As an advocate for someone in rehabilitation or in a nursing home, it is important to prepare to participate in a care plan conference.  A comprehensive care assessment can become the contract between the facility and the resident.  Major changes in the nursing home regulations were effectuated in 2016. Skilled nursing facilities that participate in the federal Medicare and Medicaid programs must satisfy newly revised minimum standards of patient care to receive reimbursement for patient services. The new requirements of participation for nursing facilities represent the greatest change in the practice and care delivery since the previously revised rules were published in 1991.

The changes reflect a shift towards person-centered care which means a focus on the resident as the locus of control and support for the resident in making his or her own choices and having control over his or her daily life. There is also a greater focus on addressing the individual and unique needs and preferences of residents. These regulations allow residents and their families to be much more engaged in the design of their care plan and the design of their discharge plans, putting the consumer in the driver’s seat. Until these regulations, a person’s care had too often been decided only by the nursing home staff. Now, it is the hope that the facility will not do what is better for the corporation or the staff, but will focus on the resident’s needs and the resident’s preferences in developing a care plan focused on the resident himself or herself.

One thing to be cautious of in the care plan conference are medications.  It is very important to be cautious about sleep medications because these have been determined to lead to more hip fractures in nursing home residents. Having legal representation at the care plan conference can be instrumental in getting the most appropriate and comprehensive care plan designed for your loved one, and can be used to advocate for the receipt of promised services.