My facility seems to have gone crazy with state reportables recently. Enough to make you want to pull your hair out & I think it's gotten way out of hand. I will give you some examples (sorry that I have to keep it so generic) and I would like you honest opinions if you would have reported. Please be honest - don't just tell me what you think I want to hear. Maybe there's something I'm not understanding
1. Family reheated food & resident took a bite. Result of less than 0.5 x 0.5 blister to lip - blister gone before end of same shift. Reportable?
2. Resident reports a staff for being hurried and rough. Closer 1:1 with resident = aide was in a hurry, going faster than resident wanted to be rushed - but absolutely no physical abuse and resident easily agrees that perfectly OK with aide continuing to provide her care. Reportable?
3. Sudden acute change of resident condition right at shift change BEFORE report has occurred. Off going nurse casually tells aides "she's been fine all night" & never gets off her rump to go check res. On coming nurse (punched in but who has not had report) is concerned w/ resident and goes to check, follows appropriate care and sends res to ER. Reportable as neglect by off going nurse (even tho resident received timely and appropriate care)?
This is just some examples. We average 2-4 reportables of this kind/week. And of course, we are suspending/terminating staff left and right over every little thing. After 25 years, I'm almost afraid to even speak to a resident in fear they may complain. Needless to say, I'm spending hours upon hours investigating complaints.
We are just coming out of an over-reporting phase in our building. We had to report certain things because of an Immed. Jeopardy tag on our last survey. That was over a year ago, corporate brought in new mgmt. (DON #4 in less than a year), and their thinking is report everything and let the state sort it out. We are finally being told, "you don't need to report this or that because we know you have systems in place and are following your own procedures." Also, corporate mock surveys are ok for basics, but our state surveyors have got some kind of weird "look for the most obscure" mentality, and often fail to notice something obvious. Reading the "guidance to surveyors" back to them just elicits a response of, "well, this is how we see it." End of discussion. If the management says it's reportable, it's reportable. They may know more about current surveys in the community, and may be on the defensive to get a jump on what other homes were blindsided by.
We report things like, physical altercation between residents, fall and sent to ER for eval, fall and xrays obtained, alleged abuse, etc ...
#1 most likely would not have been reported
#2 we have had similar situation, not reported
#3 Need more info on what the PT situation was and reason for being sent out & how much time elapsed before next shift assessed.
My DON says there is NO SUCH THING as an injury of unknown origin. Everything is investigated (all incidents) within 24hours and usually by observation or probing staff you will find out what happened. Therefore we do not have these types of reportables.
Specializes in Gerontology, Med surg, Home Health.
I report any resident to resident if there is physical contact whether there is injury or not. I had one woman involved in 6 'altercations' in the course of one year..no injuries at all. DPH came in for annual survey and asked if I had reported all of them. "Of course", I replied. They didn't look at any of my reportables. Better to over report than miss something. I report all burns no matter how insignificant.
Thank you! This issue came up recently in discussion, and a few people had differing opinions on it.
This is what I thought, and the answer I was looking for. I was actually hoping you would respond. I've read most of your posts on here and if I ever move back to the East Coast I would love to work for you! Lol.
I report any resident to resident if there is physical contact whether there is injury or not. I had one woman involved in 6 'altercations' in the course of one year..no injuries at all. DPH came in for annual survey and asked if I had reported all of them. "Of course", I replied. They didn't look at any of my reportables. Better to over report than miss something. I report all burns no matter how insignificant.
Also. I agree, better to over report... Always under the impression it's not up to us to decide if something is insignificant. Report and let DPH soft it out.
CapeCodMermaid, RN
6,092 Posts
We report on ALL those plus significant injury even if witnessed.