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

I think I answered this question in the Rehab Nursing Forum but here goes. As a State Surveyor, these are what I find in chart reviews as major causes for recent hospitalizations of residents in Skilled Nursing Facilities. Falls with injuries, COPD exacerbation, CHF exacerbation, aspiration, unstable blood sugars, new onset or extension of CVA's. Don't forget altered mental status due to UTI and Dehydration.

Sent this email to the Today Show. Maybe another broadcasting company may envoke a response. Hello; My name is Margaret. I am a nurse. Wanted to tell you guys of an incident that has many nurses offended that a rival broadcasting company did. Copied from the allnurses.com Nursing Discusion Board for nurses. The thread title is "The View" insults nursing. June 16, 2003 -- Tonight's prime time episode of ABC's "The View," which consisted of a "His and Her Body Test" designed to impart basic health information, included an attack on nursing, with co-host Meredith Vieira appearing disguised as an "ugly nurse"--as Vieira herself put it in previews--for comic interactions with passersby in a New York mall, including one segment in which Vieira cared for a woman's "shin splints" by drawing a happy face on her leg. The episode was structured around a series of multiple choice questions on health issues, with an unsurprising focus on sexuality, and it did convey some useful information. The talk show's four co-hosts and a few celebrity guests offered serious and joking answers to the test questions. A rotating crew of physicians served as quizmasters, supplying the correct answers and graciously accepting praise (such as Vieira's comment that those with the highest total quiz scores were so smart they should have gone to medical school), as well as the other benefits of appearing on national television. Of course, the lack of any real nurses on a show devoted to the patient education and preventative care at which they excel, though unfortunate, is hardly unusual in a media environment still dominated by physician-centric views. But what made the episode so anti-nurse was Vieira's "ugly nurse" segments. In contrast to the high regard the show displayed for the articulate, telegenic physicians, the "ugly nurse"'s appearance was cosmetically sabotaged. ("The View"'s web site describes these segments as Ms. Vieira "harassing unsuspecting folks at New York's Nanuet Mall when she went undercover disguised as a nurse.") The "ugly nurse" displayed no real expertise. Instead, she asked shoppers inane questions about faking orgasms and whether happy faces relieved the pain of shin splints. To the extent these segments had a conscious purpose beyond getting laughs, it may have been to emphasize how badly the average person needs the kind of guidance the episode provided, a point also made in one physician's recounting of the results of a poll the home audience had taken using the quiz questions. But the effect of using a "nurse" for this was to reinforce a harmful stereotype, namely that nurses are ditzy lightweights without knowledge or skills. The "ugly" element operated as a curious final kick, since it is still far more common to see the reverse stereotype of the attractive "naughty nurse" in the media. We can only speculate that the show, sensitive to some women's issues, could see the problems with objectifying a female character, so it chose to go in the opposite direction. Today, in the midst of a nursing shortage that is one of the nation's gravest public health problems--when dedicated, highly skilled nurses save or improve millions of lives every day despite short staffing that endangers their patients' health and their own well-being--it is sad that some seem to feel that female empowerment involves slavishly embracing medicine, to which women can now aspire, while blatantly disrespecting nurses, over 90% of whom are still women. To see these attitudes on Barbara Walters' "The View"--a popular, award-winning show celebrated for being progressive on women's issues--is more than a little ironic. The author of the post is Sandy Summers. She is the Executive Director of the Center for Nursing Advocacy. Since this post appeared on the bulletin board, many impassioned nurses have emailed both ABC and Johnson and Johnson (the sponsor of the episode) their disproval of the way The View portrayed the Nursing Profession. There has been no comment from ABC or The VIew to date. Wouldn't it be interesting for a rival broadcast company to investigate this issue? Here is the link to the post. https://allnurses.com/forums/showthread.php?s=&threadid=38921&perpage=20&display=&pagenumber=1 Here are Ms Summers links. [email protected] http://www.nursingadvocacy.org She has a lot of info on the portrayal of nurses in the media.

Anyone ever wonder why the Asian-American cast member left the program? I believe that she wanted to do more serious reporting. I have seen her work on women's issues in the middle east. She's very good. Leaving the show was a great move for her. Her name is Lisa Ling, now with MSNBC and National Geographic. I think the program went downhill after Lisa Ling left.

I have been an MDS coordinator for a few years too. As is with the rest, the length of time required to complete depends totally on how much you know about the person, how long you have been doing MDS's, how well you know your computer program, and what information is documented in the record. The workload you have for the day also plays into how long it takes too. The more you have to look for something, the longer it takes. I average 2-3 hours on an initial assessment for new residents. Have taken as long as 8 for a difficult resident. You have to develope your own style. Good Luck!!!

