QAPI Perspective
CMS’s requirements of participation provide guidance for a minimum level of care,which includes receiving medications timely and accurately, along with hygiene care. These are basic clinical practices that must meet professional standards.Additionally, when residents are moved from one room to another, there are notification requirements. A facility should implement a system that audits resident care received, along with receiving proper notification when a room change is necessary. Admission can be a time when residents experience psychosocial and emotional trauma that upsets their sense of well-being. Staff must support residents during a transition of care, albeit coming to a new facility or experiencing a room change. By proactively conducting audits or reviewing practices specific to resident plans of care, the facility can prevent substandard practices that could lead to worthless care citations from governmental agencies.
Everyone becomes a winner when a facility supports a professional level of care through strong systems, including monitoring of care practices. The resident has a positive experience, staff are empowered and supported to provide quality care based on evidence and professional standards, and the facility’s reputation is celebrated.
Risk Management Perspective
Policy/Procedure: Policies and procedures should be up-to-date specific to care plans. All family members and residents should be greeted and welcomed, with needs being assessed and any urgent care being provided. Care plans should be completed as appropriate.
Training: Train staff to warmly greet new and/or returning residents, and to be prepared for the resident’s arrival.
Audit: Morning meetings should review new arrivals from the prior day and discuss any upcoming expected arrivals for that day.
More people are coming forward after saying they were mistreated at a nursing home in Illinois. One woman spoke with the media after her grandfather unexpectedly died just three days after being admitted to the nursing home. After hearing her story, a local couple said they knew they needed to speak up as well, with the hope that their story will serve as a warning to others.
In 2016, the husband was fighting for his life after he unexpectedly collapsed in his driveway. He was rushed to the hospital,where the doctors said they did not expect him to survive. He was transferred to the nursing home to recover. He and his wife are not happy with the care he received while there. “I would have to call them at night or walk down the hall and ask, ‘Don’t I have to have my medication tonight?” he said. They moved him to different rooms, eventually leaving him out of sight and out of mind. “I was in there about ten days, and two-thirds of that time…no hygiene at all. No bath, no nothing,” he said. After less than two weeks,his wife said she couldn’t watch him suffer anymore. “I said, ‘We’re getting him out of here, whatever you have to do because he’ll be better off at home. This is ridiculous.’” The husband said that while he was lying in his bed at the facility, all he could think was, “One word: helpless.”
