Long-Term Care Survey Alert
SURVEY & CLINICAL NEWS
Nursing facilities that assume "shelter in place" is the way to go in most emergencies could be endangering residents and inviting the wrath of surveyors. To evacuate residents when necessary, SNFs should concern themselves with a preliminary Government Accountability Office report's following essential considerations:
• Adequate resources to shelter in place. Is the emergency power system reliable? Did the facility test it recently? Will the facility have access to critical supplies? How will the facility keep lines of communication open with family? How has it planned for staff support activities, such as housing, transportation and counseling?
• Determining the risk to patients. Is making the call early and having more time to evacuate safer, or can the facility reduce risk by delaying the decision?
• The availability of transportation to move patients. Are the facility's transportation agreements current? Has the facility coordinated its plans with neighboring healthcare facilities?
• Receiving facilities' ability to accept patients. Has the facility kept agreements with receiving facilities current? Does the SNF know whom to contact locally for assistance in the event of an emergency evacuation?
The report, "Disaster Preparedness: Preliminary Observations on the Evacuation of Hospitals and Nursing Homes Due to Hurricanes" (GAO-06-443R), is available online at www.gao.gov/new.items/d06443r.pdf
A timely vitamin may prevent B12 depletion in residents taking proton-pump inhibitors (PPI). Researchers at Our Lady of Mercy Medical Center (Bronx, NY) found that "among older adults not receiving B12 supplementation, PPI use significantly decreased B12 levels" after 36 months of use, according to a poster presentation by the researchers at the March 2006 American Medical Directors Association annual conference in Dallas. Regular multi-vitamin use and/or B12 treatment "were associated with higher levels of serum B12 and improved B12 status," the researchers concluded. Vitamin B12 deficiency can cause peripheral neuropathy, dementia and psychosis.
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