LTC State survey checklist

  1. Hi everyone. Happy Nurse's Week!!

    I have been out of nursing for a couple of years after having my first child. I never had to deal much with State Surveyors and although everyone hates it when State comes in, I want to be able to learn and fix whatever I might be doing wrong.

    The first facility I ever worked in didn't always do things right, and I am afraid that I picked up bad habits along the way just because I was out of school and honestly didn't know any better because that is what they were teaching me. You get that kind of naive mentality because you expect other nurses that have been a nurse for a few years to be teaching you to do things right, but yet you look back and apparently they were teaching you things just to "get by."

    I know there are a lot of very experienced and knowledgeable nurses out there, so I was hoping that perhaps someone had a checklist of what State focuses on during their surveys as far as med passes and procedures go?

    Thanks in advance for any insight you guys might be able to give me!
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    About LissaLynn

    Joined: May '11; Posts: 15; Likes: 34


  3. by   NamasteNurse
    Resident safety and infection control come to mind. Also dignity, for example they want you to take the res to their room for finger sticks and other 'procedures'. They look for outdated meds, especially insulin and inhalants like advair. They watch for hand washing or using sanitizer between residents. They may ask questions such as who is the resident abuse coordinator in your building? They like to see clean residents. Keeping the med room locked is a biggie. Checking for identification--huge. It's never fun--good luck!
  4. by   LissaLynn
    Thank you!! Yeah we just had our Corporate come in and do our mock survey, but I am new to the facility so I missed that, but I was there for the results and the DON was going over everything.
  5. by   Chin up
    HEy, lost first are a few biggies:

    Care plans, they are focusing more on these.
    Falls- are care planned
    Glucometer, testing, cleaning and usage documentation, crucial.
    Infection control.
    Documentation, on everything. Incidents, new procedures, meds, hospital visits, etc
    Doctors orders- wander guard, side rails etc..
    MDS policy, strict with the new 3.0
    Appointments- if missed, please document why and care plan if necessary.
    Meds with clear parameters.
    ABT with parameters
    Anti psychotic treatment sheets
    Proper DNR requirements.
    Proper diet, time, consistency, and temp.

    These off the top of my head, but many more. Appointments are big right now. INR too. Follow up, of any kind.

    I will let others talk, good luck, peace!
  6. by   Chin up
    Just saw the end of your post regarding med pass:

    For med pass- wash your hands, check meds three times, knock on residents door, then enter once allowed in. Check residents name, give meds, then wash hands. You may use a hand sanitized.

    G tubes- you must put each med in a separate cup, then add 5-7ml of water to dissolve. 10-15ml of H20 between each med. 30-60ml before and after, or order as written.

    Eye drops, have gloves on.

    Inhalers, make sure glass of H20 after use.

    Have all tubing dated, also date your pitchers and apple sauce. Okay, I am getting carried away, will stop now.

    Ps- keep washing hands, and then some more.
  7. by   LissaLynn
    Thank you SO much!!! I greatly appreciate that!!
  8. by   marthyellen
    To add to med pass advice: Read out loud to the surveyor what you are giving, including dosage, time, medication, resident name.
  9. by   debRN0417
    Make sure that you have medications marked that are not to be crushed and DO NOT crush them! Have a drug book handy. If you do not know what a medication is- look it up. Go over your medications now. Waiting until you are being watched is not the time to be wondering how to give a certain med or if it can or cannot be crushed. It is a good thing to talk to the urveyor as you are passing the med to let them know exactly what you are doing so that there is no question about what you have done. "I am going to prepare medications for Mrs. Smith in room 100. She takes her medications crushed in applesauce...I am going to give her eyedrops. SHe gets Timopitc 2 drops in the left eye.." make sure your bottles are dated when opened and that none of your medications are expired. Make sure that all of your medications are available. If they are not make sure you know the exact procedure that you are to follow if a medication is not available. If it is a daily med that is not available, tell the surveyor, "I don't have the Lasix for Mrs Smith that is ordered for 9am, but I will (whatever your policy/procedure is for getting the med)..." and as soon as it arrives let the surveyor know that you have the medication and ak them if they want to observe you administering it. If it is a BID or TID or medication that is administered more than once a day, then follow your policy on that, which is usually notification of the MD that the med is not available at the time it is ordered and ask what he/she wants you to do about it. But if you check your meds then you should not run into this aggrivating situation. Wash your hands...remember your 5 rights. Provide privacy, knock on door, introduce yourself, tell resident what meds you are giving, always ask about pain....
  10. by   LissaLynn
    Thank you all so very much for the tips. I greatly appreciate it!!!
  11. by   NurseGuyBri
    All I want to say is how amazing it is that it seems all LTC's have the same areas of difficulty and similar state survey examples. It proves to me that we're all going for the same goal!