culturally competent” care and services by all staff. This one area of care is stressed throughout the requirements to become effective November 28, 2019 in Phase 3 of the CMS RoP implementation. ALL DEPARTMENTS/STAFF ARE REQUIRED TO HAVE THIS TRAINING and are being looked at very closely during the survey process, as they conduct numerous functions and services for a very diverse population. Our staff must possess the ability and knowledge to communicate and to understand lifestyles, preferences, interests and behaviors influenced by culture. Factors such as race, ethnicity, culture, and religion often affect how we provide, and residents seek, or accept, health care and services. We need to understand diversity and to examine the caring process as we know it. This session is designed to enhance the healthcare professional's knowledge and skills as required by the CMS RoP. Cat will review the cultural and social differences among the elderly, along with the expectations our staff have of them. The current requirements, communication techniques, interventions and staff/resident expectations will be addressed. Be ready to meet this new survey focus!

Intended Audience: All disciplines; Long Term Care/Nursing Homes (Can be adapted to be utilized with ALL settings if needed.)

 

Elder “Bullying” - What Should We Do? (1-1.5 hours)
According to the federal government, bullying is defined with the following core elements: unwanted aggressive behavior; observed or perceived power imbalance; and repetition of behaviors or high likelihood of repetition. Bullying can happen in any number of places, contexts, or locations. Studies suggest that most senior-to-senior aggression in long term care settings is verbal abuse, and that men and women are equally likely to be the victim as well as the aggressor. However, with the range and seriousness of diagnoses of which residents are now being admitted into our facilities, we are seeing an increase in more aggressive bullying, and altercations between and among residents. So what do we do? In this session, Cat will discuss the typical traits of “bullies,” causal and risk factors, guidance in regard to developing a culture for a positive living environment, and recommendations for responding to incidents. This is an issue that we cannot ignore!

Intended Audience: All disciplines; All settings

 

CMS RoP Guidance: Psychosocial Negative Outcomes (1.5 hours)

The Psychosocial Severity Outcomes Guide was implemented in 2006, by the Centers for Medicare & Medicaid Services (CMS). Not much has been said about this guide until the implementation of the new CMS Requirements of Participation (RoP). In fact, numerous professionals are not even aware of this specific guidance. Surveyors have now been instructed to refer to this document when assessing issues regarding dignity, neglect, quality of life, medication regimen review, unnecessary drugs/antipsychotic usage, as well as a resident’s ability to “attain or maintain their highest practicable" level of care. CMS lists at least 6 major negative outcomes that surveyors are to give focus to during the survey process. In this session, Cat will provide an overview of surveyor protocol, facility practice, and their links to psychosocial harm. She will also be providing tips and recommendations as to programming, documentation, and systemic process that should be in place to help a resident maintain or attain their highest practicable level of psychosocial well-being.

Intended Audience: All disciplines; Long Term Care

 

Working with Conflict & Difficult People (1.5 hours)

Every day the health care professional faces conflict and difficult people in the workplace. The conflict or difficult person could be a resident, family member, fellow employee or manager. Discover the stages of conflict and the techniques that should be followed during each of those stages. This session takes a very humorous approach to teaching individuals how to identify specific personalities and conflict situations.  Come prepared to laugh a lot while learning coping strategies to deal with specific "problematic" people and issues.

Intended Audience: All disciplines; All settings

 

Re-Sensitizing Our Desensitized, Sensitive Staff (1.5 hours)

"What do you mean I forgot to knock on the resident's door?" "I'm sure I spoke to Mrs. Jones when I passed her in the hallway..." "He's always hollering for help - it doesn't mean he needs anything..." "Yes, I got her fed and she ate over half her meal. Did I talk to her? Yes, I told her to eat her food..." Did you know that facilities are receiving more citations for quality of life issues than ever before? Did you also know that it is our most efficient, solid, caring staff members (even department heads) that are getting these citations for us? We have become so de-sensitized to what we see, hear and work around each day, that we no longer really see our elders as individuals. We're just "getting the job done." Attend this session for a very much-needed "wake-up call!" Learn how to reacquaint yourself and your staff with the appropriate methods to meet resident needs and comply with federal/state mandates for the provision of quality of life. Learn how to put the "caring" back into "caring staff."

Intended Audience: All disciplines; All settings

 

Documentation and Compliance: Supportive Documentation for the Comprehensive Care Plan (1.5 hours)

More and more surveys contain the same wording in regard to documentation: facility "failed to document resident responses/outcomes to identified staff interventions;" facility "failed to provide documented evidence that interdisciplinary care plan has been implemented..." Sound familiar? It seems that our professional staff write so much now, that they rarely get to see the real, live individual for whom they are caring. The components of compliance are: assessment; development of an individualized, person-centered care plan; implementation of said care plan; monitoring of said care plan; and review and/or revision of said care plan. So we write, write, and then write some more....and still get the deficiency or finding. And, with the implementation of PDPM, the supporting documentation of the comprehensive care plan becomes even more important. We may not get paid due to poor or insufficient documentation. In this session, Cat will give common sense suggestions as to how we can write documentation that is both supportive of the plan that has been identified, and reflective of actual delivery of services and care, a huge factor in the PDPM process. Don't attend, dreading a session on documentation! Cat makes the topic lively, fun, and "doable!"

Intended Audience: All disciplines, Long Term Care

 

Did You Hear What I Said? - Effective Communication Techniques (1.5 hours)

Our lives are based upon relationships with other people, and these relationships depend upon communication. Interpersonal communication is the most important process in our lives, yet little time and attention are given to the personal development of this ability. We no longer live simply as a result of the products of our own hands, but through our dealings with others. Just how well can you convey your thoughts and desires to others? Does your staff understand your guidance & direction? Are you persuasive? Do people listen to what you have to say? Do you feel as if no one really listens to you? Attend this session to learn the techniques of effective communication and persuasive speaking.

Intended Audience: All disciplines; All settings

 

Dealing with Change - It's a New World Every Day! (1.5 hours)

Health care professionals deal with change on a daily basis: more requirements, different survey issues, new admissions/residents/families, new employees/coworkers, change of ownership or company leadership, and even personal changes as we grow older. For some, change can become the "enemy" and actually debilitate an organization or individual. There are others; however, who seem to make the adjustment and deal with change quite successfully. What is the determining factor? How can some adjust and adapt effortlessly, while others struggle? Participants of this session will learn coping techniques for dealing with change.

Intended Audience: All disciplines; All settings

 

Handling Complaints (1.5 hours)

Even when you have the best possible staff, delivering the best possible care, in the most efficient manner... something can still go wrong. You get a complaint! No one individual, staff or facility can be absolutely perfect. The difference between success and failure is determined by the manner in which we handle complaints. Is it possible to please everyone? Every time residents and families come in contact with a health care professional, they make a judgment about the quality of care or service they receive. This session will address techniques and protocols for dealing with complaints and service recovery.

Intended Audience: All disciplines; All settings

 

Motivating Your Staff for Quality Care (1.5 hours)

Do your employees indicate the feelings of "I LOVE my job!!"... or the feelings of "I showed up...what else do you want?" Motivation is "what drives you" to behave in a certain way or to take a particular action. It is your WHY! What motivates you? Is it possible to motivate others? This session details specific, common sense techniques to motivate your staff. Discover techniques for giving praise and guidance on constructive criticism. Learn ways to determine individual employee needs and motivation techniques that meet those needs. Be the motivator in your organization!

Intended Audience: All disciplines; All settings

 

What Do You Mean, It's Time to Go Home?? I'm NOT Finished!! (1.5 hours)

Most health care professionals believe that there are not enough hours in a day to get everything done. And even more of us truly believe that we are organized. Just take a look at our desks and offices...! Can you accomplish more in a workday? Is it really possible? The answer is a resounding "YES!" This session takes a humorous look at how the "organized" professional loses more time every day and offers time management techniques that are realistic and easy to implement.

Intended Audience: All disciplines; All settings

 

Residents' Rights, Choices & Preferences - What's the Difference, and WHY am I Being Cited? (1.5 hours)

The federal 1987 Nursing Home Reform Law guaranteed residents’ rights. The revised CMS Requirements of Participation continue to mandate that each nursing home must care for its residents in a manner that promotes and enhances the quality of life of each resident, ensuring dignity, choice and self-determination. Each person is guaranteed those “rights.” “Choice” is the act of making a selection; liberty or freedom to choose. “Preference” is a greater liking for one alternative over another or others. Sounds like a lot of “gobbledygook” when you start making the comparison between the words. At times it sounds like they all mean the “same,” and other times, it appears as if they are all three, truly, different. Is it important for us to know the difference? You had better believe it!! During surveys, facilities are being asked about their policies regarding “choice” and “preference.” Your staff is being observed to determine if preferences and choices are being honored. The MDS 3.0 is filled with data regarding what is “important” to a resident, and if they have certain “preferences.” It gets more confusing, and we continue to receive citations for not getting it “right.” In this session, Cat will 1) explain the differences between the terms, 2) share information as to how surveyors are assessing this area and 3) offer successful staff practices and strategies.

