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What does State look for?

Geriatric   (5,902 Views 15 Comments)
by ws582 ws582 (New Member) New Member

ws582 has 7 years experience and works as a Hospice Nurse.

3,936 Visitors; 40 Posts

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I'm a new grad and working my first nursing job at a Rehabilitation/LTC facility. Everyone is stressed because the state is due to come in. I've never been through this before, and I'm not exactly sure of all the rules. I've asked over and over for paperwork to study, so I can be ready, but no one has anything they can give me. They all just tell me different things they look for. I'm so nervous and just want to be prepared. Is there a website anyone knows of that will give me the information I'm looking for? Thank you in advance for your help. It's greatly appreciated.

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florianslove has 7 years experience and works as a Unit Manager.

3,354 Visitors; 75 Posts

We've just been through a state survey, they want to know about any resident's who've had a weight loss or gain and what you've done about it. They inspected the rooms, make sure all supplies such as toothbrushes are in holders and labeled, cups, pitchers, etc, all labeled. They wanted to know which residents are on psychotropic drugs. They checked a lot with MDS. If a resident was coded as a DNR they wanted to see the actual DNR in the chart. They will follow a cart nurse to see how she does a med pass, make sure you do everything right, check medications, check wrist bands, etc. WASH YOUR HANDS, before and after. Don't wear gloves in the hallway.

They may want to see a CNA perform peri care on a resident. If you can, go over this with your CNA's now to make sure they do it right. Privacy and dignity are big. Every person in the facility from nursing to housekeeping must knock and announce before entering a resident's room.

There is a lot to a survey, every department has it's own headaches. Just make sure there are no holes in your MARS or TARS. Take your time and realize as much as a pain in the butt surveys are you're all there for the same reason, the resident's health and safety.

Good Luck

Roxann:nurse::up:

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Nurserton works as a REGISTERED NURSE.

5,555 Visitors; 135 Posts

I'm a new grad and working my first nursing job at a Rehabilitation/LTC facility. Everyone is stressed because the state is due to come in. I've never been through this before, and I'm not exactly sure of all the rules. I've asked over and over for paperwork to study, so I can be ready, but no one has anything they can give me. They all just tell me different things they look for. I'm so nervous and just want to be prepared. Is there a website anyone knows of that will give me the information I'm looking for? Thank you in advance for your help. It's greatly appreciated.

I am an RN for almost a year now, but prior to I was a CNA for a long time, many years of which was in rehab/LTC. So I remember all to well the pre-state frenzy. State looks at everything, from the kitchens to the nursing staff. They sometimes will follow you in a room with a patient and observe that you're basically doing things right and by the book. You need to know your facility's policies/procedures for many issues, especially safety issues, etc. You have to know for example, where the fire extinguishers on your floor are, your role in an emergency, etc. Anything you don't know, you should know where to find the info or direct the surveyor to your superior. For specifics for your role and facility, you should really go to your manager, or your HR person, or if you have a quality or even education nurse. Most supervisors will happily explain what is expected of you when state is in the building.

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Ginger's Mom has 41 years experience.

7 Likes; 1 Article; 22,171 Visitors; 3,176 Posts

They might follow you on a medication pass, remember your 6 rights! And best of luck.

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txspadequeenRN has 20 years experience and works as a RN.

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if they cant find something then they start nit-picking...we just got wrote on falls..even though they say the patient has the right to fall..no broken bones or injuries with these falls either...we got wrote for staffing..no mandatory staffing ratios in texas ( however, we do need more staff) ...we even got wrote for some of the tiles cracked in the floor despite the fact our new floor went in this week.... if it was wrong it was corrected on the spot but we still got tagged for it....

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classicdame works as a Hospital Education Coordinator and adjunct nursing.

2 Likes; 2 Articles; 25,949 Visitors; 7,255 Posts

they will want to know that YOU know your own facility's policies and are abiding by them. Look over the ones pertaining to patient safety - like restraints, med errors, fall, etc. Don't forget the basic things, like handwashing.

In Texas you go to www.dshs.state.tx

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ws582 has 7 years experience and works as a Hospice Nurse.

3,936 Visitors; 40 Posts

Thank you everyone for your input. I sure wish there was a website I could go to and study, but all the tips you gave are very helpful. I'll be sure to read up on the facility's policies. Thank you!

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bluegeegoo2 has 11 years experience as a LPN and works as a LPN.

61 Likes; 17,433 Visitors; 748 Posts

Here's a big one that was pounded in my head in school: If they ask a question you don't know the answer to, the best response is: "I'm not sure, let me find someone who can answer that for you." Then, immediately proceed to finding the appropriate person to address their concern. That way, allegedly, it proves you know how to find the answer to a problem you may run into. We just had state leave this past Thursday for a re-visit after some tags, and I was getting hammered by a surveyor with questions that I had no idea about. (I've only been at this facility for 3 months, and have only been a nurse for 18 months, mostly nights). I used this response TO DEATH. They followed me on a med pass as well. (EEEKKK!!!) I just gave her a bit of background info on the res, their likes/dislikes, how they took their meds, (crushed, whole in applesause, etc), remembered the 6 rights, knocked on the door and announced myself, washed my hands or used hand sanitizer between each res, etc. Also, pay very close attention to meds that are to be given "before meals", "after meals" or "with food". We were tagged for that during our annual survey. I also tried to remember that they aren't ogre's, they are there to make sure the residents are being taken care of properly. They also offer a wealth of info, and most don't mind questions. (So long as you're not questioning facility policies of course!). We came away deficiency free this time. Whew! Only 363 days until the next one...

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ws582 has 7 years experience and works as a Hospice Nurse.

3,936 Visitors; 40 Posts

Thank you so much for the info. It's very helpful!

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8,141 Visitors; 291 Posts

"STATE" will look for "text book". You already know how to do that. Just do everything by the book. That sounds hard, but it is not. Do what you have been taught. One thing to remember. If you do not know the ans. to the question.....just say so. but say.....give me a moment and I will find that ans. Then go back to the person and give them the ans. Best wishes

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ws582 has 7 years experience and works as a Hospice Nurse.

3,936 Visitors; 40 Posts

You're right, it's in my head. There's just so much to remember. A coworker gave me a bunch of handouts that lists the do's and don'ts to med passes, etc. I'm feeling a bit more confident now. Thank you :)

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9,577 Visitors; 547 Posts

Infection control and isolation technique!!!!! :uhoh3:

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