Recent harm-level citations have revealed that nursing assessment skills are contributing to delayed or inaccurate post-fall responses. In several cases, residents were moved before a thorough assessment was completed, and there were delays by nurse aides and therapy staff in promptly notifying nursing of the incidents. One citation involved a facility that failed to accurately report assessment findings, attributing the resident’s limited range of motion to their baseline despite the presence of acute pain. The nurse reported no injuries to the hospice agency and did not notify the attending physician or resident representative in a timely manner. As a result, evaluation and treatment were delayed until hospice assessed the resident the following day and identified the injuries.
Under F-tag 726, §483.35 Nursing Services, CMS states that the facility must have sufficient nursing staff with the appropriate competencies and skills sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial wellbeing of each resident, as determined by resident assessments and individual plans of care and considering the number, acuity and diagnoses of the facility’s resident population in accordance with the facility assessment required at §483.71. Under §483.35(a)(3), the facility must ensure that licensed nurses have the specific competencies, and skill sets necessary to care for residents’ needs, as identified through resident assessments, and described in the plan of care.
LeadingAge Ohio has provided survey tips to help navigate the changes in the revised QSO-25-14- NH memo. The previously provided survey tips can be accessed on the LeadingAge Ohio webpage under the Communications tab, then The Source tab. CMS has updated the survey resources on the CMS Nursing Home webpage in accordance with the revised QSO-25-14- NH memo. LeadingAge Ohio encourages facilities to monitor compliance using the surveyor guidance found in the State Operations Manual Appendix PP . Additionally, the survey pathways can be found in the Survey Resources zip file on the CMS Nursing Home webpage and under the downloads section on this CMS webpage. LeadingAge has developed webinars and resources on the requirements of participation which are located on the LeadingAge learning hub. LeadingAge continues to add QuickCasts on the regulatory groups. Updated resources have also been added on the Nursing Home RoP Tools and Resources webpage.
For more information about the requirements of participation and citations occurring in Ohio, please join us on the monthly STAT: Survey Tips and Tactics call. Register now for the July 7 call at 11:00AM. LeadingAge Ohio is sharing tips to assist members during the survey process. Send questions you would like addressed in future Tips of the Week to Stephanie DeWees at sdewees@leadingageohio.org.