Intended Audience: All disciplines; Long-Term Care

 

What You Said is NOT What I Heard! (1.5 hours)

Effective communication is about more than just exchanging information. It requires you to also understand the emotion behind the information. It enables you to communicate even negative or difficult messages without creating conflict or destroying trust. Cat conducts a lot of staff training in facilities. In these situations, prior to the direct-care staff training, management will "brag" on their teamwork and good communication skills. However, once management leaves the room, the direct care staff will always state that "management" never tells them anything and they feel uninformed. So, how does this happen? How can two groups see something so differently? Why the "disconnect?" Most of us feel that we are great communicators, but in reality, it is usually not the case. We talk, but it doesn't mean people listen or even hear. In this session, Cat will teach participants four very necessary skills for effective communication. Participants will also get a chance to assess their own communication skills, and identify areas for improvement. Cat will discuss the various communication styles and how to determine the most effective techniques for your needs.

Intended Audience: All disciplines; All settings

 

She's NOT a Resident... She's My Mother! (1 hour)

Years ago, Cat's mother was diagnosed with Alzheimer's Disease. She lived in a nursing home for over one year, before her death in 2013. Having conducted dementia training for thousands of professionals throughout the United States for over 30 years, and considered a top expert in the field, one would think that Cat was the most prepared individual to deal with this situation. However, you would be wrong! It was one eye-popping, eye-opening event after another. Come and learn as Cat shares some very personal experiences of lessons learned, skills reaffirmed, and techniques validated. Perspectives from both the family member and the professional will have you laughing (and crying) as we discuss techniques that will improve the care we provide our elders who have dementia,  while making their world more comforting with less anxiety. This is one special session that should not be missed!

Intended Audience: All disciplines; All settings

 

Sexuality in Nursing Home - Myths vs. Reality (1.5 hours; could also be an intensive 3 hour)

Some of the most difficult situations for nursing home staff involve the sexual activity and sexual desires of residents. This difficulty is compounded when nursing home administration, staff and families do not have candid discussions about these issues. Most situations related to residents' sexuality are handled individually in hushed voices without making it a learning opportunity for staff. The sexuality of older people is rarely addressed in staff training. The subject of different sexual orientation is rarely considered for staff education or discussion. In the last decade, there has been a strong movement to increase nursing home residents' quality of life. Even though sexual health has been known to be an important part of the quality of life for many people, it has not been easy for staff to encourage older people to express themselves through sexual activities or even accept their needs in this area. In most cases, it is considered a "behavioral issue." Consequently, sexuality is another loss for elders. This session will provide some "talking points" to begin these discussions and increase staff awareness and sensitivity related to residents' sexual needs.

Intended Audience: All disciplines; All settings

 

Quality Initiatives - Increasing Customer Satisfaction (1.5 hours)

Just like any other business, nursing facilities must ensure that the customer comes first. Research shows that centers with the highest rates of satisfaction also perform better in other organizational indicators including staff stability, staff retention, survey results, census and cash flow. A few years back, CMS began withholding 1% of its payments to hospitals, in part related to "patient experience." It is anticipated that, at some time in the near future, this same payment process is going to be utilized with skilled nursing facilities. Would your residents and families recommend your facility to someone else? If not, why not? Cat will be sharing recommendations on staff training, marketing strategies, and discussing resident/ family satisfaction questionnaires.

Intended Audience: All disciplines; All settings

 

CMS Surveyor Guidance: Advance Directives & Advance Care Planning (1.5 hours)

CMS interpretive guidance is extensive in the area of advance directives and advanced care planning. Traditionally, questions of care were resolved at the bedside through decision-making by an individual, his or her family and health care practitioner. As technological advances have increased the ability of medicine to prolong life, questions have arisen concerning the use, withholding or withdrawing of increasingly sophisticated medical interventions. Legal developments have influenced standards of professional practice in the care and treatment of individuals in health care facilities. Several decades of professional debate and discussion have simultaneously advanced the thinking on these matters and promoted implementation of pertinent approaches to obtaining and acting on patient/resident wishes. In this session, Cat will be covering all of the changes/revisions and the implications for facilities. Cat will also provide examples of deficient practice and determination of compliance (scope and severity).

Intended Audience:  All disciplines; Long-Term Care

 

CMS Surveyor Guidance: Care & Services for a Resident with Dementia (1.5 hours)

There is no specific investigative protocol for the care of a resident with dementia. Surveyors may use the checklist titled, "Review of Care & Services for a Resident with Dementia" to assist in investigating the care and services provided to a resident with a diagnosis of dementia. This checklist includes items such as assessment, root-cause analysis, individualized interventions, use of antipsychotic medications, activities, psychosocial well-being, care planning, etc. The list goes on and on... resulting in over twenty pages of CMS revisions to surveyors for ftag 309 - Quality of Care. During this session, Cat will review the checklist and break down the guidance into understandable, common sense language that everyone can comprehend. Cat will be covering actual case studies and examples of deficient practice that have been provided to surveyors. (Included in the State Operations Manual - SOM). Determination of compliance and immediate jeopardy issues will be addressed. The instruction will also focus on the surveyor's evaluation of a facility's systemic approaches to deliver care and services for a resident with dementia. Quality Assessment & Assurance (QAA) in this area will be investigated thoroughly by surveyors.

Intended Audience:  All disciplines; All settings

 

CMS Surveyor Guidance: End of Life Care (1.5 hours)

Along with other surveyor guidance for Quality of Care, CMS provides detailed instruction for the assessment of End of Life Care. Everyone seems to be saying that nursing homes should play a more pivotal role in providing care and services during a resident's end of life. However, the reality for many residents is that once hospice has been elected, the nursing home seems to take a "back seat" in the delivery of certain services and care. We see situations where the nursing home thought hospice was supposed to provide specific care; hospice thought the nursing home was to provide the specific care; and as a result, the care was not given at all! When do you make the decision to move from "active treatment" to "end of life" or "comfort care?" Who makes that decision? And what does CMS have to say about all of this? Here is a fact for consideration: 20% of all Americans will die in a nursing facility. Sounds like we need to figure out how to provide the very best care possible to the individual who is dying... Participants in this session will learn:

  • What CMS guidance entails
  • Surveyor’s expectations in regard to care planning
  • How to coordinate services between the nursing home and hospice
  • Person-centered care
  • Appropriate interventions for the interdisciplinary team

Intended Audience:  All disciplines; Long-Term Care

 

CMS Surveyor Guidance: Reduction of Antipsychotic Usage (1.5 hours)

In April 2012, CMS released the "Initiative to Improve Behavioral Health and Reduce the Use of Antipsychotic Medications in Nursing Homes Residents" program. Reducing the use of antipsychotics by 15% was the goal for nursing facilities in 2012, with individual facility rates of usage to be reported on Nursing Home Compare. In 2013, most, if not all, facilities achieved that goal. CMS then increased the goals of reducing the use of antipsychotic medications in long-stay nursing home residents by 25% by the end of 2015, 30% by the end of 2016, with further increases in 2017. And from there.....the success began to deteriorate. This area, once again, has become a concern for providers and a focus during surveys. Numerous facilities responded to the initiatives by immediately discontinuing certain drugs and utilizing activities as a better alternative. In many cases, this resulted in chaos; primarily because the nursing homes were relying on an already overloaded, understaffed activity department (with no support or assistance from other departments). Activities can prove to be hugely successful in reducing the use of antipsychotics; however, utilizing this approach must involve the entire staff, not just the activity/recreation department. Both activity professionals and social workers play an integral role in the success of this initiative. Come to learn realistic approaches and techniques for the entire interdisciplinary team! You know this is a focused area for the surveyors! Don't you want your team prepared?

Intended Audience:  All disciplines; Activity/Recreation Professionals; Social Workers; Long-Term Care

 

CMS Surveyor Guidance: Activities (1.5 hours)

Tougher surveys... more cited activity deficiencies... changes in the survey process... more focus on the quality of life issues... care being provided to residents with dementia...end of life care...reduction of antipsychotics...infection control... It seems that many of the areas of the survey now involve activities. Will your facility and activity department be prepared for this concentrated survey focus? Will your facility and activity department be able to stand the scrutiny? This session will focus on mandates of the survey process that have occurred as a result of CMS' Requirements of Participation, and offer strategies as to how a facility can meet those expectations. If you want to learn how the surveyors are being instructed to evaluate activities in nursing homes, presented by a speaker who served on the CMS panel of experts responsible for the revision of these guidelines, this is the one session to attend!

Intended Audience:  All disciplines, Long-Term Care

 

the common sense series

 

The Common Sense Approach to Abuse and Neglect (1.5 hours)
With the implementation of the CMS RoP, “abuse and neglect” has been a topic of concern and frustration for long term care centers. In October, 2019, federal officials announced that nursing homes given certain abuse, neglect or exploitation citations would have a red open-hand “stop” icon placed next to their name on the Nursing Home Compare website. And if that was not enough, the GAO recently reported that the Centers for Medicare & Medicaid Services (CMS) had yet to enforce several of its recommendations after a GAO report found oversight gaps in abuse reporting requirements for nursing homes. The GAO found that abuse deficiencies cited in nursing homes more than doubled from 2013 to 2018. To say that this area is going to be a major focus of the survey process would be an understatement! How do we train our staff in this area? How do we recognize and report abuse and neglect? How do we investigate? Let’s take a deep breath and do what we do best…provide the best possible person-centered care to our residents! In this session, Cat will discuss the regulatory side of abuse and neglect, as well as “common-sense” strategies and training techniques to address this specific area.

