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Most Common Citations in TxHmL
Part 1
Or.......Adventures in TxHmL-land
Table of Contents
Introduction
We recently reviewed 2017’s Top 10 Frequently-Cited Principles for Home and Community-based Services (HCS) in Texas, and how Focused Software works WITH YOU to improve your survey results. This week, we’re moving on to Texas Home Living (TxHmL). The TxHmL program began as an “HCS-Lite” waiver, intended to provide similar supports at a lower cost due to the omission of a residential component. It’s grown into a long-term solution for many people with IDD and their families, providing supports not otherwise accessible during the interminable wait for HCS funding.
For providers, there is no “lite” version of the rules – managing TxHmL programs requires disciplined, stringent adherence to many of the same processes used in HCS. Focused Software has built -in many tools and quality features that assist TxHmL providers to ensure continuous compliance, and we’re now offering even more support with our “Offline Documents” for FS customers! Here’s the first half of the Top 10 TxHmL Citations rundown:
#10. Review/Prevent Abuse Quarterly: 40 TAC §9.580(k) — The program provider failed to review, at least quarterly, incidents of confirmed abuse, neglect or exploitation, complaints, temporary and permanent discharges, transfers, and unusual incidents.
This rule is comparable to HCS’s 40 TAC §9.178(f) and (p), which require the establishment of an ongoing consumer/advocate advisory committee (CAAC) that meets at least quarterly and a review of all the same data points. Many Program Providers who operate both HCS and TxHmL services choose to operate these reviews simultaneously, to review and discuss improvements for both programs. Because FS has provided a fillable form to document CAAC meetings, TxHmL providers can benefit, as well! As a Focused Software customer, you’ll have access to this and other useful documents which help keep your operations in compliance!
#9. Program Documentation in Measurable Terms: 40 TAC §9.578(f) — The program provider failed to ensure that an individual's progress or lack of progress toward achieving identified outcomes was documented in observable, measurable terms of specific outcome addressed and reviewed by the service coordinator.
Documenting (and communicating) progress or lack of progress is an ongoing struggle for many providers. With so much going on in the day-to-day lives of the people you serve, it’s difficult to prioritize monitoring documentation! Focused Software’s Implementation Plan tab provides a simple, fill-in-the-blank Review format for each service, linking identified outcomes and strategies. Additionally, the Training Goals report includes the same observable, measurable terms YOU write — necessary to clearly communicate progress (or lack of) to Service Coordinators. With FS’s FocusedAccess feature (coming soon), you’ll even be able to provide limited system access to those Service Coordinators, reducing the burden of downloading and sending the reports!
#8. No Nursing on Plan of Care: 40 TAC §9.578(q)(1) — The program provider failed to determine that an individual did not require a nursing assessment when nursing services were not on the individual's IPC and the program provider determined that no nursing task would be performed by unlicensed service providers.
This principle refers to the completion of Form 1572, the Nursing Tasks Screening Tool. This form must be completed to omit nursing services from any individual’s Individual Plan of Care. Focused Software developers are working hard to include this form in the Electronic Health Record, and it’s expected to be available online by the beginning of 2019. In the meantime, we’ve placed a downloadable copy in our Offline Documents for your convenience. You don’t even have to search for it on the HHS website. Once it’s completed, scan and save it under General File Attachments in the Consumer Chart so it’s easy to access.
#7. Signed by Witness: 40 TAC §9.580(a)(21)(C) — The program provider failed to obtain the signature of a third party witness acknowledging that the provider’s obligations had been shared with the individual or LAR.
Focused Software’s brand-new Consents feature has you covered! A template for acknowledging TxHmL Provider Obligations can be created and made available to document this information! Because we’ve included online signing capabilities, just carry your tablet or your phone with you when you inform people served of these obligations. You, the person receiving services, their guardian/LAR, and a witness can all sign right on the screen! If you’d like help setting up the form, just ask: we can install a template for you and make it available in all your consumer charts!
#6. Staff Knowledge/Report Abuse/Neglect: 40 TAC §9.579(d)(01)(B) — The program provider failed to conduct initial and periodic training that ensures staff members, service providers, and volunteers are knowledgeable about Abuse, Neglect, and Exploitation and reporting requirements.
Documenting training has never been easier than with Focused Software’s newly-released Personnel Checklist! Keep track of training dates, expirations, and you can even upload copies of training acknowledgements, certificates and tests!
Until Next Time.....
Stay tuned – next week, we’ll cover the top 5! Is your “problem principle” not listed in the Top 10? Contact us today – we’ll be happy to provide a free, no-obligation demonstration of the Focused Software Electronic Health Record, discuss provider operations and brainstorm with you so you can discover how FS can help address your challenge areas!
Call NOW – (281) 884 3537 ext. 117
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Photographs: Matthew Sleeper (Adventure Begins Picture); Geralt (Top 10 picture); Steve Johnson (#9,8,7 picture); Clem Onojeghuo (#6 picture)
