Newer RN working in SNF/Rehab with low ratings.

CapeCodMermaid, RN · Nov 9, 2014

F and G tags are not good but that doesn't mean your license in in jeopardy. Don't believe everything you hear. Go to work, do the best you can and help make the place better. The survey process is imperfect. Too much of it depends on the mood of the surveyors and the days they are in the building.

wossaa · Dec 11, 2014

Cynnie24, I don't know much about tags. However, you should go by your gut feeling.....if you feel good working there, then just stay there and be the change that's needed. If you don't have peace about being there, then it's time to move on. But don't let what you hear deter you from what you hold dear. It's about the residents and when you know you're doing your best for them, then that's a worthy cause and goal!

Fuzzywuzzypuppy · Jan 8, 2015

I was a new grad 5 yrs ago and was told in the interview that it was a 5 star nursing home, but found out that wasn't true. I didn't know any better really and just did my best every day. As time went on, it was evident the facility was not as professional as it could be. I worked because I liked my job and I thought I could make it better...management has a way of keeping things the same old way unless they want to change. Eventually, I found a true 5 star privately owned long term care facility. It is Everything a nursing home should be! A great place to work and a great place to go if I needed rehab or a place for my parents someday. My advice is to keep applying to privately owned facilities if in your area. The yrs of experience anywhere will help you in your next best job. Keep looking because the longer you stay at a badly ran facility the harder it will be to break bad habits you picked up.

favthing, APRN · Feb 15, 2015

The star ratings don't mean a whole lot to me. I work at a facility which had a 5-star rating, but a lot about this is the politics of how managers set the place up to prepare for surveys, etc. Long-term subacute care is a difficult setting because of the acuity of patients, yet the tendency of staffing for more long-term care. I find that if I am able to perform my basic nursing duties, account for my meds and narcotics, and chart, all up to standards of basic nursing care, then my license is not going to be at risk. In subacute care, you don't have time for the extras, as we are set up as nurses for the basics. I'm leaving after about three years for a med-surg setting, and to hear of 5 and 6 patients sounds like music to my ears.

CapeCodMermaid, RN · Feb 15, 2015

If you think managers can 'play' the 5 star system, think again. Most of the information to determine star status does NOT come from annual survey. There are many many components to the rating system which, by the way, just changed again two days ago.

twinsmom788 · Feb 17, 2015

Hi everyone,
The snf that Ive worked at since I graduated has low ratings... I respect a lot of the nurses there and believe they give great care including myself but apparently we had a survey not too long ago and we got tagged with deficiencies like F tags and G tags, I believe there were 3-5 tags total. We still have a pretty low rating.
I am plugging away at applying for other jobs. I read somewhere that if a facility has f or g tags that everyone's license is in jeopardy that work there. Is this true? Any advice? I am so new that I don't know what red flags to look out for. .

3-5 "tags" at an F and G level does not mean your facility and the nurses are giving bad care. The F tags mean that a situation was to affect the entire resident population such as kitchen cleanliness, linens not being available, etc. A G level deficiency means a harm has been caused to a resident such as an infection or a pressure ulcer that was not treated properly or not giving pain medication to a resident in need. There are so many possibilities and scenarios to be considered.

The only nurses who's licenses may be affected would be if they were responsible for the harms cited. A BON investigation would then determine any action. The licenses of other nurses would not be affected. The administrator is responsible for placing the survey results where the public and the residents can view it.

Please PM me with any questions.

twinsmom788 · Feb 17, 2015

"Too much of it depends on the mood of the surveyors and the days they are in the building". :) You must have cranky surveyors up there :)

CapeCodMermaid, RN · Feb 17, 2015

I can only speak for Massachusetts, but even if you're the nurse who gave bad care or didn't do something which caused a tag, chances are you won't lose your license. It's not that easy to have one's license revoked even in this state which has some of the toughest surveyors and regulations on the planet.

twinsmom788 · Feb 20, 2015

While I cannot speak for any states except for the ones I have surveyed, the surveyors do not work for the BON so they have no say in an outcome of an investigation of a particular nurse. However, in my experience, surveyors do investigate allegations of abuse and neglect during a complaint survey or during a recertification survey. I personally have done this numerous times and filled out tons of paperwork for a referral to the BON. I have been on both sides of this...surveyor/investigator and BON staff reviewing the BON field investigators reports and presenting the reports to the Board. ( Two completely separate jobs).

Additionally, as stated above, a nurse who was involved in a harm to a patient( for example, failing to follow through care as to have a patient lose their leg) would probably be fired from their facility instead of having board action against their license.

This was the same facility that said " we do the patients care plans and the figure out the MDSs from that". That was painful to hear.

twinsmom788 · Feb 20, 2015

I can only speak for Massachusetts, but even if you're the nurse who gave bad care or didn't do something which caused a tag, chances are you won't lose your license. It's not that easy to have one's license revoked even in this state which has some of the toughest surveyors and regulations on the planet.

Federal regulations are the same throughout the country. State regulations and how the process in which they are applied can be quite different from state to state. CMS oversight of the state is also different from region to region.