Intended Audience:  All disciplines; Long-term Care; Nursing Homes

 

It's ALL About ME!! The Common Sense Approach to Person-Centered Care (1.5 hours)

“Person-centered care” is a way of thinking and doing things that sees the people using health and social services as equal partners in planning, developing and monitoring care to make sure it meets their needs. This concept is referred to numerous times in the CMS Requirements of Participation (RoP), and is a major focus of the survey process. How do we provide that care? How do we train ALL of our staff in this area of care delivery? Cat will cover seven essential elements that are necessary for the provision of person-centered care. Using humor and common sense, she will provide needed guidance for your staff and explanation of CMS’ expectations/requirements. This session is a “must” for your entire interdisciplinary team - don’t miss out!

Intended Audience: All disciplines; Long Term Care

 

Help Me!! Help Me!! Help Me!! - The Common Sense Approach to Challenging Behavior (1.5 hours, or 3-hour intensive)

In many cases, facility staff has not been properly trained to deal with challenging behavior. As a result, staff continues to simply react to behavior, as opposed to preventing or minimizing the behavior. This session will teach assessment techniques that identify variables that predict and maintain problem behavior and improve the effectiveness and efficiency of behavioral support plans. Using humor, Cat will cover common sense, "down-to-earth" techniques for dealing with specific behavioral issues. Both federal and state surveys are now taking a closer look at behavior management programs in facilities. Will your programs and interventions stand up to that scrutiny?

Intended Audience:  All disciplines; All settings

 

"I Can't Hear You!" - The Common Sense Approach to Communicating with Elders Who Have Hearing Loss (1 - 1.5 hours)

When someone suffers from hearing loss, it can be difficult and even frustrating for them to communicate effectively with others. Elders who experience age-related hearing impairment often feel isolated and may withdraw from social situations, which can take a terrible toll on their overall quality of life.

While some elders benefit from assistive devices like hearing aids, not all types of hearing loss respond to this kind of treatment. Fortunately, the use of proper communication techniques can significantly improve hearing and listening performance. In this session, Cat will discuss signs and causes of hearing loss as well as effective communication interventions to assure understanding and comprehension. Every staff person in your community needs this training!

Intended Audience:  All disciplines; All settings

 

I Don't Understand What You Are Saying! - The Common Sense Approach to Communicating with Elders Who Have Dementia (1.5 hours)

Are you "swag?" Are you the "GOAT?" Would you say you are "dope," "cool" or "down?" It seems the word describing one's "hipness" or "coolness" seems to change almost daily. If it's hard for you to keep up with the nuances of our language and know what someone is talking about (especially when conversing with someone from a different generation), how do you think an elder feels? How do you think these words confuse and confound an elder with dementia?! We continue to use words and phrases that an elder could not possibly recognize or "connect" with and then document that they are "unable to understand or comprehend." This session takes a humorous look at our everyday communication with elders, while teaching effective, common-sense strategies that have proven successful with those who have dementia.

Intended Audience:  All disciplines; All settings

 

It's Everybody's Business!! - The Common Sense Approach to Customer Service & Marketing (1.5 hours)

Why market your facility? Why pay attention to public relations? Easy answer: SURVIVAL!! Who should do it... the administrator... the social worker... or everyone in the building? There are more nursing centers than ever before - all with attractive features and numerous amenities. Additionally, more and more funding is being provided to states and communities for "alternative care." The general public has become more educated, discerning and demanding. How does the community (the public) perceive your building and staff? Are you the "facility of choice" in your area? Come to this session to learn 12 Winning Techniques for Handling Inquiries, as well as specific techniques in customer relations and service. Learn the humorous, "moments of truth" in everyday practice that can result in a positive or negative opinion of your care, service and staff.

Intended Audience:  All disciplines; All settings

 

Keep 'Em Busy ALL the Time?? Really?! - The Common Sense Approach to Activity Programming (1.5 hours)

"We get our residents up early, get them dressed and out of bed into the living area. If they stay in their room, it will look like we are not doing our job... They are supposed to look busy and active at all times." REALLY!!?? Exactly where did that philosophy come from?? That's the way it was done years ago! Absolutely NOTHING in the CMS surveyor guidance intimates that perspective. And guess what? We have evolved and learned so much more regarding the provision of services that positively impact an elder's quality of life. Activity programming should be based on an elder's preferences, interests and customary routine. You may be assured that if an individual is 85 years old, has 7-9 different diagnoses, and is on 9 or more different medications, they just might want a little more voice in how they spend their day... This session will provide basic instruction on the interdisciplinary approach to activities. Learn what CMS requires, expects and what activity programming should "look like" at this time in an elder's life.

Intended Audience:  Activities/Recreation, Nursing, Social Services in Long-Term Care

 

Strategies that Work! - The Common Sense Approach to One-to-One Programming (1.5 hours)

CMS states that "One-to-One Programming" refers to programming provided to residents who will not, or cannot, effectively plan their own activity pursuits, or residents needing specialized or extended programs to enhance their overall daily routine and activity pursuit needs. The concept of individualized intervention has evolved over the years. By necessity, and response to a changing population, most activity/recreation professionals have abandoned generic interventions and large-group activities that include elders with different levels of strengths and needs. In their place, individualized interventions and one-to-one programming have been developed. This concept results in a total facility, total team approach to the delivery of activity services. Come and learn as Cat shares the benefits and "mechanics" of one-to-one programming; dynamics and implementation; documentation issues; and offers suggestions/insight for successful programming ideas.

Intended Audience:  Activities/Recreation, Nursing, Social Services, Therapy in Long-Term Care

 

What Do I Say? - The Common Sense Approach to End-of-Life Care (1.5 hours)

At the beginning of the 20th century, most people died in their own homes. Currently, 20% of all Americans are expected to die in a nursing facility.  Our society and culture is in denial of death. When the subject of death is discussed, euphemisms such as "passed away," "expired" or "left this world" are used. Few people actually use the word "died" or "dead." If you are the dying person, knowing that society feels this way, how do you cope with your feelings and the dying process? How does your family deal with the process? This session will teach your staff skills and techniques, empowering them to provide the needed services that can positively impact an elder's end of life - learning how to enrich and improve the quality of life remaining.

Intended Audience: All disciplines; All settings

 

What Were You Thinking??? - The Common Sense Approach to Critical Thinking (1.5 hours)

"I don't know about you, but I ALWAYS write my first and last name on the heels of my shoes! I also write my name in large, block letters on all of my clothes with a magic marker." If none of us really do this in our own, personal lives, it makes you wonder why these practices are found in numerous facilities across the nation. As my Grandma would say, we're not using our noggins! We no longer think for ourselves! We're almost to the point that we don't question anything regarding our policy, practice and process... We just DO it! As with all of her sessions, Cat will utilize humor to teach common sense approaches to critical thinking. Empower your staff to critique, evaluate and THINK about how and what we are doing with our elders. Question it!!

Intended Audience:  All disciplines; All settings

 

Who Does What & HOW Do We Write It?? - The Common Sense Approach to Developing and Interdisciplinary Care Plan (1.5 hours)

"Care Plans." Are we supposed to have separate, individual-discipline plans for every resident; or are we required to have one comprehensive care plan for each resident? And which care model do we use medical or social; problem-based or needs-based? The debate goes on, the confusion grows, and professionals are now becoming so concerned over writing a care plan that they have no time to implement a realistic, workable care plan. This session outlines what CMS actually requires regarding care planning, how we should write the document, who should be involved in the process and how we can simplify the development of a plan, making it both interdisciplinary and realistic.

Intended Audience:  All disciplines; Long-Term Care

 

Writing "I" Format Care Plans - The Common Sense Approach to Meeting Resident Needs (1.5 hours)

When it comes to "how" nursing homes write resident care plans, it's time to rethink the whole process! It's time for facilities to move away from traditional care planning to a community model that calls for person-centered care planning. This session will address the development of "I" Format Care Plans - a process by which staff write care plans in the first person, as if the elder were speaking directly to them - a process that transforms the "diagnosis" into a real, live person. This process adopts the voice of the elder and expresses his or her needs - from his or her point of view. Front-line staff becomes enthused and motivated when using this care plan format. It actually "makes sense" to them and they feel they can implement the plan more effectively. Come and learn a more realistic way to develop and implement care plans.

