Long-Term Care Survey Alert

Get ready for a 'zero tolerance' stance from surveyors for skin-related issues in both wound and incontinence care. That's the inside scoop from Courtney Lyder, ND, professor of nursing at University of Virginia Medical Center in Charlottesville, in a keynote address on the upcoming revised F-tags 314 (pressure ulcers) and 315 (urinary incontinence) presented at the September  2004 National Association of Subacute and Post Acute Care in Washington.
 
Facilities can expect to see more F tags for pressure ulcers, as the Centers for Medicare & Medicaid Services tries to drive down the prevalence of pressure ulcers in nursing facilities over the next few years, Lyder told NASPAC attendees.
 
Once the revised F314 tag goes into effect, surveyors will use a algorithm with drop-down boxes to determine whether the facility could have prevented a resident's pressure ulcer or its progression, Lyder reported.
  
CMS will release the F314 revisions first (reportedly any day) but the agency hadn't at press time disclosed the implementation date.
 



CMS is moving ahead with its 10-state project to identify "efficient, effective and economical" ways to conduct background checks on nursing home employees. A background check (for purposes of the CMS pilot) includes checking available registries and state and national criminal history records through a 10-fingerprint check. CMS will select the states this fall using a competitive process.

Experts cite the need to find better ways to weed out potential employees who pose a threat to residents. "Many states already require criminal background checks of various sorts, the cost of which is usually included in the Medicaid rate," observes attorney Joseph Bianculli in Arlington, VA.

"Yet these are not always effective," he notes. For example, Bianculli had a case where a CNA raped a resident. And the facility had conducted a background check on the employee that turned up nothing - even though the CNA was out on bail for raping another resident. "That particular state only reported convictions - not arrests," Bianculli explains.