Long-Term Care Survey Alert

Expect surveyors to crack down on how they observe the medication pass In a recent clarification, the Centers for Medicare & Medicaid Services instructed surveyors to observe as many nursing home staff administering medications as possible during the survey, including drugs by different routes of  administration (e.g., eye drops, injections, nasogastric administration and inhalation). CMS also directs surveyors to observe medication administration at different times of the day and to residents with care needs representative of the sample or to the actual sampled residents. In addition, CMS clarified Appendix P, Task 5-E, p. P-60, which instructs surveyors to reconcile medication pass observations with the medical record. The reconciliation must be made with the physicians order, CMS emphasizes, since the medication administration record is a transcript of the orders and may contain errors. Read the CMS clarification at www.cms.hhs.gov/medicaid/ltcsp/ltcmemos.asp.


Its official: Facilities are required to post the statement of deficiencies but can do so without fear of violating HIPAA medical privacy rules Thats according to a recent letter from the Centers for Medicare & Medicaid Services Steven Pelovitz to state survey agencies. Pelovitz essentially says OBRA trumps HIPAA, and nursing homes must display the results of federal and state survey results, which rarely provide information that can be traced to an individual resident. The letter says while CMS shares providers concerns about the privacy of nursing facility residents medical records, we must balance that concern with our statutory duties to regulate the nursing facility industry through surveys and inform the public by providing access to the results of those surveys. Tip: As a courtesy, provide a broad written disclosure informing residents or their representatives that federal law requires the facility to post the statement of deficiencies.



Failure to tend to your residents oral health can lead to life-threatening complications .  A study of 95 elderly nursing home patients hospitalized for severe aspiration pneumonia found that the disease could have developed from microorganisms in dental plaque or the oropharyngeal cavity. Conducted by researchers from the University of Buffalo, the study appeared in a recent issue of the American Journal of Respiratory and Critical Care Medicine. Aspiration pneumonia is a serious problem among the elderly and the second most frequent principal diagnosis associated with hospitalization of Medicare patients. Tips: Perform a careful oral assessment on each resident at admission and at least quarterly. Give all residents a dental care kit, including dental floss. Ensure CNAs provide and document daily mouth care. Refer residents for at least annual dental check-ups. Make dental hygiene a part of restorative nursing programs so residents become more independent in this area of care.