Long-Term Care Survey Alert

Here's how these reports can help you know what surveyors know about the facility.

There's no worse feeling than seeing a surveyor holding reports that sum up what's wrong with your facility and how it stacks up compared to other facilities -- especially when you could have obtained those reports to prepare for the inspection.

A case in point: Facilities can request OSCAR 3 and OSCAR 4 reports from the state survey agency or in some cases they have to get them from the Centers for Medicare & Medicaid Services' regional office, says Marty Pachciarz, RN, RAC-CT, clinical consultant with the Polaris Group in Tampa, FL. The OSCAR 3 report lists all of the facility's deficiencies from the last four surveys, says Pachciarz. The OSCAR 4 report shows the most recent survey deficiencies and compares those to facilities at the state, regional and national level not meeting the requirements, she adds.

"OSCAR 3 and 4 reports are important for facilities to review because the regulatory agencies are using them," says Joy Morrow, RN, PhD, senior clinical consultant with Hansen, Hunter and Co. in Beaverton, OR. "Your best defense in the survey arena is to be prepared and go on the offense."

Put another way, the reports "give surveyors ... a road map to previous problems" to scrutinize during the survey, cautions Joseph Bianculli, an attorney in private practice in Arlington, VA. That's especially true if the survey team is not personally familiar with the facility, he adds.

Facilities should, of course, be trending their deficiencies on their own, Bianculli adds. But reviewing the OSCAR 3 report can bring a facility up to speed about its history of deficiencies quickly.

The report shows the deficiencies lined up in a very organized manner for four surveys where you can see repeated citations and scope and severity, advises Pachciarz. The report can be a big help to a new director of nursing or an administrator who wants a picture of what's been going on in a facility, she adds.

The Polaris Group finds OSCAR 3 reports to be helpful when working with nursing home chains where they can look at trends across buildings and see the most common citations.

In addition to showing the facility's most recent survey deficiencies, the OSCAR 4 report also provides a profile of the facility's resident characteristics reported on the CMS 672, a form provided to surveyors at the time of the survey.

The OSCAR 4 report uses the information from the facility's last CMS 672 to compare how the facility's services and resident conditions measure up to state, regional and national averages.

For details, see "Let OSCAR 4 Shore Up QA And Survey Management," in MDS Alert, Vol. 6, No. 2. For a free copy of the article, e-mail the editor at KarenL@Eliresearch.com.