I actually worked in a facility that encouraged the ACL.  We were using it as a communicative tool for the staff.  Once we determined the client's score, we'd find the level that corresponded to (it was a color or number, I think).  All staff were to be in-serviced on the different levels.  It was then broken down into simple terms for carryover of what the client was actually capable of performing daily.  For example, the staff would know that the client needed their clothes setup for them, but they were able to dress themselves.  Or, the client may need assist bringing the washcloth to their face, before initiating their grooming.  Also, the OTs used the info to help with writing goals.  If the client score was such, then we were able to determine the client's rehab potential and possibly grade their long-term goals.

If you work in a facility where you think it could be successful, than great!  In some facilities it's hard because there are many patients and high turnover of nsg aides.  I hope this helps you out...

Just to let you know, you can email from your profiles or write comments on your profile comment wall.  This may help if you are having any communication difficulty.

We are trying to implement to Allen in our long term facility which I am very excited about and feel it will be especially helpful for the nursing staff (should they choose to listen to our recommendations) on how to manage the patients, their capabilities and what types of cues they would benefit from. One challenge I have come across as we implement this is the fact that Medicare has an issue with billing for these cognitive areas. Actually I think Medicare is easier to manage since we can bill under therapeutic activities and tie in safety, and of course self care. However, if the patient is a different insurance and requires prior authorization, it is hard to validate, as I recently found out. They see cognitive as "speech". Luckily, the person doing the authorization was an OT, so understood my point of view. I believe the ACL can do wonders and even help set up units within the facility based on functional levels, as they did in the psych hospital I worked  in. I am curious if anyone else had any problems with billing for ACL or cognitive type activities and how you deal with them. Thank you!