Intended Audience:  Nursing, Social Services, Activities/Recreation, Dietary, Therapy, Nursing Assistants in Long-Term Care

 

The Art of the Interview - The Common Sense Approach to Interviewing Elders (1.5 hours)

With the implementation of the MDS 3.0, interviewing took on a more significant role in the resident assessment process. CMS states that "all residents capable of any communication should be asked to provide information regarding what they consider to be the most important facets of their lives." There are several MDS 3.0 sections that require a direct interview of the resident as the primary source of information (e.g., mood, preferences, pain). CMS further states that "self-report is the single most reliable indicator of these topics and that staff should actively seek information from the resident regarding these specific topic areas." Who should conduct the interview? What type of individual will be the most effective interviewer? And is it possible to conduct them in a faster manner? In this session, Cat will share CMS guidance, as well as practical, common sense communication techniques that can be utilized effectively when interviewing elders.

Intended Audience:  Interdisciplinary Care Team Members; Long-Term Care

 

What's the Problem? - The Common Sense Approach to Problem Solving (1.5 hours)

Much of what managers and supervisors do is solve problems and make decisions. Often, these individuals do this by simply reacting to situations. Stressed for time and pressured for a quick fix or decision, they tend to rely on "knee-jerk" responses or fall back on what has seemed to work in the past. They feel that the quickness of a decision is more important than the long-term outcome. There are times when a quick decision is necessary; however, most decisions are not "life or death," and you DO have the time to make the right decision. How do you find the perfect balance of knowing when to make quick and easy decisions, and when to take time for the complex decisions? And what are the steps to problem-solving? Join us in this session to learn simple, common sense techniques to approach the problems that arise daily. Just think… your problem may actually be an opportunity!

Intended Audience:  All disciplines; All settings

 

It's More Than Scratch 'n Sniff! - The Common Sense Approach to Sensory Stimulation (1.5 hours)

We all enjoy the world around us through our senses... the sweet, innocent laughter and song of a child; that "first" bite of your favorite dessert; holding hands with the one you love; that "distinctive" smell of SKUNK!! Through those senses, we interpret what we have seen, heard, felt, etc. and act upon that interpretation. For an individual with dementia, the stimuli becomes confusing, frustrating and at times, overwhelming when they cannot interpret correctly, or at all. The purpose of sensory stimulation is to enable a person to overcome these obstacles and experience the pleasures of life through the senses. Did you know that sensory stimulation is more effective if ALL the senses are stimulated, instead of focusing on just one or two? Did you know that a resident's response would be more likely if sensory cues are given in a specific order? Cat will teach participants these techniques as well as others. Participants, through group demonstration, will actually develop specific sensory stimulation activities to take back to their facilities. Come prepared to learn, work and be STIMULATED!!

Intended Audience:  Activities/Recreation, Social Work, Nursing, Nursing Assistant; All settings

 

I've Heard that Story Before... - The Common Sense Approach to Reminiscence (1.5 hours)

Reminiscence, or remembering the past, is an essential human need. How many times have you looked at someone in your life and started a sentence with, "Remember when we..." or "I remember when..." What if every time you said those words, someone would say, "You already told me that..." How would it make you feel? And would you eventually just stop saying anything to anyone? The positive ability (to recall good things, be prepared for death and be able to solve problems) and negative ability (to reminisce about sad and profound events) are both significantly associated with psychosocial well-being among the elderly. Additionally, reminiscence can result in improvement of one's comprehension skills, enhancement of self-esteem and eases the feeling of depression and hopelessness. It can add to the sense of "belonging." In this session, Cat will discuss the types of reminiscence and their utilization/implementation with our elders. From structured, topic-specific reminiscence sessions, to spontaneous, "for the fun of it," individual conversations, participants will learn the correct process and benefit of this wonderful technique. Every person, from the licensed, degreed professionals, to the front-line direct caregiver, should attend this session!

Intended Audience:  Activities/Recreation, Social Work, Nursing, Nursing Assistants; All settings

 

Stop Talking to Everybody Else and Help Me Eat!! - The Common Sense Approach to Assisting with Meals for Residents Who Have Dementia (1.5 hours)

We "take" ("assist" would be a better word, but I don't think that is what we are doing...) an elder who has dementia down to the dining room forty-five minutes before a meal is served and wonder why they "holler" for someone's attention. We sit a tray or plate in front of this same person but do not provide assistance until many minutes later. In the meantime, the elder has been able to smell the food, see it sitting on the table before them, and watch others eat as they are waiting. When someone does finally arrive to assist them, their food is cold and the "assistant" talks to their co-worker the whole time. What is wrong with this picture??? In this session, Cat will walk participants through our current actions and provide reasonable, common sense approaches as to how we can make meals more meaningful and enjoyable for our elders. This will be a session you do not want to miss!!

Intended Audience:  All disciplines; Long-Term Care

 

There's a Cat Under My Bed! - The Common Sense Approach to Validation Therapy & Interacting with Residents Who Have Dementia (1.5 hours)

"No, Ms. Susie, there is NOT a cat under your bed." "No, Mr. Joe, you do NOT have to go to work today... you don't have a job anymore." "No, Mrs. Johnson, your husband is NOT coming today. He's been dead for 10 years!" Why do we keep utilizing the same worn out, broken approach with elders; traumatizing, frustrating, depressing and angering them further? Would it not be better to use a more effective, successful technique if it were out there? Validation Therapy and similar concepts are actually more successful when communicating with individuals who have dementia. In this very interactive session, Cat will teach participants successful techniques for more effective communication and interaction with elders who have dementia and provide "behavioral" challenges.

Intended Audience:  All disciplines; All settings

 

Documentation & Compliance - The Common Sense Approach to Supportive Care Plan Documentation (1.5 hours)

More and more surveys contain the same wording in regard to documentation: facility "failed to document resident responses/outcomes to identified staff interventions;" "failed to provide documented evidence that interdisciplinary care plan has been implemented..." Sound familiar? It seems that our professional staff write so much now, that they rarely get to see the real, live individual for whom they are caring. The components of compliance are: assessment; development of an individualized, person-centered care plan; implementation of said care plan; monitoring of said care plan; and review and/or revision of said care plan. So we write, write, and then write some more...and still get the deficiency or finding. In this session, Cat will discuss federal requirements regarding care plan documentation and what this means to each individual discipline and caregiver. She will give common sense suggestions as to how we can write documentation that is both supportive of the plan that has been identified and reflective of the actual delivery of services and care. Don't come dreading a session on documentation! Cat makes the topic lively, fun, and "doable!"

Intended Audience: All disciplines; Long Term Care/Nursing Homes

discipline-specific sessions

 

Meeting the Activity Needs of Younger Populations in Nursing Homes (1-1.5 hours)

Long-term care is no longer synonymous with "geriatric care." In the past 10 years, adults ages 31 to 64 have been the fastest growing population in nursing homes. In fact, they now make up 14% of the nursing home population. Faced by a variety of issues, these younger residents can provide complicated challenges to facility staff, who are attempting to meet their needs. With the CMS focus on person centered care, it is necessary to recognize this specific population and improve their quality of life during their time in a facility. One way to improve quality of life is to give the younger resident a purpose and a sense of accomplishment through activities…and NOT the activities that have normally been provided to our elder population. In this session, Cat will discuss the challenges/barriers/needs presented by the younger populations and the strategies/interventions that need to be provided. Additionally, Cat will be sharing an extensive list of successful activity ideas for this very special population. If you have struggled with programming for the younger residents in your community, this is one session you do not want to miss!

Intended Audience:  Activity/Recreation Professionals; Nursing; All settings

 

Now is the time! The Need for More Adult Activity (1-1.5 hours)

“All the activities here are ‘stupid baby games’…These activities are too childish, and I’m an adult…No, I don’t want to color - I’m not a child.” Any of these statements sound familiar? Recently, on one of the social media platforms, Cat saw a photo of residents in a nursing home dressed up as pirates. Each resident was wearing a pirate hat, and was holding a plastic sword. The photo just took her breath away and she asked herself, “WHAT are we doing?” She could not help but imagine what it might feel like to be a resident in a nursing home, and to wear a pirate hat, holding a toy plastic sword…with no children present! While it is certainly understandable that some residents require (and enjoy) childlike activities, almost no one wants to be treated as a child - with little respect and dignity as an adult, even if they have dementia. CMS requires us to provide an environment that promotes quality of life, especially with respect to dignity. In this session Cat will address the challenges that are faced in the provision of adult activities. She will be offering recommendations as participants adapt/modify current activity programs to become more reflective and representative of the ages, interests and needs of their current population.

Intended Audience:  Activity/Recreation Professionals; Nursing; All settings

 

1-1 Activities from Around the World! (1-1.5 hours)

COVID-19 turned everyone’s world upside down: in addition to the horror of the illness and death, group activities were cancelled, no communal functions/dining/ events could be scheduled, residents have been isolated and confined to their rooms, and have had no physical contact with anyone from their families or the community. The format and philosophy of activity programming HAD to change during this time to be responsive to the safety and well-being of our residents. As a result, and by default, nursing homes converted the delivery of all activity services to the provision of 1-1 activities. Although numerous states have reopened, the data shows that we have not yet successfully emerged from the continuing effects of COVID-19. In fact, reported cases of new variants are increasing. Unfortunately, based on CDC recommendations and CMS requirements, the Activity Department will have to be fully prepared to go from “reopening our facilities and group activities” to “lock-down requirements and 1-1 programming,” and back again for the foreseeable future. 1-1 Programming has become a focal point for the delivery of activity services. How do you develop a 1-1 program that is designed to meet the needs of each individual resident? How do you involve ALL staff (which is a required component to be successful)? How do you capitalize on the use of technology? And WHERE do you come up with enough ideas?? In this session, Cat will answer all those questions, plus provide participants with an extensive list of 1-1 activities from nursing homes around the world! 

