Next up on the CMSCG Blog, we’re going to dive deep into the heart of person-centered care by reviewing F699 Trauma-Informed Care. Trauma-Informed Care isn’t just about checking boxes on a care plan – it’s about understanding the lived experiences of our residents and how these experiences have shaped the way they respond to care, the environment and relationships. Whether someone’s life includes a history of abuse, neglect, institutionalization, homelessness or an adverse childhood experience, trauma leaves a mark – and facilities are required to identify it, respect it and respond appropriately to it. I often remind clients that I’m working with that trauma needs to be recognized and care planned in the same way that we’d ensure we included fracture or medication allergy in the CCP. This Ftag reminds us that every interaction that we have with a resident is either an opportunity to re-traumatize or help heal . . . but we can’t avoid re-traumatization if we haven’t done our homework. Will we get it right every time out of the gate? No. Will sometimes something occur before we get to the root of what’s really going on? Of course. But we have the opportunity to help the residents – and our staff – have a better day by ensuring everyone is on the same page.
F699 – Regulatory Requirement
F699 is a regulation that’s chock full of buzzwords, which we’ll break down as we review the definitions associated with the reg. Per SOM Appendix PP, Nursing homes are required to ensure that residents who are trauma survivors receive:
– culturally competent care
Cultural competency is one of those areas that we typically see addressed as part of orientation, but what does it really mean? Appendix PP defines both “culture” and “cultural competency.
“Culture” refers to the conceptual system that structures peoples’ worldview. Culture includes a set of norms, beliefs and values and the influence that these have on the way people live their lives and interact with other people.
“Cultural Competency” includes valuing diversity, avoiding the use of stereotypes, conducting self-assessment and managing the dynamics of difference. As individuals enhance their knowledge in these areas, they become more culturally competent.
– trauma-informed care
“Trauma” is something that results from an event/ events or a set of circumstances that an individual experiences as emotionally harmful, physically harmful or life-threatening, and has a lasting adverse effect on that individual’s functioning and well-being.
“Trauma-Informed Care” recognizes the impact and signs and symptoms of trauma in nursing home residents and incorporates that knowledge about trauma into care plans and practices to avoid re-traumatizing the resident. This approach to providing care involves understanding, recognizing and responding to the effects of all types of traumas.
– care that accounts for residents’ experiences and preferences in order to eliminate or mitigate triggers that may cause re-traumatization of the resident.
This last part of the regulation sums it all up, but it’s still an area where so many nursing home staff struggle. The “preferences” part, especially as it comes to cultural or religious needs and norms, is a bit more familiar, but understanding residents’ experiences in order to eliminate or mitigate triggers is where we see facilities tend to fall flat. It’s a good first step that you’ve identified the presence of trauma – what now? We’ll dig into that more next week.
