Tuesday, December 15, 2009

Mailing Lists, Labels, and Letters

This is the time of year to send out seasonal greeting, and maybe information on your foundation, or a monthly newsletter.

PALs makes it easy to print mailing labels, for any addresses entered. For example, Residents' contacts, physicians, pharmacies, and staff, all permit printing of labels, letters, or even emails.

Download a FREE trial of PALs Executive today and take a look. www.PALsSoftware.com

Sunday, December 13, 2009

Assisted Living Pricing & Profits

Assisted Living operations usually categorize income into three streams: Housing, Food, and Services. This discussion is meant to address Services (the heart of assisted living).

In summary, management is buying staff time at an hourly rate, then adding value (training, supervision, setting, etc.) and reselling staff time in 15 minutes units for resident cares. Hopefully, if you use monthly package pricing, the packages are based on minute of care.

So if you price your 15 minute of service to include:

1. wage related expenses including taxes and benefits (fully-loaded).
2. Administrative Overhead to include supervision, training, etc.
3. ROI - Return on Investment to convert staff time to a profit center!
4. Shift Productivity = Resident Service Hours divided by shift hour. So if a shift is 8 hours long, and includes 6 hours of direct resident care, 6/8 = .75 (75%) shift productivity. Hence, 100% - 75% = 25% non-productivity factor. The .25 is used in the following calculations. This step ensures that the full 8 hour shift is paid.

Plugging in the numbers; if your fully-loaded wage related costs are $14.00 per hour then:

$3.50 per 15 minutes ($14.00/4)
+0.88 (3.50 x .25 = 100% - 75% = 25% shift non-productivity factor)
+1.53 = 4.38 x .35 (admin overhead, 15% + ROI, 20% = 35%)
$5.91 = price per 15 minutes of service

Once you set your shift productivity by policy, and create your staff work schedule accordingly, your service side of the business is on track to create profits. Staff scheduling becomes the critical focus that needs to be managed and measured each week.

PALs includes templates to do the above calculations, and reports to review the shift productivity and resident service plan profitability.

Visit PALs Software website and download a FREE 7 day trial and calculate your price points.

Friday, November 13, 2009

Care Management in Assisted Living

PALs software supports the following 5-step process of Care Management (or Case Management) in Assisted Living Settings.

1. Resident Assessment - To identify resident needs. In most states an RN does this assessment, other states permit a "manager's assessment".

2. Service Negotiation - identifying which assessed needs will be met and how. Also, resident "wants" may be added.

3. Service Plan or Agreement - a signed agreement between the Assisted Living Provider and the Resident (or their representative) identifying the services to be provided to meet both resident needs and wants. These services will customized for the resident, and will provided at a stated time and frequency (daily or weekly or...). Finally, the cost of these services will be itemized (or combined into a monthly package).

4. The Service Plan is supervised on some schedule, based on agency policies, or state licensing requirements. In many states where services may involve delegated nursing, the services are supervised more frequently the services that are not delegated. The most common nursing delegated service is medication administration. The purpose of the regular plan supervision is to determine if the current plan is meeting the resident's needs and preferences. If there is a change in condition, a new assessment and service plan may be negotiated.

5. Re-Assessment. The may start the process anew. Most states require an annual physician review that most providers precede by a nursing assessment which accompanies the resident. In this way, the physician and Care Manager are coordinating services.

PALs supports the above process in the following ways.

1. Assessment templates are provided for Care Managers that can be edited to fit their preferences, program specialties, and state requirements.

2 & 3. Service Planning is supported by selecting services from approved services based on licensure then customizing the service for the individual resident based on the resident assessment and “wants”. These services are assigned to a shift and scheduled for a specific time and day(s). This same information is used to create a Resident Agreement to be signed, shift assignment sheets, service documentation forms, and invoices.

4. Based on the services provided, if they are Nurse Delegated or not, and state licensing requirements, PALs will compute the date for the next plan supervision. PALs also provides a plan supervision form, for the nurse to document their finding regarding the appropriateness of the plan to the residents current health care needs and preferences, staff competence in providing the service, and resident’s evaluation of the service provision. Also the service documentation forms may be reviewed noting any variations (added or cancelled services). Based on the date of this interview, the next plan supervision is computed. So the nurse may print an up-to-date plan supervision schedule at any time.

5. Finally, at the time of physician review, at least annually by regulations, the nurse is again prompted by PALs to complete a re-assessment prior to the physician visit and PALs will print a form summarizing the nurse's recommendations and current treatments and medications for physician review and signature. A list of upcoming required physician visits can be printed at any time.

The above process has proven effective in meeting state requirements as reflected in state surveys.

For more information, visit our website at www.PALsSoftware.com and consider downloading a trial version.

Thursday, November 12, 2009

Vaccination Record

PALs has updated its software to make Resident Medical Records easier to enter and access for the following components.

Diagnoses / Allergies / Medical Appointments and Changes / Vaccinations.

Print reports for any or all of the above for any date range entered.

PALs, the leader in Assisted Living Software, just keeps getting better with age!

Pennsylvania Assisted Living Forms

PALs has added Pensylvania's Adult Residential Licensing forms to its library of assessments and forms.

Personal Care Home Assessment - 55 Pa.Code 2600.225
Personal Care Home Support Plan - 2600.227
Resident Medical Evaluation - 55 Pa.Code 2600.141

Please contact our office for copies of these forms, or better yet, visit our website and download our FREE Trial.