Intended Audience:  Activity/Recreation Professionals; Nursing; All settings

 

Infection Control for the Activity & Social Service Departments (1-1.5 hours)

Our facilities face an elevated risk of COVID-19 outbreaks. Residents, living in congregate settings, are older and have more underlying medical conditions. As a result, the provision of activity services and delivery of social services has had to change. Although our facilities have strong infection prevention and control policies and process in place, the Activity and Social Service Departments need to have very specific, individualized protocols for this focused area. In this session, Cat will be addressing infection prevention and control for these departments, as well as providing specific recommendations that should be followed when reopening our facilities during the various Phases as outlined by the current Administration’s Guidelines for Opening Up American Again. She will also be addressing the new CMS Guidance for Visitation in Nursing Homes. We will probably be facing these challenges for the foreseeable future. Let’s do it correctly to keep our residents and employees safe!

Intended Audience: Activity/Recreation Professionals; Social Workers; Long Term Care

 

Trauma-Informed Care: What Your Staff NEED to Know! (1.5 hour)

(This session can also be adapted for a discipline-specific session, such as nursing, activities or social services.)
CMS states "The facility must ensure that residents who are trauma survivors receive culturally competent, trauma-informed care in accordance with professional standards of practice and accounting for residents’ experiences and preferences in order to eliminate or mitigate triggers that may cause re- traumatization of the resident.” In the current climate of COVID-19, trauma- informed care has become a primary focus of the survey process. Every employee delivering care or service to any resident should have training and competency skills in this area. The requirement addresses much more than just PTSD! This session will address aspects of trauma-informed care as it relates to the CMS requirements: physical trauma, mental/emotional/psychosocial trauma, survey focus, documentation/care planning, as well as training issues. This is a session that every employee in your facility needs - taught in a manner that everyone can understand!

Intended Audience: All disciplines; All settings

 

CMS Phase 3 Requirements: Competencies for Social Services (1.5 hours)

When the CMS Requirements of Participation (RoP) were released, they included a number of requirements for staff training and competencies. For three years now, we “should” have been preparing for this new CMS focus. In Phase 3 of the RoP implementation, effective November 28, 2019, staff competencies became a concentrated focus of the survey process. Surveyors have been instructed to assess individual staff competencies, training and skill sets in regard to specific disciplines, as well as assigned duties/responsibilities. What does this mean for Social Workers or Social Work Designees? What competencies/skill sets should they possess? What are CMS’ expectations? This session will address the care areas and service delivery necessary to meet this requirement in the social services department. Cat will be addressing both basic and “speciality” competencies for the Social Worker/Designee.

Intended Audience: Social Services; Administration; Nursing; Long Term Care

 

CMS Phase 3 Requirements: Competencies for Activities (1.5 hours)

When the CMS Requirements of Participation (RoP) were released, they included a number of requirements for staff training and competencies. For three years now, we “should” have been preparing for this new CMS focus. In Phase 3 of the RoP implementation, effective November 28, 2019, staff competencies will be a concentrated focus of the survey process. Surveyors have been instructed to assess individual staff competencies, training and skill sets in regard to specific disciplines, as well as assigned duties/responsibilities. What does this mean for the Activity/Recreation Professional? What competencies/skill sets should they possess? What are CMS’ expectations? This session will address the care areas and service delivery necessary to meet this requirement in the activities/recreation department. Cat will be addressing both basic and “speciality” competencies for the Activity/Recreation Professional.

Intended Audience: Activity/Recreation Professionals; Administration; Nursing; Long Term Care

 

Person-Centered Care Planning (3-hour intensive)
Since the new CMS survey process has gone into effect, deficiencies in “person-centered care” have been routinely cited in most facilities. The basis for individualized care revolves around, and is directed by, the resident’s comprehensive care plan. This one document causes more frustration, confusion, and concern than almost any other piece of documentation. Who is involved? How is it written? How do we make the plan “individualized,” especially when utilizing computer-generated plans? And, ultimately, what are surveyor’s expectations in this area? Join Cat as she explains the easy process of developing an individualized, person-centered care plan for each resident. During this session/training, Cat will share surveyor focus and trends in current citations. Cat continues to train state agencies (surveyors) in this area and is considered an authority in the care plan process. This is one training that ALL staff should not miss!!

Intended Audience: All disciplines; Long Term Care/Nursing Homes

 

CMS Changes to Immediate Jeopardy Policy (1.5 hours)
Last year, CMS issued new surveyor guidance for assessing Immediate Jeopardy. The guidance included four major areas of change that took effect immediately. This session will cover the new changes that went into effect, and how the changes are going to impact your next survey. One of the changes involves recognizing and citing “psychosocial harm” for IJ concerns. Added to this new guidance/policy change is the emphasis that the CMS RoP has placed on surveyor’s use of the “Psychosocial Negative Outcome” Guide. CMS states that IJ situations "must be accurately identified by surveyors, thoroughly investigated, and resolved by the entity as quickly as possible. In addition, noncompliance cited at IJ is the most serious deficiency type, and carries the most serious sanctions for providers, suppliers, or laboratories (entities). An immediate jeopardy situation is one that is clearly identifiable due to the severity of its harm or likelihood for serious harm and the immediate need for it to be corrected to avoid further or future serious harm.” We have already seen an increase in IJ citations during the past two years, and feel certain that there will be more IJ citations as a result of this new policy change. Give your professional staff the information needed to be prepared for this new survey focus! 

Intended Audience: All disciplines; Long-term Care/Nursing Homes

 

The Art of Being a Professional (1.5 hours)

"I don't get the same respect as the D.O.N..." "I'm the bottom of the totem pole..." "The only reason we have a Social Worker and/or Activity Director in our building is because the government requires us to!" In a recently published article regarding departmental roles for the activity and/or social service director, the authors equated effectiveness as a department head with the development of a positive self-image. They assert that many activity directors and social workers do not have confidence in their abilities and may actually contribute to a lack of approval by colleagues or the administrator by not behaving as supervisors. Tired of being considered a "paraprofessional" or "less than" another department? This session will teach participants how to establish a work ethic and environment that promotes individual professionalism. Earn the respect you deserve! Your education/training, appearance, communication and interpersonal skills say a lot about your professionalism. What are you saying?

Intended Audience: Activities/Recreation Professionals, Social Services; All settings

 

Defensive Documentation for the Long-Term Care Professional (1.5 hours or 3-hour intensive)

Documentation is important not only to validate the care that we are providing, but it now supports the reimbursement that we are receiving. In today's world, where everyone seems to be "sue happy," documentation becomes even more important when it is utilized to defend the actions taken by a health care facility. When involved in a lawsuit, the facility's documentation becomes a major source for the facility's defense - and not just nurses notes! Supporting documentation is necessary for all disciplines. Most seminars dealing with this topic are on such a level that only attorneys can understand the content. Your team needs to know how to document defensively! This seminar will provide simple, common sense techniques and documentation strategies for all disciplines: nursing, dietary, social services and activity/ recreation.

Intended Audience: All disciplines; Long-Term Care

 

Responding to Challenging Behavior (1.5 hours, can be expanded to a 3-hour or 6-hour intensive)

In many cases, facility staff has not been properly trained to deal with challenging behavior. As a result, staff continues to simply react to behavior, as opposed to preventing or minimizing the behavior. Effective support and treatment of residents or clients who exhibit challenging behavior depend on being able to understand both the "function" that the behavior serves for the individual and the causal factors. Often, behavior that might be seen as maladaptive, crisis-causing or catastrophic makes sense within the context of a particular person's life (i.e., gets them what they want and away from what they don't want). This session will teach assessment techniques that identify variables that predict and maintain problem behavior and improve the effectiveness and efficiency of behavioral support plans. Common sense, "down-to-earth" techniques for dealing with specific behavioral issues will be addressed in depth. Both federal and state surveys are now taking a closer look at behavior management programs in facilities. Will your programs and interventions stand up to that scrutiny?

Intended Audience: All disciplines; All settings

 

Ethical Dilemmas: Which Decision is the Correct Decision? (1.5 hours)

"Dilemma" - a choice between alternatives equally undesirable. Have you ever felt caught in this position? What happens when resident choices and decisions, family desires and "directives," professional staff "protocol" and even personal staff feelings collide and conflict? What happens when emotions and policies are confronted with very real, human situations? Do you make the "right" choice or decision? This session will provide an overview of ethics and values for long-term care professionals in the provision of aging services. It will provide professionals with a framework for making ethical decisions. Participants will be provided with actual resident scenarios/facility situations and divided into small groups to: evaluate and discuss the problematic area, determine the best course of action and determine the appropriate established ethic standard that will support their decision. We all have ethics - right?!

