Download Skilled Nursing - Silver Lining Services

Silver Lining Services
Why choose SLS LLC?
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SLS currently serves approximately 458 clients throughout our various programs, and employs
approximately 480 people in the greater Cibola and McKinley County Areas.
We have been acknowledged for our outstanding business performance by many local officials and
pride ourselves on our above average quality services and genuine concern for those in need.
SLS Supports individuals and works to improve the quality of life for those of any age who might
otherwise require institutional care.
SLS provides care for individuals in their own homes and community.
Our agency has an open door policy and our Executive Director can always be reached on or off
the job.
SLS provides home and community based services to all EEOIC recipients.
Family members may serve as HHA providers.
SLS now has two locations to serve you.
SLS has a complete education department all skilled nurses will be able to receive continued
education credits.
Our most recent additions have been service provisions to the Developmentally Disabled and
EEOIC-DOL Uranium industry workers and our skilled nursing department.
Exceptional Customer Service
Family like atmosphere
Determination to do what it takes to serve the community
Strong business staff
SLS is in the business of sharing and caring to the needs of those around us
Locally owned and operated
The owners are from and live right in Grants, NM.
We provide weekly home health aide training
Our agency prides itself on providing top quality Skilled Nursing
Homemaker/Caregiver services, Case Management, training, and advocacy. To do
this we provide all of the following services…
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Skilled Nursing
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Pain Management
Pulmonary & Respiratory Maintenance
Musculoskeletal Assessment
Restorative therapy & Ambulation
Range of Motion Exercise Daily
Nutritional Maintenance
Wound & Skin Breakdown Prevention
Emotional Support for Client and Family
Members
End of Life Support
Monitor Vitals & Oxygen Saturation
Assessments of all Body Systems
Neurological Assessment
RN Case Management
Registered Nurse
Licensed Practical Nurse
Social Services
Physical Therapy
24/7 skilled nursing available to those
that qualify
Wound Care
Wound Vac
IV Therapy
Post-operative care
Respiratory services
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Infusion therapies
Comprehensive wound care therapies
Palliative care services
Renal disease services
Cancer recovery services
Digestive disease support
Respite care
Hospice care
HHA- Eligibility
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Family members may serve as HHA providers.
SLS.LLC now has two locations to serve you.
SLS.LLC will make every reasonable attempt to accommodate out of town or out of state
participants to complete training needs.
Our agency will train and certify all HHA-Home Care Providers at no cost to the HHA. SLS.LLC
assumes all training costs.
Home Health Aid - HHA
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Cont:
Companionship and Conversation
Arrange Appointments
Medication Reminders
Plan and Prepare Meals
Assist with bath, hygiene and grooming
Light Housekeeping
Changing Linens/Laundry
Grocery Shopping
Escort to Appointments
Errands
Case Management
Information and Referral Services
Vitals, General Care and Preventive Care
Added value Benefits
SLS.LLC has a complete education department all skilled nurses will be able to receive continued
education credits.
CNA’s available
Other services and care options
Social and Cultural Activities
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Encourages learning and recreation
Supportive setting for residents and their families
Activities that support transition back into the community
Full Cycle Rehabilitation Program
Physical therapy
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Nursing and Restorative Care
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Customized plan of care for each individual
Assistance with Activities of Daily Living
Case Management
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Patient and resident advocacy
Clinical and financial resource assistance
Discharge Planning
Prior to admission
Discuss recuperation goals and plans for on-going care
During care delivery, plan is re-evaluated
What is Skilled Nursing?
