Signs You Won't Pass A Survey

  1. My coworkers and I were talking about state surveys. A question came up: What are the top signs you're working in a facility that won't pass it's upcoming survey?

    I know it might sound like a weird topic but I am interested in hearing answers. Thanks!
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  2. 21 Comments

  3. by   VivaLasViejas
    I've been both a LTC nurse and a surveyor, and I can tell you that the amount of documentation required of the nursing staff virtually doubles every time the facility is in the survey window. The number of "friendly reminder" notices on the break room bulletin board increases, but the tone becomes less friendly as survey time nears. The food begins to look better, and suddenly you can find vital sign machines and other supplies. But management also jumps on employees for every little thing, like not cleaning off the glucometer with bleach wipes each time it's used, or missing a spot in the MAR. (Not that it's OK to do those things, but we're only human after all.) It's almost anticlimactic when the State finally walks in the door, which is when you see administrators running around like chickens with their heads cut off, passing trays and answering call lights. Haha!
  4. by   TheCommuter
    I've worked at multiple nursing homes before leaving LTC nursing in 2012. I've worked in the good, bad, and ugly facilities. The ugliest facility had a full book survey that generated 47 deficiencies, eight of which were immediate jeopardy (IJ) tags.

    In my personal experience, facilities that accept inappropriate admissions (e.g. psych patients, eating disordered residents, sex offenders) and fail to meet their needs tend to flop horribly on surveys. The aforementioned patient populations are complex, and any nursing facility that accepts them needs to have good systems in place in addition to meticulous care planning.
  5. by   VivaLasViejas
    Wow...eight IJs! Did the facility get shut down?
  6. by   TheCommuter
    Quote from VivaLasViejas
    Wow...eight IJs! Did the facility get shut down?
    The owners voluntarily shut their own facility down in an orderly manner. However, the official closure date didn't come until about 14 months after those IJs were issued.
  7. by   Julius Seizure
    Quote from TheCommuter

    In my personal experience, facilities that accept inappropriate admissions (e.g. psych patients, eating disordered residents, sex offenders) and fail to meet their needs tend to flop horribly on surveys. The aforementioned patient populations are complex, and any nursing facility that accepts them needs to have good systems in place in addition to meticulous care planning.
    Sex offenders cant be admitted to nursing homes? Where do they go when they need long term care, then?
  8. by   TheCommuter
    Quote from Janey496
    Sex offenders cant be admitted to nursing homes? Where do they go when they need long term care, then?
    Nobody said sex offenders couldn't be admitted to nursing homes. However, systems and care planning must be put into place to prevent this specific patient population from harming other residents.

    Nothing's worse than walking in on a younger male resident as he's inappropriately touching a very demented elderly female. Yes, this did happen...
  9. by   amoLucia
    Quote from TheCommuter
    Nothing's worse than walking in on a younger male resident as he's inappropriately touching a very demented elderly female. Yes, this did happen...
    Yep - been there, seen that.

    To OP - somewhere, you should be able to find your last, most recent survey. Check out where the deficiencies were and what the facility's plan of correction was. To you, how well do they seem to match in addressing the problem?

    You might then see a correlation between the higher-uppers frantic activities and the facility's general status.
  10. by   mlolsonny
    In the simplest: Preventable Problems. Think pressure ulcers, contractures, weight loss, non-healing wounds, medication errors, decline in mobility/ ADL ability.

    Rationale: If adequate care is provided, most of those are prevented. Certainly you're going to have patients or residents that surprise you, and develop/ decline in condition. If you're diligently monitoring and putting interventions in place, you won't have big problems with these things that are supposed to be prevented.

    Look at your staffing patterns. If you don't have enough registered nurses to assess, and plan care ; enough LPN/LVNs to monitor, implement, and notice the daily changes; enough nursing assistants to provide the hands-on care, declines will happen.

    Talk with your residents: Use the QIS Resident Interview and Observation form. The surveyors will ask these exact questions. Don't be surprised by your resident's answers.
  11. by   amoLucia
    To add to PP's comment - think onset of incontinence since admission; facility acquired UTI, too.
  12. by   RNinIN
    Quote from TheCommuter
    I've worked at multiple nursing homes before leaving LTC nursing in 2012. I've worked in the good, bad, and ugly facilities. The ugliest facility had a full book survey that generated 47 deficiencies, eight of which were immediate jeopardy (IJ) tags.

    In my personal experience, facilities that accept inappropriate admissions (e.g. psych patients, eating disordered residents, sex offenders) and fail to meet their needs tend to flop horribly on surveys. The aforementioned patient populations are complex, and any nursing facility that accepts them needs to have good systems in place in addition to meticulous care planning.
    If you weren't so far west of me, I'd swear we've worked together
  13. by   LTC_LPN2
    I've noticed the past couple of weeks that management and DON want to rush and fix issues last minute. After a problem is so far gone you can't snap your fingers and just get it all done in one day and do your job too. Be consistent with all nurses and your expectations daily instead of procrastinating. Med carts for instance were filthy on match back but not once did those nurses voice to the med nurse, clean the cart, make sure it's stocked, ...well I get on the cart taking ab extra shift on a different hall and was not even shocked to see meds that were dcd still on the cart, MOM and Robitussin spilled everywhere and bottles sticky...they know their duties as Med nurses however they expect the next nurse to clean up behind them. My shift is 7-3 n I got out of there at 830 at night because I was worried survey would come the next day. Embarrassing! You can't do it all by yourself but they'll definitely let you go down alone to get the monkey off their backs...
  14. by   bluegeegoo2
    One sign you won't pass is when you see your pharmacy consultant shaking her head muttering to herself and madly scribbling in her notebook every time she opens a med cart drawer.

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