State surveyors here again...and being super picky...

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It's crazy--they are watching things like how thick the thickened liquids are if the CNA's do a "spoon test" every time to determine if the liquid is at the proper thickness. It just amazes me because I worked as a CNA at a LTC that was a NIGHTMARE--80 residents to 5 or 6 CNA's and 3 nurses. It was a house of horrors and the state was barely even seen . But the place I work at right now as an LPN is actually quite nice and yet we are ALWAYS getting hammered by the surveyors for little things...

I don't know, just venting at this point, I guess. I'm sure this has been talked about to death but if anyone has any stories or insights to share, feel free! :)

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Our turn is coming soon. It's just so incredibly stressful and you never really have any idea what areas they're going to focus on. We all try so hard but having EVERYTHING state perfect is impossible.

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My facility is getting hammered by state. is it totally unjustified. No. For us, if the administration would discipline or fire that ones making that mistakes, we would do ok. But alas, this doesn't happen. Now while many of the marked have been counseled, there has been a lot of favoritism here especially towards the opposite sex(and no not females) One girl got fired for not filling out a certain document while her male counterpart(who had many more infractions on this same form) was promoted. Another example, a female was fired for less infractions than a male counterpart who had made many more of the same infractions. This male was, of course, was the employee of the year. Go figure.

And before I get flamed about male vs female, I really don't care as long as it is fair, that the best suited person gets the job, so to speak. In some facilities, the men being promoted were better suited, some (not). I just noticed at this facility it is very obvious.

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life is NOT perfect...i dont know why these state surveyors xpect a nursing home to be perfect..

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Specializes in Critical Care, Education.

LOL - why shouldn't everything be 'perfect' when you have time to prepare in advance? I know you may not know the exact day, but - believe me - your admin knows pretty much when the surveyors are going to be there. It's like a take-home test.

I have dealt with surveyors of all types - CMS is the WORST because they can affect a facility's reimbursement. But their 'conditions of participation' are not difficult to meet - and they are all directly related to providing safe, high quality care. I found that most problems are due to two things: 1. staff think they are doing the right thing, but they aren't (lack of training) or 2. not enough staff to do things the right way. Both can easily be solved by good supervision & administration.

As taxpayers and potential health care customers, we should all be supportive of higher standards in health care and this includes managers who are capable of ensuring that their organization meets regulatory requirements.

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We no longer thicken liquids on the unit. Only dietary does that. We buy some nasty Hydrolyte water that's already nectar or honey. The residents hate it.

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Specializes in Gerontology, Med surg, Home Health.
LOL - why shouldn't everything be 'perfect' when you have time to prepare in advance? I know you may not know the exact day, but - believe me - your admin knows pretty much when the surveyors are going to be there. It's like a take-home test.

I have dealt with surveyors of all types - CMS is the WORST because they can affect a facility's reimbursement. But their 'conditions of participation' are not difficult to meet - and they are all directly related to providing safe, high quality care. I found that most problems are due to two things: 1. staff think they are doing the right thing, but they aren't (lack of training) or 2. not enough staff to do things the right way. Both can easily be solved by good supervision & administration.

As taxpayers and potential health care customers, we should all be supportive of higher standards in health care and this includes managers who are capable of ensuring that their organization meets regulatory requirements.

Sorry but you live in a delusion. In Massachusetts we NEVER know when the surveyors will make their appearance. They can come back from 9-15 months after the last survey and they NEVER give a hint as to when. At my current facility they are a month later than anyone expected them to be. Before you make blanket statements, I'd suggest you check your facts. It doesn't matter how much you prepare...unless 100% of the staff is perfect 100% of the time (yah, like that's possible) the surveyors can find fault.

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State surveys are one of the perks of long term care that I don't miss.

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Surveyors arrived on Tuesday morning. Yesterday they were interviewing CENAs on my hall, including calling at 10pm to talk to 2nd shifters. The lady who called talked to one person for an hour. AN HOUR!!! He answered most of her questions correctly but inadvertently gave them something else to nitpick--when he couldn't remember what the 'C' in 'RACE' stood for, he asked her to hang on while he checked his name badge. Now they know that we have safety/emergency info cards on our badge clips and will be checking for them today. Also, during that hour, the hall was lit up like a Christmas tree. Most of the call lights were from people wanting ice water. Did I mention that the ice machine is at the opposite corner of the building, and we can't have a cooler on the hall anymore b/c the surveyors said it was unsanitary? With one aide 'off the floor' talking to the surveyor, the other aides couldn't leave the floor to get ice. :mad: I'm really glad I'm off today.

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Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

An Ice cooler in the hall is not unsanitary, unless it is used in an unsanitary manner and is not clean....here in Virginia, they use them all the time to pass ice.

And the survey requirements are the minimum requirements...it is being in "substantial compliance". Perfection is hard to achieve but I have seen it done many times. I just came from a facility that last year had over 20 deficiencies, harm level tags and revisits- this year they got one deficiency and it was not a quality of care or quality of life citation. To me that is perfect!

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We no longer thicken liquids on the unit. Only dietary does that. We buy some nasty Hydrolyte water that's already nectar or honey. The residents hate it.

Same thing at our facility. All of our fluids are pre-thickened in little packages. Just for this reason...got a ding from the state last year for CNA's not doing the spoon test

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I am awaiting survey in my building. OHiO. I have friends who are DON's at different SNF's, and 2 had survey within a few miles of each other this week, so here is what they shared"

THEY REVIEWED THEIR PROCEDURES FOR ELOPEMENT

THEY WANTED TO NURSE/STNA RATIOS FOR THE SHIFTS, WE POST THAT ON THE WALL HOWEVER THEY ASKED FOR THE PAST 2 WEEKS OF THIS.

THE GLUCOMETERS ARE CLEANED BETWEEN EACH RESIDENT, WE HAVE DISINFECTANT WIPES BUT THIS IS THE KEY.....THEY MUST BE BLEACH BASED AND YOU NEED THE MSDS SHEETS FOR THESE.

THEY ASKED FOR THE ORIGINAL CONTRACT FOR MEDICAL WASTE, CITED MDS FOR A CHANGE NOT REFLECTED ON THE MDS, AND THE MDS NURSE SAID THE CHANGE WAS JUST FROM THE DAY BEFORE.

HIT HARD ON MED RECORDS OF DISCHARGED PATIENTS

PHARMACY PROGRESS NOTES

INSERVICES ENSURE ALL STAFF HAVE THE 12

VERIFIED ALL STAFF CREDENTIALS VALID

EXPIRED MEDS

INCIDENT REPORTS

TREATMENTS

I AM ANTICIPATING STATE AT MY BUILDING MONDAY AND AM NEW AT THE BUILDING AND MY POSITION,....NEW ADMINISTRATOR AND SO FORTH.. SHOULD BE FUN.....LOL JUST KIDDING.. I AM LOOKING FORWARD TO THE CHALLENGE.

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