Often, the I/DD care coordinator possesses a knowledge
defi cit as well. Nurses working with this population
rarely have formal education or training to prepare
them for providing care for these individuals ( Fisheret al., 2012 ). Because of factors such as poor retention,
lack of peer support in the community setting, and lack
of mentors, care coordinators often learn “on the job.”
Residential care settings are federally funded and administered
by individual states; therefore, the care provided
is also regulated by federal and state agencies,
specifically Medicaid and Medicare ( National Council
on Disability, 2012 ). While necessary to ensure that the
residents have safe, effective care, it is at the same time
challenging to stay up-to-date and in compliance with
the continually changing regulations. This may create
confusion among healthcare providers who are unfamiliar
with these regulations. The discharge planning
process is especially challenging.