Catsrule16

There is no way to tell from a website which facilities are focus facilities. Facilities are supposed to put survey results readily accessible to anyone who may want to view them. You may want to look at those results to see how often the state comes in. The results should be titled as to complaint investigation or recertification survey.

State Survey Agencies have facilities that are known as "Special Focus Facilities" that are surveyed every 6 months. Usually a poor performaing facility. This has been happening since 1999. CMS issues an Action Plan for Quality Improvement yearly. The 2004 Action Plan explains how a facility is chosen. "11. Special Focus Facilities - Since 1999, each state has selected two nursing homes (i.e., "Special Focus" Facilities) that receive more intensive monitoring and follow-up than other facilities in the state. The states select facilities from a CMS list, which identifies facilities with a history of poor compliance, as indicated by deficiencies found during surveys and complaint investigations. Once a nursing home is placed on the Special Focus Facility (SFF) list, it has one additional standard survey per year in an effort to identify and improve care in these homes. Here is a link to more information on Focus Facilities http://www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter05-13.pdf

check the this site for volunteering as an unpaid hhs employee eligible for workers comp coverage and reimbersement for some expenses. http://www.hhs.gov/katrina/ health care professionals and relief personnel worker page the office of the surgeon general and the office of public health emergency preparedness are in the process of mobilizing and identifying healthcare professionals and relief personnel to assist in hurricane katrina relief efforts. as our nation and global community is now aware, the healthcare needs resulting from katrina are critical. we are currently looking for multidisciplinary healthcare professionals and relief personnel with expertise in the following areas: administration/finance officers morticians* chaplain mortuary assistants* clinical physicians nursing assistants/nursing support technicians coroners* nursing staff directors dental forensics* paramedics* dentists patient transporters/volunteers dieticians pharmacists emt* psychologists environmental health physician's assistants or nurse practitioners epidemiologists physician chiefs of staff facility managers radiologic technicians* housekeepers respiratory therapists it/communications officers rns laboratory technicians* safety officers lpns security officers medical clerks social workers medical examiners* supply managers mental health workers veterinarians *these categories added as of september 5, 2005. if you are a healthcare professional or relief personnel with expertise in the above areas and would like to participate**, please complete the form below. medical reserve corps (mrc) members: to ensure that your local community needs are met first, please contact your local mrc unit leader prior to completing this application form. when you do complete the form, please write "mrc member" in as a specialty - this will allow us to identify you as an mrc member. for more information about the medical reserve corps, see www.medicalreservecorps.gov the office of the surgeon general will be contacting those that meet the requirements and needs on the field as soon as we are able. however, at this time, hhs is unable to respond to individual queries regarding hurricane katrina recovery efforts through this website. individuals who do not fit into one of the above categories can find information on volunteering at www.usafreedomcorps.gov. thank you for visiting. we appreciate and commend your efforts. **please be advised that individuals must be healthy enough to function under field conditions.** this may include all or some of the following: 12 hour shifts austere conditions (possibly no showers, housing in tents) no air conditioning long periods of standing sleep accommodations on bed roll military ready to eat meals portable toilets these workers will be non-paid temporary federal employees, and will therefore be eligible for coverage under the federal tort claims act for liability coverage and workman's compensation when functioning as hhs employees. although there will not be any salary, travel and per diem will be paid. assignments may last 14 days or longer. it is required that applicants have hepatitis b and tetorifice/diphtheria immunizations for this assignment.

It is a good practice for facility employees not to sign this kind of legal document because of the possible financial gains through mishandling of funds that could cause problems. A good attorney would see a signature from an employee and imply that the facility expected to benefit from this. (I've seen it happen.) Administration should be involved with this.

Sounds like this spouse needs to be involved in a dementia support group. Adult protective services should be contacted as well. Be the advocate for the resident. Try contacting your local Ombudsman for suggestions. If you don't protect the resident, then your facility is not in compliance with the federal regulations. DOCUMENT everything you see and do. Educate him/her on the disease process and what is expected to happen. If you have to supervise his visits, then so be it. The facility can be held responsible for not protecting the resident. Good Luck!

The term body buddy is not one I have herad before. Sounds like you are refering to bolsters that keep a resident from rolling out of bed. If a resident doesn't want it, even if it is a physician's order.... DOCUMENT everything! Document on the cognitive status of the resident, any conversations with family members, etc. If the resident is cognitively intact, make sure you have informed them of the risks vs benefits of what they are refusing.

If the facility can't get the psyche back in to see her, file a complaint against him with the local Medical Association. Did he get paid by Medicare for his visit to her? if he didn't see her and charged for it, that is fraud. Has the facility had the primary MD try other antianxiety meds?

As the info under my username implies, I am a State Surveyor. I have been known to enter a facility at 10:30 PM for a complaint investigation and stay till 2:00 AM to return at 9:00 AM. I've gone in on a sunday at 9:30 AM and extended a survey through a weekend because things weren't going well. The President's initiative set forth that in motion. 10% of a state's surveys are to be "off hours" surveys. Even had the federal surveyors enter with us at midnight.

In SC this would be inadequate staffing. Minimum Staffing requirements: Nurses all shifts 1 for every 44 residents 1st shift (7-3) CNAs 1 for every 9 residents 2nd shift (3-11) CNAs 1 for every 13 residents 3rd shift (11-7) CNAs 1 to every 22 residents.

This practice has also been known to reduce the incidence of UTIs. The wet brief may act as an incubator for the normal flora on the skin to grow in and cause an infection. Have to look at all the outcomes, good or bad from leaving briefs off while in bed. While the resident has the right to wear the briefs, if they do or can cause more harm than good, then the safety of the resident overrides his right. Just because someone wants likes to play with matches, doesn't mean they should.

Apparently your Clinical Instructor has no idea how a NH operates. Quality of Life and Quality of Care are the two most important areas of focus in a NH. Are they reaching the maximum potential for what is going on with the resident? Is there life in the facility fulfilling to the resident? NH are not required to write care plans in NANDA format. Care Plans in NH do include medical diagnoses but focus more on the quality of care and life improvements. So what if a resident has elevated blood sugars from being non-compliant. Are those elevated blood sugars interfering with the quality of life? Are there any negative outcomes from the blood sugars being elevated? How long have they been elevated? Could what we preceive as elevated be normal for that person? I have polycystic ovaries and for me normal blood sugars range from 50 to 100. I do not have symptoms of problems at 50. When I was writing care plans in NH, when I needed to prioritize medical problems, I focused on those that would effect the resident's life first, A seizure disorder, safety, possible extension of a CVA, aspiration, drug interaction, etc. Don't know if I helped. Hope so. Good Luck anyways.

LTC is not regulated by JCAHO. CMS contracts with each state to survey healthcare facilities. A LTC facility can be certified to receive Medicare/Medicaid funding without being JCAHO accredited. JCAHO Accreditation for LTC facilites are good fro marketing purposes but not required.

Does your state have staffing requirements? Every time I worked in a situation where I didn't have enough CNAs or enough Nurses to meet the minimum staffing requirements, I reported my facility to the Certification and Licensure Agencies. I also kept a signature page of everyone that was there with me when I did work that way. I also reported my facility to the state Board of Nursing for placing me at risk for problems. If I was going down for something I did wrong while in that situation, I was not going to be the only one.

Manor Care changed their name in South Carolina to Heartland. Jokingly refered to as Heartless. Lots of problems at one facility. VA pulled their contract with them as well as all their resident

Staffing ratios in SC 1st shift 1 CNA to 9 residents 2nd shift 1 CNA to 13 residents 3rd shift 1 CNA to 22 residents Nurses 1 - 44 residents