Intended Audience: All disciplines; All settings

 

Implications of CMS Guidance for Activities, Social Services, Staff Practices & Negative Psychosocial Outcomes (1.5 hours)

The Activity Guidance and Psychosocial Severity Outcomes Guide were implemented in 2006, by the Centers for Medicare & Medicaid Services (CMS). Has the guidance actually made a difference in the survey process? Have facilities significantly changed the process by which they provide activity services and meet residents' psychosocial well-being? And has this process stimulated a "total team" concept for meeting all of these needs? Surveyors have been better trained and instructed to look for individualized activity programming and assess residents' psychosocial well-being. Surveyors are now able to link non-compliance in activities, social services and other aspects of care with actual psychosocial harm. Cat Selman, a nationally-recognized educator & speaker who served on the CMS Panel of Experts that drafted the current Activities Guidance, will provide an overview of surveyor protocol, facility practice and their links to psychosocial harm. She will also be providing tips and recommendations as to programming, documentation and systemic process that should be in place to help a resident maintain or attain their highest practicable level of psychosocial well-being. This is the session to attend if you want to be fully prepared for your next survey!

Intended Audience: All disciplines; Long-Term Care

 

The Survey Protocol for Activity Requirements in Nursing Homes (1.5 hours, can be expanded to a 3-hour or 6-hour intensive)

Tougher surveys... more cited activity deficiencies than ever before... changes in the survey process... more focus on the quality of life issues... It seems that the healthcare industry is inundated with major change on a daily basis, so it comes as no surprise that the Centers for Medicare & Medicaid Services (CMS) has revised the guidance and survey protocol for activity requirements in nursing facilities. Will your facility be prepared for the new focus? Will your activity department be able to stand the scrutiny? This session will focus on the specific changes in the survey process that have occurred as a result of the new guidance. If you want to learn how the surveyors are being instructed to evaluate activities in nursing homes, presented by a speaker who served on the CMS panel of experts responsible for the revision of the guidelines, this is the one session to attend!

Intended Audience: Activities/Recreation Professionals, Nursing; Long-Term Care

 

Activity Interventions for Challenging Behavior (1.5 hours)

CMS has placed much more survey focus on facility interventions for behavioral challenges and dementia care, as well as utilization of non-pharmacologic interventions for the reduction of antipsychotics. Alleviating the symptoms of the behavior becomes an increasing challenge for the activity and recreation professional, especially as the percentage of nursing home and assisted living residents with dementia steadily increases. Oftentimes the activity department merely becomes a "dumping ground" for residents who exhibit more challenging behaviors for facility staff. This session will identify causal factors and provide valid activity interventions for a variety of behaviors. Surveyors have been given examples of successful activity interventions and expect to find these when they assess facility programs. Shouldn't your staff have this information also?

Intended Audience: Activity/Recreation Professionals, Nursing, Social Services; All settings

 

Documentation 101 for Activities (1.5 hours)

Wouldn't you love for someone to cover the basic components of documentation for activities? Cat will do just that in this session, covering everything from accurate coding of the MDS, CAAs, completion of activity assessments and the development of person-centered care plans to progress notes. This is a great session for new professionals beginning in the field, as well as a "refresher" course for the experienced professional.

Intended Audience: Activity Professionals, Certified Therapeutic Recreation Specialists

 

Documentation 101 for Social Services (1.5 hours)

Wouldn't you love for someone to cover the basic components of documentation for social work in long-term care? Cat will do just that in this session, covering everything from accurate coding of the MDS, CAAs, completion of social history/social assessments, discharge plans and the development of person-centered care plans to progress notes. This is a great session for new Social Workers/Designees beginning in the field, as well as a "refresher" course for the experienced professional.

Intended Audience: Social Workers, Social Services Designees

 

Programming for the Resident with Special Needs (1.5 hours)

Both federal and state surveyors are now focusing more closely on programming for the cognitively impaired, special needs resident. With the release of revised CMS Surveyor Guidance regarding the care of residents who have dementia, interventions and programming have become a focal point during the survey process. This session will teach participants important techniques regarding the assessment of the resident, development of individualized, one-to-one activity programming and an interdisciplinary team concept.

Intended Audience: Activities/Recreation Professionals, Nursing; Long-Term Care

 

Activity Programming for the Assisted Living Resident (1.5 hours)

Are individuals who live in an assisted living center different from those who live in a nursing home? Can we provide the same activities? Should we be doing anything differently? What about documentation requirements? And how do you develop an activity program that will meet the needs of everyone in the building? This session will address the components of developing an activity program for residents who reside in assisted living centers. Individual resident assessment, population surveys and programming format will be addressed in-depth.

Intended Audience: Activity/Recreation Professionals; Assisted Living

 

Surveying Social Service Requirements in Nursing Homes (1.5 hours)

What do surveyors look for when assessing social services and psychosocial well-being? What does "highest practicable" mean? The purpose of this session is to educate and inform individuals on issues concerning surveying the Social Service requirements for nursing homes. The session provides surveyors and providers with an understanding of:

  • The social service requirements and guidelines as required by CMS Requirements of Participation
  • Good social assessment and care planning techniques
  • Psychosocial well-being issues
  • Surveyor investigative techniques
  • How surveyors write deficiencies in the social service area

Intended Audience: Social Workers, Social Service Designees, Nursing; Long-Term Care

 

Customer Service and Problem Solving for Environmental Services (1.5 hours)

Even when you have the best possible staff, delivering the best possible service, in the most efficient manner... something can go wrong. The difference between success and failure is determined by our ability to "problem solve" and our "customer service" philosophy. Come to this session to learn specific techniques in customer service and relations, as well as effective "common sense" techniques/approaches to problem-solving. Learn the humorous, "moments of truth" in everyday practice that can result in a positive or negative opinion of your care, service and staff.

Intended Audience: Environmental Services; All disciplines; All settings

 

CATs, CAAs & Care Planning for Activities and Social Services (3-hour intensive)

CATs provide a "flag" for the IDT members, indicating that a triggered care area needs to be assessed more completely prior to making care-planning decisions. For the MDS 3.0, we now have Care Area Assessments (CAAs). In this session, Cat will provide guidance and instruction on the Care Area Assessment (CAA) Process, the utilization of the Care Area Triggers (CATs) and their relationship to the development of an individualized, person-centered comprehensive care plan. She will specifically address the CAAs that have implications for the activities and social service departments, as well as identify specific related care areas that can negatively impact a facility's survey. Surveyors will expect the plan of care to address identified factors with the goal of: (1) improvement where possible or (2) maintenance and prevention of avoidable declines. The RAI helps nursing home staff look at residents holistically, as individuals for whom quality of life and quality of care are mutually significant and necessary. Cat will demonstrate how the RAI process culminates in the development of an individualized, person-centered care plan that meets resident needs and survey requirements.

Intended Audience: Social Workers, Social Service Designees, Activity/Recreation Professionals, Nursing

 

Reduction of Antipsychotic Drug Usage - The Social Worker & Activity Professional's Role

In April 2012, CMS released the "Initiative to Improve Behavioral Health and Reduce the Use of Antipsychotic Medications in Nursing Homes Residents" program. Reducing the use of antipsychotics by 15% was the goal for nursing facilities in 2012, with individual facility rates of usage to be reported on Nursing Home Compare. In 2013, most, if not all, facilities achieved that goal. CMS increased the goals of reducing the use of antipsychotic medications in long-stay nursing home residents by 25% by the end of 2015, 30% by the end of 2016, and more increases in 2017. And from there.....the success began to deteriorate. This area, once again, has become a concern for providers and a focus during surveys. Numerous facilities have responded to these initiatives by immediately discontinuing certain drugs and utilizing activities as a better alternative. In many cases, this has resulted in chaos; primarily because the nursing homes are relying on an already overloaded, understaffed, activity department (with no support or assistance from other departments). Activities can prove to be hugely successful in reducing the use of antipsychotics; however, utilizing this approach must involve the entire staff, not just the activity/recreation department. Both activity professionals and social workers play an integral role in the success of this initiative. Come to learn realistic approaches and techniques for the entire interdisciplinary team! You know this is a focused area for the surveyors! Don't you want your team prepared?

Intended Audience: All disciplines; Social Workers, Activity/Recreation Professionals; Long-Term Care

 

Immediate Jeopardy & Psychosocial Harm - What You Don't Know Could Hurt You! (1.5 hours)

"Immediate Jeopardy" means that what a nursing home is doing has caused, or is likely to cause, serious injury or death. There has been a gradual upswing in citations at the Immediate Jeopardy level, with some states reporting as much as a 20%-50% increase from prior years. It is evident that surveyors are taking a closer look at the criteria for establishing Immediate Jeopardy. Often overlooked, "psychosocial harm" is beginning to play a more integral role in this equation. Immediate Jeopardy can be cited as much for the psychosocial harm as it can for physical harm. Does your staff know how "psychosocial harm" and "well-being" are being defined by CMS? Are they aware of the Immediate Jeopardy "triggers" that have been provided to surveyors? Do they know the negative outcomes regarding "harm" as they appear on the CMS Psychosocial Severity Grid? And finally, do they understand the documentation requirements that can either help or harm your facility when it is under scrutiny for Immediate Jeopardy consideration? This session will answer all of these questions and more! Cat will explain the Immediate Jeopardy process, CMS definitions/expectations and provide guidance for accurate and appropriate documentation.

