"State's Here!": Demystifying the Long-Term Care Survey - page 2
It's the same every year: a contingent from "The State" invades your facility and commences with scrutinizing your work, poring over your records, nosing around the kitchen and dining areas, and... Read More
0Feb 12, '14 by merrywhiteroseI totally agree with you! We've had more falls due to residents being able to un-velcro those stupid lap buddies & fall before we can get to them. Seat belts that can't be unfastened for dementia residents would stop many of our falls.
1Feb 12, '14 by merrywhiteroseThe state stayed an extra day "because we couldn't find anything, yet".
5Feb 13, '14 by casiI think that the biggest problem at the facilities that I work with state coming in is that management gets in such an anxiety fill tizzy that it drips down to all of the other staff. Every year when our window opens and management starts enforcing the rules for state inspection my question is always, "why haven't we been doing this all year? It wouldn't be a big deal if it was done all year."
7Feb 13, '14 by mellsterThe reason why the regulations aren't followed all year in most cases is that the facilities REFUSE to staff in such a way that it is possible to do your job properly. I think it is a disgrace that all the admins come out of their offices and help only when the state is there. I have seen that at every facility I have worked at. State surveyers know what is going on, but they don't do anything about it and look the other way. It is totally obvious that the administrators don't help when the surveyers aren't there. They are funny to watch- don't have a damn clue as to what they are doing!! However, all the administrators and state people just stick their heads in the sand and pretend the problems don't exist. Most people in those positions should be very ashamed of themselves. Why do we not care about our elderly in this country?? It's not all about not having any money. I reasearched how much healthcare CEOs make, and it is sick. There is a special place in hell for someone that gets 7 digit per year compensation while our elderly suffer because they won't staff the facility.
4Feb 13, '14 by CapeCodMermaid, RNDo some research before you make a blanket statement. I see the numbers every month and believe me, there is no extra money these days. We are staffedbetter than most of the facilities around us. We do the right thing every day whether DPH is there or not. It doesn't matter. If they've had a bad night, we're more likely to be cited. There are new ridiculous rules every year without any more medicare or medicaid money to pay for it. We lose money on every medicaid resident every day.
It's a complex industry and we are held to a far higher standard than hospitals. But, we do the right thing every day. My managers and I are on the floors helping every day. The majority of DPH surveyors are rude and condescending.
0Mar 14, '14 by lglnrs33Hi VivaLasViejas,
Great article. Thank you! Is there any way that I can get in touch with you? I would like to ask you a couple of questions. Thank you!
0Mar 14, '14 by NurseNightOwlQuote from CapeCodMermaidLol, just when the OP was making me feel better... 😲I disagree 100%. Surveyors love to intimidate any staff membee they can. They are rude, condescending, and demeaning. They try to twist what staff members say and they misquote us when they write out the SOD.
YOU might not be that kind if surveyor, but most, if not all, of the ones I've dealt with over the years have been awful.
4Mar 15, '14 by CapeCodMermaid, RNSorry for the stress rant about surveyors. We just finished ours. They were SO late coming this year the stress was even worse than usual. I'd like to give a shout out to my excellent staff for having an excellent survey.
1Mar 16, '14 by Mn nurse 22Our facility does do a good job staffing so while there are days that staff might get busy for a while with an emergency most of our staff routinely gets to take their breaks and feel like they have enough time to do a good job.
Our managers do come out on the floor during surveys and try to help and when I heard the staff complaining about it, I asked our managers why they tried to help when they don't ever help when state isn't there.
The answer I got was they recognize how stressful it is during a survey and that can lead to staff taking more time to do a job and they want staff to be able to continue to keep our times as good as they usually are and if they fall behind for any reason the managers are available to help get everyone caught up.
They weren't doing it to put on a show but simply trying to be helpful during a stressful time.
1Mar 19, '14 by VivaLasViejas, ASN, RN GuideYou can PM me anytime, lglnrs. :-)
1Mar 31, '14 by twinsmom788Thanks for this article. From a surveyor point of view, this information is 100% accurate. Well said. I have been on both sides of the fence and understand where the other is coming from. Believe me, we know that the (most) managers don't clean tables, feed residents, or come out of their offices as much as they do when the state is there. Although, when I was the ADON in a small facility, I fed residents everyday.
Comments made by surveyors should sometimes be taken with a grain of salt such as "we are coming back another day because we haven't found anything yet". That is never appropriate ( as per the training I received)
As far as surveyors working late/early, CMS guidance instructs that if there is a concern on a specific shift, the surveyor must observe during that time period to validate the issue. I have gone into a facility many times at night or on a weekend. Although state operational policies differ from state to state and for different regions of CMS.
We do our best to remain professional in our communication with the facility staff. However, we are only human and when a case of abuse or neglect is not investigated properly ( per their own policy) or worse a DON/administrator doesn't seem to care about the situation then it might be difficult not to at least think "What were you thinking?"
1May 14, '15 by momofIAndTThis is a complete load of crap. Survey is a joke. I've seen the worst dumps get "deficiency free" and then a really well run place take 4 tags (yes I said 4 TAGS) because a surveyor didn't like a doctors handwriting. State surveyors are condescending, overpaid (one that works in my state makes over 111,000 dollars a year) and they're SNEAKY! They are absolutely there to intimidate, insult, and abuse you. If you're in management they will make you WISH you never went into that line of work in the first place. I was once berated for over an hour about a mistake in transcription for a pro biotic order and the error didn't even reach the patient! She actually made me feel so bad about it I cried later on in the bathroom because we missed the mistake on edits! A pro biotic for goodness sake!
State surveyors exist to belittle, insult and intimidate nursing home workers. And if the surveyors know the management team and like them, then the surveyor will look the other way. It's even more unfair now that CMS has the 5 star rating. They want me to discontinue antipsychotic medications for people who have been on them and therapeutic for years! I'm sorry but call a spade a shovel; DPH surveyors are *******s. It's just another example of a corrupt government system.
0May 14, '15 by momofIAndTYou can't staff if you can't pay them. Surveyors don't say anything because it's a problem with medicare and Medicaid reimbursement. Your managers help out during survey because they know it's going to take you longer to do your job than normal because in order to follow the 25 kazillion regulations you're following (with a surveyor looking over your shoulder) it'll take you a half hour to do a dressing instead of 15 minutes.
Next time you want to ***** about your DON or nurse manager not helping out on the unit, why don't you offer to help her with the safety device audit or maybe a few family meetings, or those grievances, or that Medicare/care plan/ID meeting. Or maybe those staff reviews, those write ups or even the QA meetings. How about a pharmacy audit or dealing with the errors the staff nurses make on the lab slips? How about if you give her a hand with the CNA meeting since she's exhausted from the staff calling her 4 times throughout the night on her time at home because a nurse didn't use a gait belt and a patient fell and went to the hospital.
Oh yeah. You can't. The DON/CCO is qualified to do everyone else's job, but nobody else can do theirs.