Princeton Place Did Not Always Comply With Care Plans for Residents Who Were Diagnosed With Urinary Tract Infections (A-06-17-02002)

Princeton Place did not always provide services to Medicaid-eligible residents diagnosed with UTIs in accordance with their care plans, as required by Federal regulations. Specifically, Princeton Place staff did not always document that they monitored the residents' urine appearance at the frequencies specified in their care plans. Princeton Place did not have policies and procedures to ensure that its staff provided services in accordance with its residents' care plans. As a result of Princeton Place not following residents' care plans, the residents were at increased risk for contracting UTIs and for incurring complications from UTIs, including requiring hospitalization.

EVS personnel play a critical role in preventing the spread of germs and healthcare-associated infections

“EVS and the Battle Against Infection” is an interactive graphic novel illustrating the important role of EVS personnel in the prevention of healthcare-associated infections. The online version of the training tool features real-world infection prevention and control scenarios and allows participants to choose options that affect the outcome of the story. 

Healthcare professionals are the first line of defense against healthcare-associated infections (HAIs) and the spread of germs in healthcare settings. CDC now offers a new online interactive infection control training, “Let’s Talk Patient Safety: Reducing HAI Transmission Risk,” to help healthcare professionals identify infection risks and prevent the spread of HAIs. The training provides free continuing education for healthcare professionals, including nurses, physician assistants, medical assistants, health educators, and other clinicians. (0.1 CEU and 0.6 CNE).

The free online training can be completed anywhere. It has two modules and takes approximately 30 minutes to complete the entire training.

Module 1: “What’s the Risk?” 

This interactive module transports healthcare professionals into a scenario where they must identify infection risks and take action to protect patients, colleagues, and visitors. 

Module 2: “Chain of Infection” 

This story-based interactive module challenges professionals to break the chain of infection in a busy healthcare environment and educates them on the consequences of not following infection prevention and control recommendations.

Please join Christine LaRocca, MD and the National Nursing Home Quality Improvement Campaign to learn more about sepsis, who is at risk and the signs and symptoms for early detection. In addition, we will:

·        Review examples of sepsis screening tools commonly used in hospital settings;

·        Learn what tools to use while recognizing the limitations of sepsis screening tools in the nursing home population; and

·        Understand the elements of evidence-based treatment for optimal outcomes.

This table provides the data collection timeframes for quality measures in the Skilled Nursing Facility Quality Reporting Program (SNF QRP) displayed on the Nursing Home Compare website for Calendar Year (CY) 2019. The first column displays the plain language measure name used on the Compare website, the second column displays the full technical measure name, the third column displays the reporting cycle which describes the collection period and refresh frequency, and the last four columns contain the timeframe for each quarterly Compare website refresh.

The Department of Health and Human Services Office of Inspector General issued two new reports that address the identification, reporting and investigation of incidents of potential abuse and neglect of our nation's most vulnerable populations, including seniors and individuals with developmental disabilities. OIG issued an early alert in 2017 based on the preliminary findings of this work. Our resulting work, released in June 2019, identify thousands of Medicare claims that indicate abuse and neglect of beneficiaries, including beneficiaries in skilled nursing facilities. If you suspect someone is the victim of abuse or neglect, contact law enforcement immediately.

Reports:

CMS Could Use Medicare Data To Identify Instances of Potential Abuse or Neglect 

Incidents of Potential Abuse and Neglect at Skilled Nursing Facilities Were Not Always Reported and Investigated

In the realm of the revised survey process, an interesting F-tag has joined the list of the most frequently cited deficiencies across the country. The tag is F-842, and in case that regulatory number is not immediately familiar, it has to do with documentation: “Resident Records – Identifiable Information.”

Given our profession’s consistent focus on documentation, does that come as a surprise? It certainly did for this writer! Between January 2018 and April 2019, F-842 has been cited nearly 3,000 times, across all CMS Survey and Certification Regional Offices. In 2019 so far, there have been 250 deficiencies cited under F-842. Long-term care has long been required to maintain residents’ personal privacy and keep medical records confidential. This is not a new requirement of participation, so what is happening? Many of the citations stem from the medical record not being accurate and complete, which is a component of F-842.

Below are brief descriptions of a few of the cited deficiencies.

Effective this November 28, trauma-informed care will take center stage in the survey process for nursing facilities (NFs) and skilled nursing facilities (SNFs) as the Centers for Medicare & Medicaid Services (CMS) completes the final stage of rolling out the revised requirements for participation in Medicaid and Medicare. CMS will implement new trauma-informed care regulations under F699 (trauma-informed care), which is a quality-of-care F-tag; F659 (comprehensive care plans/qualified persons); F741 (sufficient/competent staff‐behavioral health needs); and F949 (behavioral health training).

These new or revised F-tags will come on top of two already implemented tags that address trauma—F742 (treatment/service for mental/psychosocial concerns) and F743 (no pattern of behavioral difficulties unless unavoidable)—giving surveyors a full suite of trauma-informed care tags to guide their investigations. Note: Read the Code of Federal Regulations citations that underpin the trauma-informed care requirements for each F-tag at the end of this article.

These apply to all four QRP programs, including the SNF QRP:

• GG0110 Prior Device Use with Information From Multiple Sources. This 4-minute video demonstrates how a caregiver can utilize information collected from multiple scenarios to accurately code GG0110. Prior Device Use. 
• Decision Tree for Coding Section GG0130. Self-Care and GG0170. Mobility. This 12-minute video demonstrates how to apply the six-point coding scale to GG0130. Self-Care and GG0170. Mobility using GG0170D. Sit to stand as an example.
  
• Coding GG0170C. Lying to sitting on side of bed This 4-minute video demonstrates how to distinguish between Code 02, Substantial/maximal assistance and Code 03, Partial/moderate assistance when coding GG0170C. Lying to sitting on side of bed.
• Coding GG0130B. Oral Hygiene. This 4-minute video demonstrates how to distinguish between Code 05, Set-up or clean-up assistance and Code 04, Supervision or touching assistance when coding GG0130B. Oral Hygiene.