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Questions on State Visits



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No. 10
Old Apr 29, 2009, 10:33 PM

Default Re: Questions on State Visits
Originally Posted by CapeCodMermaid View Post
I have worked in LTC for years and never once saw anyone shave a resident's legs. What tag could it be under? I would definitely IDR this. We are due for our survey any day now. It is what it is. We take excellent care of the residents.

I would imagine they could make this fall into a dignity tag if this was something that was very important to the resident and they (or their family) chose to make a stink about the issue.

Years ago had a very ambulatory, but fairly advanced alz. resident. She really didn't know her own name and certainly didn't know her kids by name. They threw the biggest ugliest hissy fit over Mom having hairy legs/armpits. All the way up corporate chain over our neglect of her care (and of course corporate backed them up). Said we were neglectful and the family should not have to request this be done. Should be standard of care as much as brushing teeth! Crazy!
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No. 11
from debRN0417
Old May 01, 2009, 08:46 PM

Default Re: Questions on State Visits
Unless the resident is able to speak for themself or the family states that "mom would have died if she were out in public with hairy legs" or something like that, I don't know how a deficiency could be written just based on a surveyors observation. It is not what you or I want, it is what the resident wants. Some women have facial hair. I personally would not want to have facial hair, but if a resident says. "It don't bother me", well then, that is the way it is. There is no deficient practice there. The same with hairy legs- I personally wouldn't want hairy legs, but there are some people who don't care, and some cultures that do not shave....It is not about me, it is all about the resident.
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No. 12
Old May 02, 2009, 05:05 AM

Default Re: Questions on State Visits
Originally Posted by debRN0417 View Post
... I don't know how a deficiency could be written just based on a surveyors observation. It is not what you or I want, it is what the resident wants...
Agree.

Likely this occurred from an interview with a family member. As previously posted, if a responsible party went on the record that the SNF had been advised of the importance to the resident of the care not furnished, then a tag for dignity or QOL may be justifiable.
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No. 13
from caliotter3
Old May 02, 2009, 05:35 PM

Default Re: Questions on State Visits
The thing that would make me nervous is when they have their meeting with residents and solicit complaints or comments. There are residents who wait for the moment to complain, and others who are coerced to complain. These are the things you can't really prevent completely. I would want to strangle the nursing assistants who would purposefully go around egging on residents to complain and laugh about their ability to do so.
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No. 14
from debRN0417
Old May 04, 2009, 06:53 PM

Default Re: Questions on State Visits
Originally Posted by caliotter3 View Post
The thing that would make me nervous is when they have their meeting with residents and solicit complaints or comments. There are residents who wait for the moment to complain, and others who are coerced to complain. These are the things you can't really prevent completely. I would want to strangle the nursing assistants who would purposefully go around egging on residents to complain and laugh about their ability to do so.
I agree, but disagree. Complaints are not solicited- there is a list of questions that are standard that are asked at all group interviews. Yes, there are some folks who wait until the state gets there to tell everything and complain about everything- but the next question from the surveyor should be "Have you discussed this with the facility staff or administrator?" "Are they aware that this happened to you or that you are concerned about this?" If the facility doesn't know that it's broken- how can they fix it? Same goes for any complaints received during private interviews- does the facility know? When did you tell them? What did they say? The facility needs to be permitted to respond to the allegation if the resident states that they told the facility- Allegations of abuse or neglect are the same, although reported immediately-- does the facility know? Again- you can't fix it if you don't know it's broken. If the same problem/complaint has been present AFTER the person has told the facility and maybe there is evidence of that in the resident counsel minutes then that is a problem....
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No. 15
Old May 04, 2009, 08:29 PM

Default Re: Questions on State Visits
The State assumes we as managers are supposed to know everything. "Have you told anyone" is not one of the things I've ever heard a surveyor ask. I HAVE heard them ask leading and misleading questions and I have seen them set a nurse up to fail. I've also read their reports with outrageous misquotes. Surveyors are there for one thing...to find fault. Some are reasonable, most are zealots.
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No. 16
from morte
Old May 05, 2009, 09:40 AM

Default Re: Questions on State Visits
Originally Posted by CapeCodMermaid View Post
I have worked in LTC for years and never once saw anyone shave a resident's legs. What tag could it be under? I would definitely IDR this. We are due for our survey any day now. It is what it is. We take excellent care of the residents.
i dont know a thing about the technicalities of survey......but i would hazard a guess the resident who didnt get their legs shaved might have been a younger, rehab patient? and might have to do with "dignity" issues? just a guess
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No. 17
Old May 05, 2009, 06:02 PM

Default Re: Questions on State Visits
If it were a rehab resident, they should be shaving their own legs. Who's going to do it when they get home???
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No. 18
from debRN0417
Old May 08, 2009, 10:14 PM

Default Re: Questions on State Visits
Originally Posted by CapeCodMermaid View Post
The State assumes we as managers are supposed to know everything. "Have you told anyone" is not one of the things I've ever heard a surveyor ask. I HAVE heard them ask leading and misleading questions and I have seen them set a nurse up to fail. I've also read their reports with outrageous misquotes. Surveyors are there for one thing...to find fault. Some are reasonable, most are zealots.
Obviously you have had some rough surveys. Not all are like that, but I have known a few myself- I have had several discussions with some about attitudes and such. My experience is not to find fault but ensure regulations are being followed, but most important, that the residents are receiving the care that they deserve and the best that we can provide them.
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No. 19
from morte
Old May 09, 2009, 10:33 AM

Default Re: Questions on State Visits
Originally Posted by CapeCodMermaid View Post
If it were a rehab resident, they should be shaving their own legs. Who's going to do it when they get home???
not if they are an incomplete quad.....or low back surgery....etc......there are a few things that might make it not possible to do....complex abd surgery......etc
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