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H08- 071 – Procedure

October 8, 2008

|TO: |Area Agency on Aging (AAA) Directors |

| |Home and Community Services (HCS) Division Regional Administrators |

| |Division of Developmental Disabilities (DDD) Regional Administrators |

|FROM: |Bill Moss, Director, Home and Community Services Division |

| |Linda Rolfe, Director, Division of Developmental Disabilities |

|SUBJECT: |Revisions to Long-term Care Manual Chapter 24, Nursing Services and Skin Observation Protocol Related to DDD |

| |Clients |

|Purpose: |To notify staff of updates to the Skin Observation Protocol (SOP) to include direction to DDD Case Resource |

| |Managers. |

|Background: |In June 2007, all DDD clients began to be assessed using the Comprehensive Assessment Reporting Evaluation |

| |(CARE) tool. Embedded within the CARE assessment is the Skin Observation Protocol and its associated data |

| |elements. Clients who had not previously been assessed in CARE, and have no access to usual Nursing Services|

| |resources, are now triggering the Skin Observation Protocol. |

| | |

| |The directions and revisions to the Skin Observation Protocol specifically address the needs of DDD clients |

| |who do not have access to Medicaid Personal Care or Waiver Personal Care nursing resources (e.g. Nursing |

| |Services or Nurse Delegation) for completion of the Skin Observation Protocol. |

|What’s new, changed, or |The following has been added to the Skin Observation Protocol: |

|Clarified |A Skin Observation Protocol Referral Tree for DDD clients. |

| |A client letter describing the Skin Observation Protocol and suggestions for follow-up care. |

| |Educational materials for clients and caregivers. |

| | |

| |The Long-term Care Manual, Nursing Services Chapter, is currently being updated to include these changes. |

|ACTION: |Effective immediately: |

| |Use the Updated Nursing Services Chapter |

| |DDD Case Resource Managers will follow the instructions on the Skin Observation Protocol Referral Tree for |

| |referral and resource information. |

| |MIP and ADH program managers shall distribute SOP provider memos to contracted organizations. |

| |DDD Case Resource Managers will provide a copy of the Client Referral Letter to clients without access to |

| |nursing resources. |

|Related |Educational Materials (Healthy Skin 1 & 2, Taking Care of Pressure Sores) |

|REFERENCES: | |

|ATTACHMENT(S): |Long-term Care Manual, Nursing Services Chapter changes: |

| |[pic] |

| |Skin Observation Protocol Referral Tree: |

| |[pic] |

| |MIP Provider Memo: |

| |[pic] |

| |ADH Provider Memo: |

| |[pic] |

| |SOP Pressure Ulcer Assessment and Documentation: |

| |[pic] |

| |Basic Skin Assessment: |

| |[pic] |

| |Client Letter: |

| |[pic] |

|CONTACT(S): |Candace Goehring, Unit Manager |

| |Clinical Effectiveness and Performance Improvement Unit |

| |(360) 725-2562 |

| |goehrcs@dshs. |

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