Nursing Home State Survey

Dorali, BSN, LPN, RN · Jan 29, 2011

State surveys are definitely stressful. We had ours about 2 months ago. I believe they usually stay about 3 days.

It was my understanding that they send a letter before they come stating that they will be there within the next 30 days (or so). They can show up st any time, middle of the night, lunch time, etc. First thing they did was pull charts. Then they followed the nurses around. Their last day, they pulled the CNAs to watch them perform procedures. The way they did me, I would walk past one of the surveyors and they ASKED me how to do this or that. One time it was how to give a shower. I started listing the steps I take and she stopped me about halfway through and asked questions pertaining to safety. Would you ever leave a resident alone in the shower? (Absolutely not.) What do you do if you need help? (Pull the call light and wait for my partner to come.) They also ask you your name at some point during this, so yes your name is in the report.

We ended up with a few tags. However, they give the facility like 45 days to correct the issues, then they come back for Round 2. The second time, my partner and I were actually pulled into a room to perform pericare. I think, they want to make sure you know the basics. Wiping front to back, etc. We passed with no issues! I think if you fail to correct the mistakes the second time around, that's when they are issued any fines.

This was my first survey so I don't know if it's ever different, but this is the short story of what I dealt with. If you have any more questions, I'd be happy to try and answer them.

Dondie

interceptinglight, CNA · Jan 31, 2011

Thanks, Dondie!! You confirmed some things I wanted to know about this. The facility I work got a few tags last year, nothing horrendous. It's pretty much impossible not to get tagged during a survey. I'm actually looking forward to it because there are a few things that need to be addressed in the Special Care Unit (dementia) where I work and this may be the only way to bring about some changes.

halfpint1021 · Jan 31, 2011

State surveys usually last 3-4 days depending on the size of the LTC. First of all the state surveyors do not give any warning of when they might be coming. Second, the surveyors will watch the C.N.A.'s perform care and yes if the nurse aide does something wrong, the facility could get cited for it. But that all depends on the severity of what the nurse aide did wrong especially if it is related to infection control or safety issues. Also, the staff members name does not go into the state report, at least not in Texas. The surveyors assign a number to the staff member like C.N.A. #1, or LVN #1, etc. Don't get nervous about the surveyors being there. Just do things like you were trained in C.N.A. School and you will be fine.

systoly · Jan 31, 2011

The most important thing to do during a survey is to be truthful. If you don't know the answer to something just say so. But don't leave it at that. Tell the surveyor, "I'm sorry, I don't know the answer to that, but I can find out right away. I will ask ...(fill in appropriate person)." Although, sometimes state surveyors make mistakes or are mistaken, it's like dealing with the IRS, no point in arguing.

interceptinglight, CNA · Feb 1, 2011

Cool. It's funny though, what I'm worried most about is calling someone 'Dear' in front of a surveyor. We were taught in CNA class and I was told by my boss....it's a NO-NO to call a resident anything but their name; however most of us who have a very friendly and professionally affectionate relationship with the people we take such personal care of can't help but call some of them 'Dear' once in a while.

Dorali, BSN, LPN, RN · Feb 3, 2011

So glad I could help!!

I got really bad about calling them grandma, dear, honey, etc. As we get new admits, I've tried to stop that and replace it with Mrs. Smith or Miss Betty. The other ones, I have continued with just because that's what we're used to. I've noticed that I haven't been getting as attached to them this way as well. It also seems like they don't stop and talk for 20 minutes if I stay on that professional level. I don't mind talking, there just isn't any time.

yousoldtheworld · Feb 3, 2011

I won't lie to you, calling people by their formal names is the hardest thing for me.

I don't do it when state's not there. Not at all. I work with disabled kids and young adults, who aren't that different from OTHER kids and young adults - they love to be teased and played with and they love having nicknames.

And I am a nickname giver for sure. haha. Names for my usual residents include things like punkin, wee-man, boogerbutt, punk, doodle, poohbear, pookie, and lots of various plays and shortenings of their names. Hahah. A state surveyor would have a field day with me.

But, I'm pretty good about not doing it when state is there. I just think it's ridiculous that calling a resident something like "dear" or "pumpkin" can be considered abuse. Unprofessional, sure. But abuse? Give me a break. Unless the resident dislikes terms of endearment and prefers to be called a certain name only, that's just ridiculous.

Dorali, BSN, LPN, RN · Feb 4, 2011

I just think it's ridiculous that calling a resident something like "dear" or "pumpkin" can be considered abuse. Unprofessional, sure. But abuse? Give me a break. Unless the resident dislikes terms of endearment and prefers to be called a certain name only, that's just ridiculous.

I agree with this 100%! I also think it's stupid to have to introduce yourself to someone you have known for probably several months. I guess I can understand why, but really? Some of these residents are with it and Know you. "Hello Mrs. Jones, I have known you for almost a year now, but my name is Dondie and I am a CNA. I am here to do pericare. Is that ok?" Geez!

interceptinglight, CNA · Feb 4, 2011

I agree with this 100%! I also think it's stupid to have to introduce yourself to someone you have known for probably several months. I guess I can understand why, but really? Some of these residents are with it and Know you. "Hello Mrs. Jones, I have known you for almost a year now, but my name is Dondie and I am a CNA. I am here to do pericare. Is that ok?" Geez!

I agree as well.....except for the fact that I work with dementia residents and there are a couple of them that don't seem to remember from one day to the next who I am. As I assist them with dressing or whatever they exclaim, 'Oh, it's so nice of you to help me with this !!'.....as if it were the first time I did any such thing.... With these sweet people I usually don't bother to say my name to them unless they ask. :lol2:

Dorali, BSN, LPN, RN · Feb 11, 2011

The ones with dementia are the ones that make me smile the most! They tend to appreciate what you're doing more than most.

northernguy · Feb 20, 2011

Hmm, I didnt realize we were supposed to introduce ourselves to the residents and refer to them as Mr or MRS. I just knocked on the door and greeted the resident using their first name per usual. I dont think I introduced myself by name and I know I never referred to them by their last name in front of the inspectors, a couple of the more alert residents probably would have laughed at me and made a smart comment if I had done that. I did explain what I was going to do before doing it though, which I usually do anyway.

I guess it is probably a good idea to do all that in front of them, but no one ever said anything to me about it afterwards, and I'm pretty sure we werent cited for it. Guess I better read the official report, there might be a lot of references to "CNA X" (IE me) and his lack of proper introductions for all I know.