Preparing for "State"---what does your facility do? Inservices, reading?

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Specializes in NICU, Peds, Med-Surg.

I'm new to SNF..... Lately, EVERYthing is about "STATE"......random things we're SUPPOSED to know, but there's no way to know all of it without inservices, reading materials, etc. Lately I've been asking everyone many questions, but I want to know the TRUE answers!!! I realize I can do a google search, but thought I'd also ask those of you who have actually been through it!

One thing I'd really like to ask those of you who've been through an inspection (and I realize every state is different!), what about HANDWASHING in residents' rooms? I almost ALWAYS use their sink; otherwise it is a longgg way to the nearest employee bathroom, which would really interfere with my time management. Not only that, on the way to said employee bathroom (or I go to a utility or shower room to wash), inevitably, I will encounter a resident who needs something, yet my hands aren't clean yet.

Sooo, I use the resident's sinks, yet, many times, their personal items such as drinking cups, denture cups, toothbrushes, etc, are DIRECTLY under the soap dispenser, so of course I move those items, but this just seems to me to be something "STATE" wouldn't like.

I'd appreciate input on this or ANY other details with "State".....it is ALLLLL my boss rants about lately! Oh, and we keep hearing how "such and such will cause us to have a five thousand dollar fine!".....or "we had to pay a 100,000 fine for _____ a couple years ago!"......why the HECK are these fines so HIGH????? Is "JACHO" this bad/ strict????

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Specializes in LTC.

Those personal items, toothbrush, toothpaste, combs, etc are supposed to be kept in clear baggies with the resident's name on them as well as their name on the items themselves to prevent cross-contamination. In most of the facilities that I have worked, we had approximately 12 million in-services when we were approaching state window. If you're facility was so concerned about potential tags, they would be in-servicing as well. That is the single most effective way to insure staff education on state mandates as well as facility policy IMO.

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Specializes in retired LTC.

Inservicing AND followup inspections to insure staff compliance. Otherwise, it's information in one ear and out the other for many.

>>>>>>>>>>>>>>>>

To OP - there have been several good past postings here on AN re:preparation for survey. Check them out. Your Staff Devel person may also have some info and your pharmacy usually has pointers re: med pass. A suggestion might be to check your facility's last survey report to see what the previous problems tags were. Surveyors like to check and see that the facility's Plan of Correction is being followed so the prior problems are no more.

And yes, facilities can be fined BIG $$$. Other sanctions may also include that reimbursement payments can be withheld, no new admissions allowed, facility can be closed with pts being relocated somewhere else. And the Administrator and/or DON can be escorted out & replaced. These are the rather extreme corrective actions that can be levied, but the deficiencies usually would have to be super serious and/or repeat, repeat deficiencies, and/or Plan of Correction never implemented (as in the facility lied). And if ANY dept does really badly, that dept head's job may well be jeopardized. These things do really happen so some places do get nervous.

Sometimes you can read the newspaper Want Ads and infer that some place had a recent bad survey. Like Hskpg and Maint Directors wanted (the place was dirty with broken stuff or safety problems). Or Social Worker and MDS Coord (pt rights issues and/or discharge plans). Dietary is freq a biggie! When they want ADON/Staff Dev/supervisors/Unit Mgrs in combo, the nsg dept probably was slammed! Esp if they start advertising to hire nurses & CNAs! Not all the time, but I do wonder when I read these types of ads.

So yes, facilities DO take surveys seriously. Good places are proactive and should be survey-ready at any time.

Infection control is a big issue so freq & immed handwashing is so, so important. I'm surprised that first PP comments haven't been implemented to some degree already where you work. (Altho it is so hard to get the LOLs to keep their toothbrushes in a baggie!) So many areas are reviewed during survey, fire & safety, inf control, pt rights, abuse, actual pt care, employee staffing, education & credentialing, pharmacy, medical records, care plans, WOUNDS, weights. It's amazing what they look at! Surveyors talk with pts, families and staff. They watch nurses do med pass and treatments. They can watch meal service, recreation/activities programs, resident council meetings. Etc. etc, etc.

They can look at just about anything & everything. I know that many in nsg and administration consider them a horrendous nuisance, but their job is to ensure that safe standards of care are being followed. Just think of what some places would be without them! Think if your grandmom were in some place without inspection!

Sorry about this post's length. You got me on a soapbox!!! Those of us who've been thru surveys know about the picky little things. And there are a gazillion more things that could be discussed and a gazillion more that we forget. You can only be responsible for yourself and what you do. Just remember all the good techniques you learned in school and you'll be ok.

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Specializes in retired LTC.

Oh, one other thing - be aware that surveyors can come into the facility anytime and anyday (any shift, weekends and holidays included).

Like I was a Unit Manager and got a phone call at 5:30 pm on a Sunday early evening. The receptionist said; "State just came in, full survey team. Administrator is requesting all management to come in".

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Specializes in ICU, CM, Geriatrics, Management.

Mock surveys done by corporate... feedback follows.

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Specializes in retired LTC.
Mock surveys done by corporate... feedback follows.
You reminded me. I always thought the corporate mock surveys were more nerve wracking than the State ones.

I worked one place that we did our own in-house surveys. Individual employees from all depts, INCLUDING CNAs, housekeepers, diet aides (NOT dept heads) were selected to be 'pretend' surveyors and were responsible to 'survey' things like the surveyors did. It was meant to be non-criticizing or punitive. It was verrrry informative and eye-opening!!! Boy, the stuff that our peers were able to pick up on!!! Because we all knew...

It was a fun-day for the 'survey' employees, too, as they could dress-up and go out for lunch and park out in the front parking lot.

For any DONS out there, this might be a good idea to be considered as a learning or preparatory activity for staff. And it could be expanded to other depts. Like a self-improvement QI program. Come up with some kind of guide for the participants to help them stay focused and specific, but not to tread into inappropriate areas.

The only caveat would be to insure it would not be critical or punitive. Employees could decline to participate; those participating had to keep it secret as 'survey days' were unannounced.

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Specializes in ICU, CM, Geriatrics, Management.

Like striving to make the prep a fun thing. Smart!

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Specializes in retired LTC.
Like striving to make the prep a fun thing. Smart!
YES!

Those in-house ones were fun and informative.

Not like corporate which could be BRUTAL!!! (They were ex-DONS who could now get their nugies off!)

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Specializes in LTC, assisted living, med-surg, psych.

After being the bug under glass during recent (and brutal) surveys at the executive level, my new facility's next inspection will be a breeze....all I'll have to do is my job. :) Talk about stress-free!

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Specializes in retired LTC.
After being the bug under glass during recent (and brutal) surveys at the executive level, my new facility's next inspection will be a breeze....all I'll have to do is my job. :) Talk about stress-free!
You deserve a break - you've earned it.:yes:
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I work in a state facility, and we actually get surveyed by a mixture of federal surveyors and a private company. (I will admit I don't really understand how it works). The result is we are way less over-regulated compared to traditional LTC. For example, I was passing meds and a surveyor flat out told me she could care less if I pushed the med cart in the dinning room and passed meds during breakfast. She said it was safest to pass meds to the members while they're all mostly in one spot, and that taking meds during breakfast is the most natural way. Nice for common sense to take precedent once in a while.

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Specializes in ICU, CM, Geriatrics, Management.

Why am I thinking of McDonald's after reading this thread, Amo??? :)

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