State survey

[kappykatlpn]

Hello all!

This isn't really a question, but mainly a vent. We recently had our state survey and got a cite for skin integ. The state is saying that a resident developed a pressure ulcer. We are saying its a stasis ulcer from poor circulation. (this resident is in poor health, DM Dialysis, has already lost one leg dt this) We have documentation, and The would doctor that comes in and his own doctor have both documented well on this residents wounds being stasis ulcer.

Now the sate surveyers win. We get the cite. How can they do that?? They are basically lying in my opinion just to give us the cite. They surverys also stated that someone in management made a statement that was never said. I just don't understand how they can do this. How can they sleep at night?

I have been in LTC for about 15 years, I have never seen surveyers do this.

thanks!!

Kathy

[eriksoln, BSN, RN]

Don't kid yourself. "They" and the survey process matter very much and can cause a great deal of grief for facilities burdened with persistently negative findings.

Not really. Have you seen some of the places that continue to stay open despite multiple infractions. In the end, at most, there will be a few fines. Some administrator will lose a bonus or get fired, and a few workers will be thrown under the bus. And it will only go that far if the surveyor really pushes the issue. It takes time/money/work to push the envelope like this, so it rarely happens.

Only reason administration even bothers with them is, the infractions become public knowledge and then patients or "clients" with the ability to choose care providers (those that are insured, have options, are able to get to facilities other than the one in the general neighborhood) might choose to go elsewhere. In times like these, that matters, you need all the paying patients you can get. More often than not though, bad marks by these types has no identifiable consequence. Its just egg on the face in the end.

[jmtndl]

I am not in LTC now because of state surveyers.They are,to me,terrorists sanctioned by the state. I have never known one thing done by the state to make a facility better or patients safer.They lie, they twist situations,they have no grasp or interest of the complexities of long term care.They exist to destroy others hard work.I suffer from PTSD due to the surveyers(yes I have received help), and consider them sub-human.:uhoh21:

[eriksoln, BSN, RN]

I am not in LTC now because of state surveyers.They are,to me,terrorists sanctioned by the state. I have never known one thing done by the state to make a facility better or patients safer.They lie, they twist situations,they have no grasp or interest of the complexities of long term care.They exist to destroy others hard work.I suffer from PTSD due to the surveyers(yes I have received help), and consider them sub-human.:uhoh21:

Should've use my method with them. Tell them "talk to the hand" and stay focused on the patients. I've never had one come up with an answer or solution to this when I do it. Only once did I have a manager even mention the incident to me after I went that route. That was when I was a travel nurse and the situation was not the norm. The "surveyor" was directed to me for whatever reason and I blew her off. Surveyor got upset with the manager for telling her to interview "such an uncooperative individual". Nothing else came of it.

They only have as much control as you give them. They are.........eh, like flies. Ignore them and they will buzz off.

[David13, MSN, RN]

We cannot know exactly what evidence was presented- we only have one side of the story. Again, I don't want to offend anyone, but until you yourself have sat down and reviewed the evidence, how can you know? Common sense? I can tell you some horror stories about common sense....or lack thereof...I know that I am a disliked minority- I truly wish it were not that way.

I'm a little confused. Are you saying common sense is a good thing or a bad thing?

I can only speak for myself, but I was speaking in generalities and not about the specific stasis ulcer incident of the OP. So, to clarify as I see it, if a surveyor makes a claim that is indeed not founded, the burden is then placed upon the nurse or the facility to prove that the surveyor is wrong; a.k.a. guilty until one is proved to be innocent.

[tobesmartt]

I think they should do away with "state survey" . I think it is ridiculous for these surveyors to think that life and situations comes from a text. They(surveyors) should come in the facility and have different jobs and we(nursing,dietary,housekeeping, secretary, etc.) do the the work. Bet all that critisism critisize will stop.

Hello all!

This isn't really a question, but mainly a vent. We recently had our state survey and got a cite for skin integ. The state is saying that a resident developed a pressure ulcer. We are saying its a stasis ulcer from poor circulation. (this resident is in poor health, DM Dialysis, has already lost one leg dt this) We have documentation, and The would doctor that comes in and his own doctor have both documented well on this residents wounds being stasis ulcer.

Now the sate surveyers win. We get the cite. How can they do that?? They are basically lying in my opinion just to give us the cite. They surverys also stated that someone in management made a statement that was never said. I just don't understand how they can do this. How can they sleep at night?

I have been in LTC for about 15 years, I have never seen surveyers do this.

thanks!!

Kathy

[Orca, ADN, ASN, RN]

The most frustrating aspect of these situations is that the surveyor’s interpretation goes on the report. If you want to dispute it, there is an entire bureaucracy with which you have to contend.

My response to their report on our facility - and all of their misinterpretations and outright mistakes - was four pages long. The most aggravating thing is that we have to endure the inspections and pay for them, but since we aren't a hospital their opinions are only advisory.

[tobesmartt]

are they picky or what? let them work there and see if all their perfection , charting and all that will out shine.

My response to their report on our facility - and all of their misinterpretations and outright mistakes - was four pages long. The most aggravating thing is that we have to endure the inspections and pay for them, but since we aren't a hospital their opinions are only advisory.

[debRN0417]

I'm a little confused. Are you saying common sense is a good thing or a bad thing?

I can only speak for myself, but I was speaking in generalities and not about the specific stasis ulcer incident of the OP. So, to clarify as I see it, if a surveyor makes a claim that is indeed not founded, the burden is then placed upon the nurse or the facility to prove that the surveyor is wrong; a.k.a. guilty until one is proved to be innocent.

Sorry- I meant to say that common sense is a good thing- that the lack of it has caused some very scary things to happen...

I have worked in LTC as a CNA, staff nurse, charge nurse, unit manager, staff education, ADON, and DON. I know what the real world is like. I have worked in a 60 bed facility, 110 bed facility, 180 bed facility and a 240 bed facility. I am proud of what I do. Not all of us are "terrorists" or "misinterpretors" or "falsifiers"...I treat people with respect and expect to be treated the same. ugh-

[pennyaline]

...The most aggravating thing is that we have to endure the inspections and pay for them, but since we aren't a hospital their opinions are only advisory.

Huh???

[Orca, ADN, ASN, RN]

Since our facility is not classified as a hospital, we are not legally obligated to follow the recommendations that the inspectors make. It sounds crazy, but that is how it is. It may have something to do with being a state agency, and not a health-related agency at that.

[pennyaline]

Since our facility is not classified as a hospital, we are not legally obligated to follow the recommendations that the inspectors make. It sounds crazy, but that is how it is. It may have something to do with being a state agency, and not a health-related agency at that.

What type of facility do you work for?

[Orca, ADN, ASN, RN]

It's a women's prison. They were inspeting our infirmary.