I worked as an MDS nurse. I liked the investigation part of the job but the case load was entirely too much. I worked in 2 different facilities as an MDS coordinator. A 44 bed hospital based unit and a 120 bed facility. At both places I was pulled to work the floors, I had to take call, and I didn't earn overtime. The MDS is a federally mandated form. It is used in Longterm care facilities to determine how much Medicare will pay the facility. In some states it also determines how much Medicaid will pay. It is the basis for determining what should be care planned. The person who does this job needs to have a good care planning skils. It's not for the inexperienced. I suggest you work in Long Term Care for a few years before taking a position like this. The MDS Nurse is the most unappreciated person. Over worked and underpaid. Other nurses resent the fact you dictate in the care plan how they should take care of their residents. Few even look at the care plan. The MDS nurse in the first to be blamed when the survey is bad based on the assessment even though he/she is just the gatherer of the information based on the documentation in the records. Think before you take this position. :chuckle If you take it, buy stock in an antacid company for the heartburn you'll experience, Lilly Pharmacuticals for all the Prozac you'll need, get up to date photos of your family and loved ones so you can remember what they looked like, and make sure your insurance plan covers nervous breakdowns from the pressure that comes with the job

Wow, Night owl! Had they ever thought about getting a lazyboy type recliner to let him sleep in? Seemed like a logical option for this resident. I have seen a recliner used for someone who had obstructive sleep apnea and would only sleep on her back. She refused to use bi-pap because she felt like she was being smothered with something on her face. We did every other day skin checks for breakdown. We had the physician evaluate the continued need for sleeping in the recliner. Got the family involved by including them in the process. Had them sign a wavier with the understanding that if the resident's condition warranted the bed, the resident would have to go back to sleeping in a bed. With the psych diagnosis your resident had, getting the psychiatrist involved would have been most important. The resident would have gotten the illusion of sitting up while reclining and getting rest. Just curious, did they family sue the facility?

Your best bet would be to contact your local nursing board and get their opinion or advisory on the use of rubber stamp signatures as well as facility policy.

Have you thought about using a bicycle helmet to reduce the risk of head injuries? I realize the resident has the "right" to be free of restraint but the resident also has the "responsibility" to cooperate with the treatment plan. If you feel your facility has done everything possible to protect this resident and he/she continues to be uncooperative with the treatment plan AND you have the documentation to support this, you can discharge this resident. Make sure you read and follow the regulations regarding discharge. Can't think of the F tag for it but there is one. If you truly cannot provide the care this resident needs to remain safe, then the resident is inappropriately placed and it is the facility's responsibility to inform and assist the family with finding more suitable surroundings. Since the resident is able to pass all the neuro and psych testing, then he/she should also understand the consequences of his/her uncooperativeness with the treatment plan. Include your Medical Director and the resident's physician in the process.

I travel to a lot of nursing home and I see a lot of activities. Recently saw a memory bag in use. The bag consisted of of things that dealt with a theme... boy's bag, baby bag, fishing bag, etc. I saw the boy bag used in a small group of men. 3-4. As a piece was taken out of the bag, they residents were encouraged to describe a memory associated with the object. There was an airplane with a rubber band propeller, army men, cowboys, indians, a stuffed puppy, and marbles. Lots of great ideas. One facility has a scrap booking club. Another facility has a desert club, they make a desert once a week and share with the other residents. One facility has a quilting club. They have entered things in the state fair and the residents have actually won. There are crafts activities, card games, and board games. Bowling, gardening, casting a fishing pole. One facility goes to the local animal shelter once a month and bring an animal for pet therapy.

Sorry you had such a day. In South Carolina, there are some minimum staffing requirements set by the State. In SNF's for Nusres (RN/LPN) 1:44 1st shift CNA 1:9 2nd shift CNA 1:15 3rd shift CNA 1:22 These are the minimum. I worked in a facility that just met these standards. Didn't work there long... I was too worried about my license. One nurse there had no problem picking up the phone and calling state boardswhen the person responsible for staffing didn't have the minimum. I now work on the regulatory side of LTC. Go with your gut feeling. If you stay may I suggest you keep a journal. It doesn't have to be detailed. I inspected one facility where a resident kept a calander of the staffing on her unit. When it was compared to the staffing schedule and staffing ratios required, the facility was cited.