Intended Audience: All disciplines; Long-Term Care

 

Writing Activity Care Plans (1.5 hours)

CMS has stated that they will not accept activity care plans that include goals of "will attend 3 group activities a week." They indicate that the plan must be more person-appropriate and specific for the individual resident. So, what are they looking for? Do we have to have an "activity problem" for every resident? What if there are no problems? What do we do then? Where do we write and keep the plan? This session will teach participants how to formulate an individualized activity care plan for the residents in their care. Utilizing the MDS 3.0 and Activity Assessment as a foundation, Cat will share guidance as to the identification of needs, issues, strengths and the development of person-centered, individualized goals and interventions that will be truly reflective of the care and services we are providing. Participants will get a chance to actually develop plans during the session.

Intended Audience: Activity/Recreation Professionals; Long-Term Care

 

Writing Social Care Plans (1.5 hours)

It seems that when we begin to write or develop social care plans, we get so caught up in "textbook terminology" that no one really understands what the social worker has written. The plans seem to be so generic that they could be applied to any and all residents in the building. In many cases, the plan is not reflective of the actual care and service that is being provided to the resident. And let's be honest, most social workers write more when less would be so much better. Surveyors are being asked to determine how the care plan links goals to psychosocial functioning/well-being. So what are the components of a well-developed social care plan? Utilizing the MDS 3.0 and Social History/Assessment as a foundation, Cat will share guidance as to the identification of needs, issues, strengths and the development of the person-centered, individualized goals and interventions that will be truly reflective of the care and services we are providing. Participants will get a chance to actually develop plans during the session.

Intended Audience: Social Workers, Social Service Designees; Long-Term Care

 

Choices, Ethics & End of Life Care (1.5 hours)

Technical advances in the care of advanced illness have created ethical challenges for physicians, residents and families at the end of life. In the effort to survive longer, they are often confronted with difficult choices regarding medical advances that may inadvertently prolong suffering and the dying process rather than bring healing and recovery. Four major principles of medical ethics assist in making meaningful and morally acceptable choices with respect to end of life care: nonmaleficence, beneficence, autonomy and justice. The nature of these principles and their application in decision-making and communication during end of life care will be addressed. Here is a fact for consideration: 20% of all Americans are expected to die in a nursing facility. Sounds like we need to figure out how to provide the very best care possible to the individual who is dying.

Intended Audience: All disciplines; All settings

 

Transitions in Care - BE Successful (1.5 hours)

It is common for residents in the long-term care continuum to be transferred from one care setting, level of care or caregiver team to another. It is also all too common for adverse events and avoidable complications to occur as a result of poor communication and coordination among caregivers, health care professionals and the resident during such transitions. Poorly executed care transitions increase hospital readmissions, duplication of services and waste of resources. Poor transitions are the leading cause of medication errors, which frequently result from a lack of coordination between prescribers across settings. It is often unclear which practitioner is responsible for the resident in the interval between discharge from one setting and admission to another. Some older adults are at particular risk for transition problems following a hospitalization. Those with multiple medical problems, cognitive deficits or depression or other mental health problems are especially vulnerable. When we ensure continuity of care for older residents during care transitions, we can improve outcomes and the rate of avoidable rehospitalization can be reduced. Come and learn the barriers we face in those transitions, and discover successful strategies for more effective practice resulting in positive outcomes. As always, Cat will address these issues in a down-to-earth, common sense manner.

Intended Audience: All disciplines; All settings

 

Winning Activities - Beyond the Basics (1.5 hours)

Cat is often asked, "Do you ever run out of activity ideas?" And the answer is a resounding, "NO!" How does one continue to discover "new," individualized activities and assure their success? Thinking "outside the box" simply means being creative and approaching everyday situations and activities in new ways. Many facilities have embarked on a journey to improve their activity programs and the way residents, families and communities view them. Most programs strive to be more engaging, interesting, satisfying and stimulating, providing innovative activities that go way beyond bingo while keeping in mind the individual interests and preferences of residents. With limited budgets and limited staff resources, how can providers offer daily activity programs that are individualized and designed to promote the highest level of independence for each person? Come and join Cat as she shares exactly HOW we can solve "old" problems in "new" ways. Special Note: Participants are asked to bring at least one “really unique” activity idea, or a “different take” on an old activity idea, to this session. Again, be prepared to share and learn!!

Intended Audience: Activity/Recreation Professionals

 

That's a GREAT Idea!! Successful Activity Strategies for Persons with Dementia (1.5 hours)

The concept of individualized intervention has evolved over the years. By necessity and response to a changing population, most activity/recreation professionals have abandoned generic interventions and large-group activities that include elders with different levels of strengths and needs. In their place, individualized interventions and programming have been developed. This concept results in a total facility, total team approach to the delivery of activity services. Come and learn as Cat shares the benefits and “mechanics” of person-centered activity programming, dynamics of program implementation and offers suggestions/insight for successful programming ideas. Special Note: Participants are asked to bring at least one successful activity idea designed for residents who have dementia to this session. Be prepared to share and learn!!!

Intended Audience: Activity/Recreation Professionals; All Interdisciplinary Care Team Members

 

Activities & Reduction of Antipsychotics - It's GOT to be INTERDISCIPLINARY!! (1.5 hours)

When CMS began their Initiative to reduce the use of antipsychotics in nursing homes, many facilities simply discontinued those medications and began involving the affected residents in activities. Good idea, unless you have only one or two activity directors and absolutely no help or support from the rest of the staff! This is a deficiency waiting to happen!! Can we reduce antipsychotic usage utilizing activities? Yes, but it involves a facility-wide commitment and responsibility. Come and learn how to use activity interventions appropriately!

Intended Audience: All disciplines; All settings

 

1-2 day stand-alone intensives

 

The Interdisciplinary Approach to Care Planning (5-6 hours)

"Care Plans." Those two words alone can cause fear and frustration to most long-term care professionals. Are we supposed to have separate, individual-discipline plans for every resident or are we required to have one comprehensive care plan for each resident? And which care model do we use - medical or social, problem-based or needs-based? The debate goes on, the confusion grows, and professionals are now becoming so concerned overwriting a care plan that they have no time to actually implement a realistic, workable care plan. Care planning is an essential part of healthcare but is often misunderstood or regarded as a waste of time. Without a specific document delineating the plan of care important issues are likely to be neglected. Care planning provides guidance to every care team member who is responsible for a resident's care. Many people believe that the care plan is the sole domain of nurses. This view is damaging to all members of the interdisciplinary team, as it shortchanges the non-nursing contributors while overloading the nursing staff. This practice can also lead to citations, poor care and even litigation. To be effective and comprehensive, the care planning process must involve all disciplines that are involved in the care of the resident.

 

This educational offering will give participants an overview of the comprehensive care plan process, as well as specific details regarding:

  • CMS Requirements and Guidance
  • Person-Centered Care
  • Individualizing Each Resident’s Plan of Care
  • Interdisciplinary Assessment
  • The “Total Team” Concept
  • Plans that Promote Psychosocial Well-Being
  • Pain, Behavior, Depression and End-of-Life Issues
  • Legal Aspects of the Care Plan

 

Participants will be able to identify federal requirements; surveyors' expectations and specific care issues as they relate to the care plan process. Care team members will learn how each discipline can truly assist in the development of a "resident-centered" care plan that is designed to meet specific care/medical issues, as well as help the resident "attain or maintain their highest practicable psychosocial well-being."

Intended Audience: All disciplines; Long-Term Care

 

The Surveyor's Approach to Care Planning (5-6 hours)

So... just how do we write the care plan? Which method should we use? What do surveyors actually look for when evaluating care plans? Are there any "red flags" that will draw their attention? And shouldn't we be writing care plans that actually "make sense" to the professionals providing the care? Seminar participants will learn the answers to all of these questions and much more! They will also be able to identify federal requirements, surveyors' expectations and specific care issues as they relate to the care plan process. Care team members will learn how each discipline can truly assist in the development of a "resident-centered" care plan that is designed to meet specific care/medical issues, as well as help the resident "attain or maintain their highest practicable psychosocial well-being." Areas addressed during training:

 

  • Federal Regulations Regarding the Comprehensive Care Plan, Quality of Care, Quality of Life
  • What the Centers for Medicare and Medicaid Services (CMS) has to Say About Care Planning
  • The Survey Components of Care Plan Compliance
  • Areas of Survey Focus
  • Quality of Care-Physical/Medical
  • Pain
  • Palliative Care/End-of-Life/Hospice
  • Behavior
  • Cognitive Losses/Impairment
  • Resident Choices
  • Psychosocial Well-Being
  • Communication
  • Activities
  • Symptoms of Depression
  • Risks and Potential concerns
  • State-Specific Deficiencies in Care Planning, Process and Outcomes
  • Examples of “Problematic” Care Plans
  • “Do’s and Don’ts of Care Planning
  • Care Plan “Red Flags” for Surveyors
  • Care Plan Process
  • Basis/Documentation for the Plan
  • Anticipated Outcomes
  • Delivery of Services
  • Staff Communication
  • How to Write/Develop a Realistic, Common-Sense Care Play that Staff Feel They can Implement
  • How to Convert a Traditional, Computerized, “Generic” Care Plan into an Individualized, Person-Centered and/or “I” Format Care Plan

 

The last two hours of this session will consist of group work - your care team will convert a traditional care plan (an elder's plan from your own home) into either a realistic, "person-centered" care plan or an "I" Format care plan. This format is being highly recommended and encouraged by the Centers for Medicare and Medicaid Services (CMS). Come and learn this new concept for addressing and meeting elders' needs.


