Report - Disability Rights Texas

# Provision Assessment of Status Compliance
Graph Element 3/2010 3/2012 8/2012
The graph is appropriate to the nature of the
0% 36% 67%
data.
Horizontal axis and label 0% 100% 67%
Vertical axis and label 0% 91% 67%
Condition change lines 0% 100% 67%
Condition labels 0% 100% 67%
Data points and path 0% 100% 67%
IOA and data integrity 0% 0% 0%
Demarcation of changes in medication, health
status or other events
0% 100% 67%
Other than the issues related to IOA and data integrity, the four sets of data graphs and
progress notes were very thorough, included abundant treatment information, and
reflected sophisticated data graphs. Due to the very limited sample provided by the
Facility, additional review will be required during the March 2013 site visit.
K11
Commencing within six months of
the Effective Date hereof and with
full implementation within one
year, each Facility shall ensure that
PBSPs are written so that they can
be understood and implemented
by direct care staff.
One element of ensuring that PBSPs can be understood and implemented by staff is
writing in a style that is concise, clearly organized, and makes use of simple language.
Writing style can be assessed and quantified using the Flesch‐Kincaid Grade Levels.
Microsoft Word 2010 includes an option to establish the grade level of a selection of text
using the Flesch‐Kincaid Grade Levels.
During the March 2012 site visit, documentation provided by RGSC reflected that the
staff instructions portion of all PBSPs was within the 9 th to 10 th grade reading level.
During the current site visit, the Monitor utilized Microsoft Word 2010 to calculate
readability and found documentation reflected that 80% of staff instructions for PBSPs
were rated below the 12 th grade level, and the average grade reading level for those
instructions was grade 11.9.
Noncompliance
Based upon this information alone, it appeared that PBSPs at RGSC had become less
rather than more readable. It should be noted, however, that the readability data
provided by the Facility reflected all PBSPs. Of those few PBSPs completed in the new
format, although readability data were unavailable, the language and writing style used
suggested that the staff instructions from those PBSPs were much easier to read and
comprehend.
As indicated above, readability statistics are only one element of ensuring that PBSPs can
be understood and implemented by staff. Additional elements require that the Facility
implement a system to monitor and ensure treatment integrity during which staff are
Rio Grande State Center, November 19, 2012
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