Important Background Information Regarding “Skilled Level” Patients:
There are certain conditions that must be met for a patient to qualify for skilled home health services
under Medicare, Medicaid, and some insurance companies; they are:
• Be confined to the home (homebound);
• Be under the care of a physician;
• Receive services under a plan of care established and periodically reviewed by a physician;
• Be in need of skilled nursing care on an intermittent basis or need physical therapy or speech
therapy;
• Have a continuing need for occupational therapy
Clarification of Homebound:
This does not mean the patient must never leave their home. In general terms, a patient is considered
“home bound” if they:
• Have a medical condition or an injury that restricts their ability to leave their home unless
they use an assistive device (crutches, cane, wheelchair, walker);
• Require the use of special transportation;
• Require the assistance of another person;
• Or, leaving their home is not medically advised
Patients may leave their homes occasionally; for church services, hairdressing, attending a family
functions while being driven in a vehicle by another person. Absences from the home to receive
medical treatments are also allowed, such as:
• kidney dialysis;
• chemo/radiation therapy;
• and outpatient physical therapy, including whirlpool therapy
Clarification of Skilled Nursing Duties:
A skilled nursing patient is one who requires the skills of a Registered Nurse or Licensed Practical Nurse.
The nurse is responsible for:
• making the initial evaluation visit to the patient,
• reevaluating their needs regularly,
• initiating and revising the nursing plan of care,
• providing the services that require more specialized nursing care,
• planning for preventative and rehabilitative care,
• preparing clinical notes and informing physicians and others participating in the patient’s care
of changes as they occur.
According to the Medicare Benefit Manual, 30.4, (Medicare reimbursement) “skilled nursing care
must be reasonable and necessary, needed on an intermittent basis, and not be solely needed for
venipunctures for the purposes of obtaining blood samples.”
Some examples of patients who would qualify for skilled nursing care:
• Patients who require intravenous and intramuscular injections
• Patients needing Foley catheter insertions
• Patients with pre-existing peripheral vascular or circulatory disease (needing observation for
complications, pain management, teaching related to skin care, preservation of skin integrity,
and prevention of skin breakdown)
• A patient who requires teaching related to illness or injury until they can demonstrate
independence in their care.
• Patients in need of medication management which also requires a nursing assessment (such as
blood pressures, pulses, respiratory assessment, blood sugars, oxygen saturations), monitoring
of medication changes or physician consults.
In home health care, it is anticipated that the patient and/or caregiver's) will be taught how to perform
self-cares by the registered nurse. Typically this teaching is done over several days/weeks,
depending on the complexity of the task and the patient’s condition. For this reason, agencies can
expect to see patients frequently upon admission, and then begin to reduce the number of registered
nurse visits when competency in the task is demonstrated and documented.
If the patient’s nursing goals are met (considered to be stable), or teaching can be completed in one
visit, the patient is no longer considered “skilled” and no longer considered “qualified” for skilled
care.
Any DOL cardholder with moderate to severe respiratory problems qualifies for skilled nursing care.
Examples of patients who do not qualify for skilled care:
• Skilled nurse admits a patient to agency for bathing, and completes the teaching of medication
administration and safety in the home, at the admission visit.
• Patient is not compliant with taking medications, and needs reminders to take them on time.
• Patient has a wound, which the caregiver manages competently, and patient is driving their
own vehicle.
• Medication set-up when the medications taken do not require ongoing nursing assessments,
monitoring or physician consults.
Venipunctures alone do not qualify a patient for home care. The documentation must support the
rationale behind the venipunctures, for example:
• A patient is taking coumadin (blood thinner) and requires protimes to monitor it effectiveness.
Documentation reflects no changes in the coumadin therapy for 6 weeks. This patient would
not qualify for skilled care based on this alone.
• A physician requests a chemistry panel and CBC drawn on his patient prior to the patient’s 6
month check up. This patient would not qualify for skilled care based on this alone.
• A patient newly diagnosed with Atrial Fibrillation, and new to coumadin therapy, needs
protimes to monitor for therapeutic effects. This patient would qualify for skilled care.
Contact Information
If you have any further questions or concerns please contact
Silver Lining Services Director of Nursing Shelia Gholston.
Office: 505-285-3445
Cell: 505-240-0252
[email protected]