Long-Term Care Survey Alert

 Don't expect the survey and enforcement system to lighten up any time soon. The General Accounting Office recently advised the Centers for Medicare & Medicaid Services to rev up its survey activities, tighten oversight of state survey agencies - and make sure it has systems to adequately manage complaints about quality of care. The report, "Prevalence of Serious Problems, While Declining, Reinforces Importance of Enhanced Oversight," found that the proportion of nursing homes with serious quality problems remains unacceptably high, despite some small improvements. Surveyors cited actual harm or more serious deficiencies in 3,500 nursing homes during an 18-month period ending January 2002, compared to 29 percent for an earlier period. Read the report (GAO-03-561) at www.gpoaccess.gov/gaoreports/ index.html.



JCAHO 2004 patient safety goals include a new infection focus and a requirement to read back critical test results. The Joint Commission on Accreditation of Healthcare Organizations recently approved its 2004 National Patient Safety Goals and Requirements (NPSGs). The goals add a new goal to reduce the risk of health care-acquired (nosocomial) infections. Nursing homes and other JCAHO-accredited organizations comply with this goal by following current Centers for Disease Control & Prevention hand hygiene guidelines.
 
Starting in 2004, JCAHO also expects health care organizations to manage as sentinel events all identified cases of unanticipated death or major permanent loss of function associated with a health care-acquired infection.
 
In addition, health care staff receiving critical test results verbally must read them back to the person providing them. To review the patient safety goals, go to www.jcaho.org/accredited+organizations/patient+safety/npsg/04_npsg.htm.




Have you checked your residents for anemia lately? Anemia doubles the risk that an older person will experience serious physical declines, according to a new epidemiological study supported by the National Institute on Aging and others. The study, published in the Aug. 1, 2003 issue of the American Journal of Medicine, also found that older people with borderline hemoglobin levels are 1.5 times more likely to develop physical declines than their counterparts with normal readings. The World Health Organization defines anemia as hemoglobin levels below 12g/dL in women and below 13g/dL in men.
 
Vitamin or mineral deficiencies, particularly of iron, vitamin B12 and folic acid, can cause anemia, as can underlying conditions, including cancer, rheumatoid arthritis and chronic kidney disease. 
 
Study Implications: While the study focuses on elderly people living in the community, staying on top of anemia in nursing homes might protect residents' functional capabilities.