In 2-3 pages, describe how a nursing facility might go about marketing itself and the services it provides to the community. When might management use a public relations firm? Please give examples.
In a three to four-page essay, explain the survey process. Compare the three types of surveys: traditional, Quality Indicator Survey (QIS), and the newest survey process that began in November, 2017. Please be specific. NOTE: You may have to interview a seasoned administrator to complete this assignment. Also be aware that the QIS survey was not implemented in every state, so you may need to do some research.
Your nursing home was recently assessed two deficiencies (in the attached file) during a survey. Write a Plan of Correction in response to the findings; your response should be 2-3 pages long. For each citation, be sure to address:
How corrective actions will be accomplished for those residents affected by the deficient practice;
How the facility will identify other residents who have potential to be affected by the same deficient practice;
What measures will be implemented to prevent the recurrence of the deficient practice;
How will the facility monitor to ensure the deficient practices do not recur; and
The date when the facility expects to have the deficient practice corrected.
Scope and Severity=D
483.15(a) DIGNITY AND RESPECT OF INDIVIDUALITY The facility must promote care for residents in a manner and in an environment that maintains or enhances each resident’s dignity and respect in full recognition of his or her individuality.
Based on observation, interview and record review, the facility failed to ensure dependent residents were served meals in a manner to preserve their dignity regarding lengthy meal waits for 1 of 5 residents reviewed for dignified dining experience (Resident E). Findings include:
During the 3/17/16 breakfast observation from 8:07 a.m. to 9:13 a.m. (66 minutes), five dependent residents were seated in broda chairs facing a table located in the hallway. The residents’ food had already been placed in front of them on the table. One staff member was present and assisting two of the residents. At 8:15 a.m. a second staff member arrived and began to assist two other residents. One resident (Resident E) sitting at the end of the table was left unassisted, while the other residents ate, until the Assistant Director of Nursing arrived at 8:50 a.m. (43 minutes).
Resident E’s clinical record was reviewed on 3/17/16 at 4:25 p.m. Resident E’s current diagnoses included, but were not limited to, dementia, anemia, chronic obstructive pulmonary disease, congestive heart failure and urinary retention.
Resident E had a current, significant change, Minimum Data Set (MDS) assessment, dated 1/25/16, which indicated the resident was severely cognitively impaired and rarely or never made decisions and required staff maximum assistance for locomotion (purposeful movement from one location to another).
Resident E had a current, 12/24/15, care plan problem regarding requiring assistance with activities of daily living. Approaches to this problem included, but was not limited to, providing assistance with activities of daily living such as bathing, grooming and eating.
During an interview on 3/17/16 at 9:33 a.m., the Administrator indicated there should be 3 staff members assisting the dependent residents with their meals. The Administrator also indicated if the direct care nursing staff were unable to provide the required assistance, the management staff should assist.
During an interview on 3/17/16 at 11:25 a.m., CNA #1 indicated the following “There are usually two CNAs to help feed. Every once in a while a nurse will come help. But there is usually just 2 CNAs.” CNA #1 indicated if a staff member called in the facility would try to replace them so there would be at least 2 staff members assisting with the meals, but that there had been times in the past where only one CNA was there to help assist with 5 residents.
During an interview on 3/17/16 at 1:52 p.m., CNA #2 indicated residents who required assistance with meals had been the last to be served. “Just yesterday they changed it to having them served first. I think this will work out better and they won’t have to wait as long.”
483.65 INFECTION CONTROL, PREVENT SPREAD, LINENS
The facility must establish and maintain an Infection Control Program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of disease and infection.
(a) Infection Control Program The facility must establish an Infection Control Program under which it –
(1) Investigates, controls, and prevents infections in the facility;
(2) Decides what procedures, such as isolation, should be applied to an individual resident; and
(3) Maintains a record of incidents and corrective actions related to infections.
(b) Preventing Spread of Infection
(1) When the Infection Control Program determines that a resident needs isolation to prevent the spread of infection, the facility must isolate the resident.
(2) The facility must prohibit employees with a communicable disease or infected skin lesions from direct contact with residents or their food, if direct contact will transmit the disease.
(3) The facility must require staff to wash their hands after each direct resident contact for which hand washing is indicated by accepted professional practice.
Personnel must handle, store, process and transport linens so as to prevent the spread of infection.
Based on observation and interview, the facility failed to ensure infection control practices were followed when transporting soiled linens used during resident wound care (Resident C). This practice had the potential to affect 1 of 3 residents reviewed for infection control. (LPN#3)
During an observation on 3/17/16 at 10:37 a.m., Resident C was in bed for a dressing change to the left heel. LPN #3 provided the wound care and dressing change per physician orders. After the dressing change had been provided, LPN #3 washed her hands and wrapped the used linens in a clean towel and left the room. While transporting the soiled linens down the hall to the soiled hold, LPN #3 held the linens against her body.
During an interview on 3/17/16 at 10:55 a.m., the Director of Nursing indicated soiled linens were to be bagged for transport from a resident’s room and never carried held against the body. The Director of Nursing indicated LPN #3 was new and she would inservice her on the proper handling of soiled linens. The Director of Nursing also indicated LPN #3 was currently providing care on the 100 hall but would also be helping in the main dining room during meals.
A current policy dated 12/2015, provided by the Director of Nursing on 3/17/16 at 3:37 p.m., titled “Linen, Handling” stated:
“Policy: The facility shall handle linen in a manner to prevent the spread of infection. Procedure:…
2. Linen will not be carried against the body…
5. Gloves will be worn when contact with soiled linen is anticipated…
Soiled linen will be placed in a container (i.e., linen barrel, plastic bag, etc.) prior to taking it into the hallway….”
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