How many deficiencies does your facility have?

Nascar nurse, ASN, RN · Jan 30, 2010

Per our cooperate policy for elopement.. one step across the threshold of the door is an elopement.

Also Indiana has recently posted new surveyor guidelines on abuse... All substantiated cases of abuse WILL BE CITED despite any action taken by the facility to prevent abuse or despite every appropriate action taken after abuse has been identified. Only the scope and severity will be determined based on the actions or reaction of the facility.

In other words, we hire a CNA, do all the appropriate background/licensure checks, complete all the required training on abuse/neglect, etc. They go out to the unit and verbally abuse a resident.. faciility management immediately suspends/terminates employee, provides any necessary care to resident related to the abuse, reports to state, etc... the facility will still receive an abuse tag, although in the above case it would only be a scope/severity of a D. Now this really stinks!

Commuter, in my part of the world, the average faciility seems to receive 10-25 tags. They "cross walk" many MANY tags. For example, we missed a pain assessment and they tagged the same issue under 3 different F-tags. Maybe this is how you got to 47 so quickly?

Plagueis · Jan 31, 2010

How many state-issued deficiencies does your workplace have?
I think that the facility in which I am currently employed takes the cake in this category. The most recent full book state survey of the nursing home where I work yielded a whopping 47 deficiencies, 8 of which were IJ tags (immediate jeopardy).

Wow! 47? I'm curious: what happens next to a facility with so many deficiencies, especially with the IJ tags?

TheCommuter, BSN, RN · Jan 31, 2010

Wow! 47? I'm curious: what happens next to a facility with so many deficiencies, especially with the IJ tags?

I am not certain of all of the legalities involved since I am not in management or administration, but I do know that nearly $100,000 worth of fines have been paid out by the facility where I am employed so far. The place is not going to shut down or anything since 40 of these deficiencies were recently cleared during a revisit by state surveyors.

AlexisWilliamsCNA · Jan 31, 2010

Only one deficiency :)

and it was for flour on a lightswitch

mondkmondk · Feb 1, 2010

Sorry, nursing only had one deficiency where I work. It was for documentation.

Blessings, Michelle

noc4senuf · Feb 3, 2010

We had "1" at a "D" level and are a 5 star facility.

debRN0417 · Feb 12, 2010

If you see them go out, and the alarm rings, and you intervene and get them back in before they are really out the door (or too far)- then I don't understand how this could be an elopement- it is an attempt, but nothing happened. An elopement occurs when they get out and you don't know that they're out- or at least that's what I thought.

If you have the interventions but for some reason they do not work- resident removes alarm or system malfunction- and the resident gets out, then it could be a problem, depending on if a) were you aware that the resident removes the alarm and what were you doing about it (b.are you checking your alarm system- not just once a month, but periodically and testing your wanderguard bracelets to ensure that they are operational and have evidence of that-and of course is all this care planned. There should be some type of elopment P/P your facility has for prevention and interventions and what to do if it occurs.

It's like a vistor comes in and says "Did you know that Mrs Smith is walking down the street toward the 7-11?" That's an elopement.... or you can't find a resident that you just saw fifteen minutes ago and there he is wandering through the parking lot trying to get someone to give him a ride home...that's an elopement...is it harm- no- potential, yes. Harm of course occurs when Mr. Smith gets out and you don't know he's out and he gets hurt, falls down the hill, breaks something or whatever. IJ (Immediate Jeopardy) happens when there is a systematic failure- but there must be culpability and theres some trigger things that have to be met..but culpibility is important...- you have to know that your wanderguard system wasn't working, or that you never test it so how would you know, or you assessed someone as a risk for elopement and you didn't do anything about it and they got out or that not all the doors have the alarms, or one back door does not have the alarm, and the facility thinks that no residents will go there, but they do...- stuff like that. It does not have to involve lots of residents, just one can throw you in to IJ and then opens up the door for all the other residents who may have the same "condition"- then the substandard quality of care and extended survey and what stress.....

CapeCodMermaid, RN · Feb 12, 2010

If only YOU were a state surveyor!

debRN0417 · Feb 22, 2010

I am a surveyor.

Moogie · Feb 22, 2010

I am a surveyor.

As you are a surveyor, could you please share, for the sake of discussion, some of the deficiencies that maybe catch your attention the most? I have learned, the hard way, that I will never work in a LTC again without first looking at its previous state surveys to see what kind of deficiencies they've had, how they've corrected them, and if the deficiencies represent some sort of pattern.

I've also heard administrators and managers claim that the surveyor was "biased" against them or picking on them. Do you think such claims ever have merit or it is possible that the administrators/managers were trying to blame someone else for their problems?

(Okay to PM me privately if you don't feel comfortable giving the answer on the board. At this time, no, I am not working in LTC and, after my experiences, I am not sure there's enough Maalox in the world to deal with the ulcers I'd get from working in that sort of environment again---at least, not in the last facility in which I worked.)

Thank you!

Nascar nurse, ASN, RN · Feb 22, 2010

As you are a surveyor, could you please share, for the sake of discussion, some of the deficiencies that maybe catch your attention the most? I have learned, the hard way, that I will never work in a LTC again without first looking at its previous state surveys to see what kind of deficiencies they've had, how they've corrected them, and if the deficiencies represent some sort of pattern.
I've also heard administrators and managers claim that the surveyor was "biased" against them or picking on them. Do you think such claims ever have merit or it is possible that the administrators/managers were trying to blame someone else for their problems?
(Okay to PM me privately if you don't feel comfortable giving the answer on the board. At this time, no, I am not working in LTC and, after my experiences, I am not sure there's enough Maalox in the world to deal with the ulcers I'd get from working in that sort of environment again---at least, not in the last facility in which I worked.)
Thank you!

Great questions Moogie.. I am hoping they are answered on the public forum, although I would understand if she responds via PM.

debRN0417 · Feb 23, 2010

I would be happy to respond. I am just briefly scanning the boards tonight and don't have time to fully devote to this right now, but will post within the next week (going out again). I wanted to respond though so that you'd know I will get back to you.