Fall Region Forums - 2014

1. Nursing Home Survey Findings Fall Region Forums - 2014 Doug Beardsley VP Member Services Care Providers of Minnesota

2. Many similar trends, but a few new ones • Increased Problem Areas: • Infection Control • Dialysis • Antipsychotic Medications • Physician Responses to Pharmaceutical Recommendations • Drug Storage

3. Many similar trends, but a few new ones • Decreased Problem Areas: • Pressure Ulcers • Incontinence • Reporting of Suspected Abuse • Policies regarding reporting of suspected abuse

4. Many similar trends, but a few new ones • Oddities: • Posting of Staff Hours • Dialysis focus • Expired Nurses licenses • Failure to act/respond to issues in the Resident Council Minutes • Providing notice of new roommate • Call lights not within reach

5. Average Number of Deficiencies per Survey

6. What is being cited during Nursing Home surveys?

8. Current Nursing Home survey deficiencies issued in 40% or moreof surveys F441: Infection Control • Infection control program • Staff infection control breaches • Resource – QIS Infection Control List

9. Current Nursing Home survey deficiencies issued in 30% - 40% of surveys F282: Qualified Staff F329: Unnecessary Drugs F371: Kitchen Issues

10. Current Nursing Home survey deficiencies issued in 30% - 40% of surveys F282: Qualified Staff • Staff not performing their job consistent with the directives of the Care Plan or facility policies and procedures.

11. Current Nursing Home survey deficiencies issued in 30% - 40% of surveys F329: Unnecessary Drug • Antipsychotics remain the major focus • Also sleep medications, antidepressants, & prn • Resource – QIS Unnecessary Meds Pathway

12. Current Nursing Home survey deficiencies issued in 30% - 40% of surveys F371: Kitchen Stuff • Cleanliness and upkeep of the kitchen • Infection control (hand washing/gloving) • Proper cooling of food for storage • Steam table food temps during meal • Dishwasher temperatures • Resources – Food Cooling Poster and Training Sheet QIS Kitchen/Food Service Observation Form

13. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F309: Highest Practicable Level F431: Storage of Drugs F323: Accidents & Supervision F279: Care Plans F428: Monthly Med Review

14. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F309: Highest Practicable Level • Pain • Dialysis • Hospice • Positioning • Etc. • Resources – QIS Resident Interview QIS Dialysis Critical Elements form

15. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F431: Storage of Drugs • Expired Meds • Multi-Use Vials not dated when opened • Temperatures • Unsecured meds

16. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F323: Accidents & Supervision • Falls • Alarms • Siderails

17. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F279: Care Plans • Ineffective or nonexistent approaches to identified or observed patient care needs or issues • Dialysis

18. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F428: Monthly Med Review • Consultant Pharmacist missed something • Physician failed to act on Consultant Pharmacists recommendations

19. Take-Aways: • Look at the examples provided • Audit your nursing home to determine if you have similar deficient practices • Make changes, and re-audit!