PALs, the leader in Assisted Living Software, just keeps getting better with age!

Building Manager

PALs has updated it's building manager program to make it more user friendly.

The building manager is a program to create Work Orders related to apartments or other assets (like equipment or buildings).

These Work Orders are assigned to a shift (generally maintenance or housekeeping) for either a specific time and date or repeating. In the latter case, a task can be entered once and repeated on either a weekly, monthly, or ___ (enter Number) of days to repeat-cyle.

A task list is printed for a specific date or range of dates, for staff to complete. Completed tasks are checked off, and any monetary charges recorded and staff time documented.

For Example. If a resident calls down with a request to fix a leaky faucet, a one-time Work Order is completed and entered into the system.

If the North Stairway needs to be swept and mopped every Wednesday, that is entered into the system to repeat on every Wednesday.

If Furnace filters need to be replaced every 6 months, that is entered to repeat every 180 days (30x6).

Print Work Orders daily, and each of the above will print on the correct date.

PALs, the leader in Assisted Living Software, just keeps getting better with age!

iPhone and PALs

I just bought an iPhone, and let me tell you, the entire experience was a joy.

First of all, the sales staff were delightful, informed and loved their product. It was infectious. They took the time orient me about the phone, then I was off on an adventure. And soon downloaded my first app from the app store.

And here is where I want to link the iPhone to PALs. I wanted to be able to access PALs from my iPhone. No problem, "there is an app for that". I downloaded iTap RDP, and in no time at all, I was using PALs on my new iPhone. FANTASTIC!

I know other smart phones can do this also, if running windows mobile v5 or higher. But my experience with the iPhone was just too good not to share.

PALs, the leader in Assisted Living Software, just keeps getting better with age!

Saturday, August 15, 2009

Staff Alerts

PALs monitors a number of items to ensure regulatory compliance related to Nursing/Clinical regulations - See Nursing Alerts below. PALs has now expanded its "alerts" to monitor regulatory compliance for staff.

We have always monitored training hours, but now that has been expanded to monitor and issue "Alerts" if any of the following are out of compliance or nearing due dates:

1. Annual Training Hours
2. TB or TST (Tuberculin skin tests) due
3. Certification for Aides, or License for nursing staff
4. CPR certification due
5. Work Status (work permit or passport) expiration dates
6. Flu shots

PALs is committed to partnering with Assisted Living Communities in providing Resident Focused, Quality Care that is both regulatory compliant and profitable.

Tuesday, March 10, 2009

Nursing Alerts

PALs Software has added Nursing Alerts to it's assisted living software.

PALs has always printed reports to remind nurses of actions that need to be taken that relate to clinical care or regulatory compliance, but with this new feature, nurses are automatically notified when they log on to PALs.

The Nursing Alerts include:

1. Medication Compliance
2. Medication Ordering
3. Physician Orders Due
4. Nursing Assessment & Care Plan reviews
5. Resident Annual MD Visit and Orders
6. Resident Health Insurance Expirations
7. Service Authorization Expiration Dates
8. Staff Training Hours related to requirements
9. Staff TB Testing Due

PALs Software is in its 10th year of operation, and continues to meet the needs of assisted living providers to remain compliant with regulations and provide quality care while remaining profitable.

Tuesday, February 10, 2009

Audit Tool Added

PALs has recently added an Audit Tool. This enhancement not only tracks who has access to Personal Health Information (PHI), but limits their access according to user-group, and also documents changes to records, noting both previous and changed data.

For Example, Aides may be restricting to only viewing certain information; while nurses may view and enter new records, change existing records, or delete records.

The audit tool will "TRACK" when an aide logs-in capturing their name, id, date and time; and what action they took (printed shift assignment sheet), and when they log-out.

If a nurse logs-in and changes a record, an audit trail will identify who the nurse is, the date and time of the record change, and the previous and changed values of the changed record. So if a medication is changed from ASA 250mg to ASA 500mg, both these values as captured along with the date and time and name of the person making the change.

PALs continues to build on user requests and changes in the regulatory environment.

Thursday, January 29, 2009

Documentation Choices

In PALs, you can document Medications and/or Services (1) on the computer - Real Time; (2) on Paper or (3) a combination - Documentation by Exception.

(1) PALs can be setup for computer entry of Meds or Services using a mouse or touch-screen for an input device. This approach is the most costly and complex, and often, most time consuming because of the complexity, required training, and number of staff using the system.

But it is very accurate. Every service and meds is documented in real-time. If you need to know if that Med or Service was provided at 10:30 am and not at 10:45 am and you need to know it real-time, this is the approach for you. An eMAR or eSAR will print automatically.

(2) The paper form, default, will simply require to staff initial on a monthly MAR or SAR. The is the most simple and least costly approach. Supervisory staff would need to review each resident's MAR or SAR to see variations and missing services.

(3) The Combination approach, Documentation by Exception, combines the above two. Staff print a Shift Assignment sheet for both Meds and Services. During the printing process, all meds and services are automatically entered into the computer as "provided" by the staff person who logged in. Then, maybe two or three times during their shift, staff chart by exception, noting services or meds NOT GIVEN. Using this method, supervisory staff know what services were missed and eMARs and eSARs print automatically, along with variation reports.

This latter approach combines the eMAR and eSAR of #1, without the need for additional computers, input devices, or setup and maintenance of a wireless network.

With PALs you have choices.