Special Note: All participants will be asked to bring a completed care plan on an elder from their facility. Staff should make certain to remove all personal identifying information as mandated by HIPAA.

 

Of Special Interest: Cat Selman has over 30 years' experience and expertise in this specific area of care. She has trained both federal and state surveyors in the care plan process. In numerous states, she has trained entire state survey agencies on this topic! If you want to learn the accurate, most progressive and up to date information - THIS IS THE SEMINAR TO ATTEND!!

Intended Audience: All disciplines; Long-Term Care

 

Advanced Activity Training - Moving Beyond the Basics (5-6 hours)

This session takes the activity and recreation professional beyond the "elementary" and moves into more specific issues: going beyond the basic activity assessment; individualized care planning that "makes sense;" problems vs. needs; CMS requirements/guidance for the activity care plan; resident choices; 1-1 programming; responding to challenging behavior - care planning - surveyor focus - activity interventions; most cited deficiencies; professionalism; and "how to talk" with administration, management and surveyors. This training is requested by professionals who want more than "just the basics" in an educational offering. Seasoned participants comment: "Always learn a great deal to carry back to my facility. This is my 25th year. Wow - you held my attention all day." And "I feel more passionate, energized, and more informed after your workshop." If you have a choice of educational opportunities, this is the one you want to make certain to attend!

Intended Audience: Activity/Recreation Professionals; Long-Term Care

 

Social Work Practice in Long-Term Care - Part 1 & 2 (4 days: 6 hours each day; Part 1 – 2 days, Part 2 – 2 days)

These two training courses were developed in response to a need voiced by practicing social workers and social work designees in nursing homes. Part 1 is designed to cover the function of social services from "A to Z": to identify the role, function and value of social work in nursing homes; to provide material that can be the basis for social work practice in nursing homes; and to comprehensively cover the psychosocial needs of residents and how to meet them. Part 2 takes professionals a step further in social work practice for the elderly in nursing facilities and goes beyond the "basics." Dealing with families; case-mix reimbursement issues; ethical dilemmas & decisions affecting resident care & social work practice; quality indicators/quality measures; management, staffing and budgetary constraints; & defensive documentation/legal aspects are just a few of the areas that will be addressed in the advanced course. Special Note: The courses should be offered at least one month apart so that learned techniques and principles may be implemented by participants during the interim time period. Both courses would cover a 4-day time period.

Intended Audience: Social Workers, Social Service Designees; Long-Term Care

 

Survey Process for Psychosocial Outcomes (6 hours)

Federal and state surveyors are actively utilizing guidance to determine the severity level of psychosocial outcomes for residents. Surveyors have been instructed to assess facility practice as it relates to a resident's psychosocial well-being. Although the assessment of a resident's ability to maintain or attain their "highest practicable level of psychosocial well-being" has always been a requirement of OBRA, more emphasis was placed on negative outcomes involving potential or actual physical harm, injury, danger or death to the resident rather than psychosocial harm. Surveyors have been instructed to focus on facility practice that results in negative outcomes such as apathy, anger, depressed mood, dehumanization, humiliation and boredom. Facilities may need to reevaluate the manner in which they provide care and services to their residents. This session provides instruction in this area for the long-term care staff and social worker/designee.

Intended Audience: Social Workers, Social Service Designees, Nursing, Activity/Recreation Professionals; Long-Term Care

 

Survey Process for Activity Requirements in Nursing Homes (6 hours)

Tougher surveys... more cited activity deficiencies than ever before... changes in the survey process... more focus on the quality of life issues... It seems that the healthcare industry is inundated with major change on a daily basis, so it comes as no surprise that the Centers for Medicare & Medicaid Services (CMS) is paying more attention to the quality of life and activities in nursing homes. Will your facility be prepared for the interdisciplinary focus? Will your activity department be able to stand the scrutiny? If you want to learn how the surveyors are being instructed to evaluate activities in nursing homes, presented by a speaker who served on the CMS panel of experts responsible for the revision of the guidelines, this is the one session to attend!

Intended Audience: Activity/Recreation Professionals, Nursing, Social Services

 

Defensive Documentation for Long-Term Care Professionals (6 hours - Session can be converted to a 3-hour session to accommodate conference breakouts)

Documentation is important not only to validate the care that we are providing, but it now supports the reimbursement that we are receiving. In today's world, where everyone seems to be "sue happy," documentation becomes even more important when it is utilized to defend the actions taken by a health care facility. When involved in a lawsuit, the facility's documentation becomes a major source for the facility's defense - and not just nurses notes! Supporting documentation is necessary for all disciplines. Most seminars dealing with this topic are on such a level that only attorneys can understand the content. Your team needs to know how to document defensively! This seminar will provide simple, common sense techniques and documentation strategies for all disciplines: nursing, dietary, social services and activity/recreation.

Intended Audience: All disciplines; Long-Term Care

 

CATs, CAAs & Care Planning for Activities & Social Services (6 hours)

CATs provide a flag for the IDT members, indicating that a triggered care area needs to be assessed more completely prior to making care-planning decisions. For the MDS 3.0, we now have Care Area Assessments (CAAs) and CAA Summaries. In this session, Cat Selman will provide guidance and instruction on the Care Area Assessment (CAA) Process, the utilization of the Care Area Triggers (CATs) and their relationship to the development of an individualized, person-centered comprehensive care plan. She will specifically address the CAAs that have implications for the activities and social service departments as well as identify specific related care areas that can negatively impact a facility's survey. Surveyors will expect the plan of care to address identified factors with the goal of: (1) improvement where possible or (2) maintenance and prevention of avoidable declines. The RAI helps nursing home staff look at residents holistically, as individuals for whom quality of life and quality of care are mutually significant and necessary. Ms. Selman will demonstrate how the RAI process culminates in the development of an individualized, person-centered care plan that meets resident needs and survey requirements.

Intended Audience: Social Workers, Social Service Designees, Activity/Recreation Professionals, Nursing; Long-Term Care

 

Resident Voice - Assuring Quality of Life Through the MDS 3.0 (3-6 hour intensive)

The Centers for Medicare and Medicaid Services (CMS) has taken tremendous interest in determining how the MDS 3.0 can be utilized to assure an elder's quality of life. As a result, surveyors are looking more closely at the link between documentation on the MDS and the delivery of care and services to the elders in our facilities regarding the quality of life. Guidance from the Centers for Medicare & Medicaid Services (CMS): "The facility must create an environment that is respectful of the right of each resident to exercise his or her autonomy regarding what the resident considers to be important facets of his or her life." This includes actively seeking information from the resident regarding significant interests and preferences in order to provide necessary assistance to help residents fulfill their choices over aspects of their lives in the facility.

 

What is "quality of life?" Does one definition fit everyone? How do surveyors assess this important aspect of an elder's life? The RAI helps nursing home staff look at residents holistically "as individuals for whom quality of life and quality of care are mutually significant and necessary." Interdisciplinary use of the RAI promotes this emphasis on quality of care and quality of life. Nursing homes have found that involving all disciplines in the RAI process has fostered a more holistic approach to resident care and strengthened team communication. This interdisciplinary process, which includes input from the elder and/or their family/legal representative, directly influences an individual's experience of care, including: workplace practices, the nursing home's cultural and physical environment, elder/staff satisfaction, clinical and care practice delivery, shared leadership, family and community relationships and Federal/ State/local government regulations.

 

84% of all elders living in a healthcare setting are capable of providing information regarding what they consider to be the most important facets of their lives. There are several MDS 3.0 sections that require a direct interview of the elder as the primary source of information (e.g., mood, preferences, pain). Self-report is the single most reliable indicator of these topics. Guidance from the MDS 3.0/RAI Manual indicates that staff should actively seek information from the resident regarding these specific topic areas, and that resident interview/inquiry should become part of a supportive care environment that helps residents fulfill their choices over aspects of their lives.

 

This session will seek to provide guidance/suggestions/recommendations on the utilization of the MDS/RAI process in meeting quality of life requirements for each individual residing in a health care setting. Through a resident voice and professional interdisciplinary assessment, the delivery of care and services becomes a dynamic, collaborative process. This process assures that the elder is able to attain and/or maintain their highest practicable level of physical, mental and psychosocial well-being.

Intended Audience: Interdisciplinary Care Team (Nursing, Social Services, Activity/Recreation Professionals, Dietary, Nursing Assistants, Therapists)

 

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Choose any combination of session topics from Cat’s “repository” to build your own 1 – 2 day intensive training.

 

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