Long-Term Care Survey Alert

Heed the Centers for Medicare & Medicaid Services' clarification on these three fire safety issues. A recent survey and certification Q&A memo (S&C-05-38) sheds some light on sprinkler requirements for wardrobe closets, outdoor canopies - and when facilities need a paved surface for exits. For example, CMS does not require sprinklers in freestanding portable wardrobe units used as a closet to store clothing and other resident personal belongings. But surveyors are supposed to check whether the sprinkler system coverage extends to the exterior of the wardrobe.

The memo also addresses the question of whether sprinkler protection is required for a canopy, such as a weather cover at a front entrance. Canopies less than four feet in width don't have to be sprinklered regardless of construction type if the facility doesn't store or handle combustibles under them (excluding cars dropping off or picking up people).

Exterior roofs or canopies exceeding four feet in width must have sprinklers installed under them - unless the canopy or roof is constructed of noncombustible or limited combustible materials. That requirement applies to the entire canopy assembly and not just the exposed surfaces. So-called "exit discharges" must have a hard surface pathway to the public way "if there is much rain or snow and if patients are expected to exit or be evacuated in wheelchairs or beds" or using walkers. Surveyors will make this determination based on the local weather condition and the difficulty residents may encounter exiting the building.

Are you assessing residents with  dementia for visual problems? One in three nursing home residents with Alzheimer's disease don't use or have eyeglasses strong enough to correct their eyesight. That's the finding of a new study that appears in the July issue of the Journal of the American Medical Directors Association. Vision problems make it difficult for a person to function and can aggravate symptoms of dementia.

MDS tip: To detect residents with visual problems, look at what you've coded in Section D1 (vision) to D2 (visual limitations/difficulties) and D3 (visual appliances.)