Long-Term Care Survey Alert

Published on Mon Apr 21, 2008 PDF

Follow this long-term care provider's lead.

Giving survey agencies and surveyors a heads up about your culture-change plans can head off citations at the gate. That's because the Centers for Medicare & Medicaid Services is championing person-centered care and wants providers to succeed with their efforts. Even so, "there's a perception among some people that regulations get in the way of culture change or a facility doing things differently," says Wendy Kronmiller, director of the Maryland survey agency. "We work really hard to remove that myth," she tells Eli.

Case in point: Saint Elizabeth Community has found that many of the things it's doing with culture change don't cause a survey issue at all. And "we are finding that surveyors are supportive of our doing culture change and welcoming the changes," reports Janelle Hackett, RN/RPTA, life enhancement coach for the organization with facilities in Rhode Island.

Saint Elizabeth's administration meets with surveyors every other week to discuss what the organization is doing with culture change -- and how it relates to F tags.

Example: The facility is working with the state to address a survey concern about having CNAs prepare food for residents who choose to sleep late and want breakfast after the kitchen is no longer serving it.

Hackett says the survey agency is talking about having the direct caregivers take an eight-hour safe food-handling course so they could be certified to handle food. "It's all about using appropriate infection control and hand-washing."

The same holds true for facilities that implement models where staff joins residents for meals at family-style tables. "There's no rule that says staff can't eat with residents," says Diana Waugh, RN, BSN, principal of Waugh Consulting in Waterville. OH. "Staff can easily be taught to adhere to practices that will eliminate the potential for contamination [of food] while engaging residents in a social eating situation."

Food for thought: Residents requesting their breakfast eggs "sunnyside up"? You can accommodate their dietary choice and steer clear of F tags by simply using pasteurized eggs, Waugh says.