State Surveyors

CapeCodMermaid, RN · May 16, 2014

Rules?!? In Massachusetts we have more rules and regulations than the nuclear power industry. Do the right thing every day whether the surveyors are there or not. They aren't stupid...they'll know if you're putting on a show for them. Practice the rights of medication administration. Knock before you go in anyone's room. Never say "I don't know". Say "I can find out" and then find out. Don't keep them waiting if they ask for a chart or piece of information. Read the posts here...there are literally hundreds on here about the survey process.

Long Term Care Columnist / Guide · May 16, 2014

What CCM said ^^.

Another "must" is a cooperative attitude. Never argue with a surveyor, even if you disagree with what they're saying or doing. We expect you to stand your ground if you know your stuff and will even respect you for it; but surveyors are human and may look harder for potential citations if the staff seems hostile.

With all that's at stake during a survey you wouldn't think that would happen, but it does, and it's supremely frustrating for the survey team because we ALL have a job to do.

CapeCodMermaid, RN · May 16, 2014

I've disagreed many times with surveyors but I'm respectful about it.....except for the time that the surveyor screamed my name in the hall and poked her finger in my face.

Long Term Care Columnist / Guide · May 17, 2014

I've disagreed many times with surveyors but I'm respectful about it.....except for the time that the surveyor screamed my name in the hall and poked her finger in my face.

Can't blame you there! :yes:

bluegeegoo2, LPN · May 17, 2014

The worst experience I have had, hands down, was when State and Feds entered for survey. Dear. God. I was taken to "the room" with 4 State and 2 Feds and a State Surveyor drilled me for 45 minutes on a chart of a relatively new admit. She literally went through each and every section of the chart, "...here is says this. What do you know about it? What about that?" On and on and on. I took half a page of "I'm not sure, but I will find the answer for you..." notes to address for them. When I was "paroled" from their custody I immediately gathered the answers to their questions and presented them to them. I looked up the results of that horrendous survey a few months later. (I had since taken another job.) 96 tags. (I don't recall the breakdown of scope and severity) plus 7 IJ's. I knew the building had serious issues but never dreamed it would turn out that bad. I don't wish that experience on my worst enemy.

The best survey experience was at a different building. Management was relaxed. The ADON did nothing more than give mini in-services with small groups/individuals just to refresh on proper procedures. We received 4 F-tags in nursing. POC's were written, implemented, and we went on with our lives. Of course, that building was a well-oiled machine and staff were expected to perform to standard at all times. Makes a big difference in how well surveys go or how painful they can be, IMO.

Brekka, ADN, RN · May 18, 2014

Definitely one of the most stressful times working as a nurse. Always puts me back into the mindset of being in nursing school where I second guess a bunch and get intimidated. By far the worst survey we've had was when state came for their survey and we were in the middle of a NV outbreak with 70+ on isolation, short staff due to NV, and were exhausted working as many hours a day as we were allowed to make it through. Good news is we made it.

Oh, and yeah, state is in town and we are in our window. Rumor has it they'll be there on Monday... :banghead:

Long Term Care Columnist / Guide · May 18, 2014

You mean the surveyors actually conducted the survey with Noro in the building??! :wideyed: A couple of months ago, my team entered a facility and left an hour later.....half their residents and staff were sick. Not only would it have been completely unfair to the facility, but we didn't want to be sick either!

Best of luck on your next one. :yes:

CapeCodMermaid, RN · May 18, 2014

The past two years we've had a GI bug (untested so we can't say it was the Norovirus) in the building when the surveyors arrived. This past one, they spent much less time on the units than usual. Was it fear of getting the bug, or trying to work with our new computer sysytem? We'll never know. :speechless:

NurseQT · May 19, 2014

Just try to stay calm. If they ask you a question, give the answer and nothing more! If you don't know the answer than tell them you will find out. If they want to interview you don't hesitate to request another nurse to be in the room with you. Never leave meds on top of your cart and always lock it! Was your hands for 30 seconds. Don't argue or be abrasive, smile and be polite and respectful.

I had a DON once that would get so unbelievably frazzled when state showed up. One year she was in the building for 36 hours straight! When she finally went home to try and rest she came back the next morning wearing two completely different shoes! No joke! Her anxiousness rubbed off on the staff and everyone became a nervous wreck when state was there.

june2009 · May 21, 2014

We just had our state survey. They exited around 4 pm. It was the worst one I've ever been involved with. Also my 1st as the new ADON. We went from deficiency free last year to about 7 tags ( we think). Most of the tags were for small stuff that will be simple POCs. One of my nurses didn't wipe the glucometer off in between residents. The biggest thing was that no one ever got an order to up-size a Foley. But we survived and will live to fight another day?

twinsmom788 · May 21, 2014

I am retired so I can be frank....if the Feds come in...it is going to su** big time. Bring in all the help you can and try to remain calm. The feds ( in theory) are there to evaluate the state, but in my experience, they tend to drive the survey. In Texas, things went well with the Feds. In another state where I worked as a surveyor, it tended to go down hill rapidly with IJs all around.