Preparing for Survey

1
Preparing for Survey

• A Guide for the LPN/RN

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Objectives

• Understand the goal of survey
• Realize what surveyors look for
• Be aware of interviewing protocol
• Understand F tags of importance

3
The Goal of the Survey

• For the state to ensure the nursing homes
  compliance with federal regulations which require
  the nursing home to provide care for residents
  that either maintains or improves their physical,
  mental, and psychosocial
• well-being.

4
What Surveyors Look For

• Clothing and Footwear
• Staff response
• Talking to residents
• Activities
• Response to behaviors
• Skin conditions
• Skin tears, bruising, fxs
• Hydration

• Edema, contractures
• Positioning
• Restraints
• Infections
• Pressure Ulcers
• Restraints
• Feeding tubes (HOB)
• Significant wt loss

5
Who Surveyors Interview

• New admits, especially if within 14 days
• High risk of abuse or neglect
• Anybody who shares a room with 4 people
• Hospice
• ESRD
• lt55 years old
• MI/MR
• ASL, ESL, or non-oral communication device

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F309

• Residents must receive, and facilities must
  provide, services to maintain or improve
  physical, mental, and psychosocial well-being

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Examples of F309 Deficiencies

• Resident in w/c not repositioned q2h (most common
  reason this tag is used)
• Resident was care planned for TED hose but it was
  not on when surveyor looked
• Missed labs
• Failure to follow MD orders

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F312

• A resident who is unable to carry out ADLs
  receives the necessary services to maintain good
  nutrition, grooming, and personal and oral care
• The licensed nurses responsibility often
  delegated to the CNA

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F Tags of Interest

• F279 Care plans
• F281 Professional standards of care
• F314 Pressure ulcers
• F315 Dont cath unless necessary
• F316 Urinary incontinence
• F322 NG or gastrostomy tube
• F327 Hydration

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F328 Special Needs

• Injections
• Parenteral and enteral fluids
• Ostomy care
• Tracheostomy care
• Tracheal suctioning
• Respiratory care
• Foot care
• Prostheses

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F331/332 Medication Errors

• The med error must be lt5
• Errors must not be significant
• Med pass will be observed for 20-25 opportunities
  for errors
• Be aware of detailed guidelines contained in
  Guidance to Surveyors

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F431/432 Med Labels/Storage

• Medications must be labeled, including accessory
  and cautionary instructions, and expiration dates
• Get rid of expired medications
• Meds must be stored in locked compartments under
  proper temperature controls
• Only proper personal may have keys
• Schedule II meds must be double locked

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Questions?