QAPI Perspective
Skilled nursing facilities are entrusted with maintaining resident safety, including prevention of abuse, neglect,mistreatment, and exploitation. The requirements of participation by CMS specifically address these topics. It is important to consider how facility policies and procedures address visitors. The policy should include visitors signing in with notation of who they are visiting, how staff is made aware of this information, and what to do if the staff are concerned with the actions of visitors while in the facility. Additionally, training should address the role and expectations for visitors and related staff responsibilities. Visitors should be required to have a specific reason for visiting and should be monitored while in the facility. Once the visitor’s reason for coming to the facility is no longer valid, the visitor should not be allowed access to the facility. This becomes difficult when visitors are family members and become friends with other residents, and then their family member passes away. A process must be implemented to determine if an individual is an appropriate visitor for a resident.
Risk Management Perspective
Policy/Procedure: Visitor and volunteer policies and procedures need to be up-to-date. Visitors and volunteers should be monitored for any inappropriate behaviors.
Training: Visitors should not be granted free access to all areas throughout a facility without facility staff present. Staff need to be trained to engage and report. All staff should wear ID and name tags.
Audit: Staff and management should be aware of visitors and volunteers who are in the building, and all staff should be aware of what is happening in the facility environment. Audit to determine that all staff are wearing their name tags.
A 44-year-old man accused of sexually assaulting a female resident with dementia at a South Carolina nursing home was charged with 3rd degree criminal sexual conduct. Staff at the facility told the woman’s family that he had been caught in the act. The resident had only been in the facility for three weeks. The man charged did not work at the facility, and the family said they did not know him. “From the information we received, his family member passed in April. That facility just continues to let him come to the facility and let him visit and hang around people,” a community activist, who is helping the family, said. The family’s attorney said nursing home regulations are supposed to have a family member sign off on visitors when a patient has dementia.
