Long-Term Care Survey Alert

Published on Mon Mar 01, 2010 PDF

Cover the bases with this 4 strategy plan.

Maintaining and updating your building can pay off in spades, but when construction and repairs are underway, you have to maintain resident care and safety as usual.

Proactive approach: Work with your construction contractor and staff to come up with a plan that helps to prevent problems at the get-go.

For example, when Frank L. Blum Construction did a renovation project for a senior living facility with a dementia wing, its managers met with the facility staff to find out how they normally maintained safety and security on the unit,reports Mark Dunnagan, preconstruction services manager for the company in Winston Salem, N.C. Then they worked with the facility staff to come up with a safety plan that included the following features:

􀁺 Making sure doors that need to be locked stayed locked.

􀁺 Implementing a process that ensured that "construction personnel, residents, and facility staff traffic intermix as little as possible," says Dunnagan.

􀁺 Reminding construction staff to avoid leaving tools and materials unattended.

"It's obvious stuff, but you also want to make sure nurses can get to the people they need to get to," says Dunnagan. The up-front discussion also gets everyone on the same page about the plans and safety measures. "We make sure the provisions are in place, and in writing, and that everyone understands and enacts them before starting the construction project," he explains.

Strategy No. 2: Anticipate,address resident/family concerns. In addition, Blum Construction managers always meet with residents and families before doing a project. The goal is to create a relationship with the residents, says Kevin Masten, also with the company. That way, if residents or families have an issue with the construction noise or disruption, they "let us or the facility staff know rather than bottling it up and becoming angry about it. We also give the staff and residents weekly schedules, letting them know the times when they may hear equipment or beepers."

Survey and safety management tips: Facilities that perform ongoing safety rounds can also catch problems whether construction crews are on site or not. People are human and make mistakes, says Joy Jordan, RN, MSN, RAC-CT, with Boyer & Associates Inc. in Brookfield, Wis. She notes that a can of paint with the lid off can look like vanilla pudding to a resident with dementia.

"If you're doing major renovation of a wing, it's a good idea if you can close off a wing and have a backdoor the construction crew can come in," says nursing home administrator Joyce Halling, who also advocates educating facility staff to be on the lookout for hazardous construction materials and chemicals.

3. Consider requiring contractors to do background checks. The federal regulations don't require facilities to do background checks on vendors entering a nursing facility, advisesattorney Loretta Lebar, partner with Ford & Huff LC in Salt Lake City, Utah. And she doesn't advise facilities to do the checks on all vendors."But if you have contractor staff coming into a building to do capital repairs or renovation for a month or longer, I'd ask the construction contractor to do the background checks as part of their bid [price]."

What might the contractor include in the screening? Blum Construction screens its full-time employees with a pre-employment drug screen, criminal background check, motor vehicle record check, and an I-9 employee eligibility check. At the client's request, the company will ask its subcontractors to screen their employees, according to the company via its media relations contact.

4. Share the facility's sexual harassment policy. The facility also has a responsibility to inform the contractor about the facility's sexual harassment policy and provide the policy in writing, advises Halling."The facility administration has an obligation to protect staff from sexual harassment from anyone -- vendors or even residents."