In the past I have posted on nursing home receiving violations from state and federal nursing home inspectors. What are these regulations? Who actually issues the violations? How do the regulations impact nursing homes?
This guest post from Jenn at Nursing Home Surveyor blog addresses these questions and provides useful guidance in interpreting the regulations. Jenn's perspective on regulations is exceptionally useful as she is a state nursing home surveyor.
Hospitals and Nursing Homes, places that are supposed to be of benefit to many people, yet for many others, they are places that have brought problems and even unexpected, needless death. It’s almost a daily occurrence where one can read or hear in the news of a problem in a hospital or nursing home that led to the needless suffering and/or death of someone who put their trust and faith in a facility. It is because of the problems that occur on a daily basis in some places that all of us need to be aware of what to look for. You need to keep you eyes open whenever you or a loved one enters a hospital or nursing home. You should also be aware of where the regulations that govern a hospital or nursing home are located.
There are state regulations, and each state will have a different code, title, or set of regulations. They may vary from one state to another, but very often the state regulations will mirror the federal regulations. The federal regulations can be found in a document the Centers for Medicare and Medicaid publish. This document is the State Operations Manual. It is composed of many chapters and many ‘appendices”. It is the appendices that contain a copy of the text of regulations that govern hospitals and nursing homes, as well as the “guidelines” that help investigators of nursing homes and hospitals conduct an investigation (a survey) of a facility. I go into more detail about this at my blog, if you would like more detail.
Let me talk about the nursing home regulations for a bit. Those are found in what is called Appendix PP (Appendix double P). The set up of the Appendix has a regulation first, and then some guidance, probes, and procedures following it. In order to easily find particular parts of regulations, the nursing home regulations are split into tags, called “F-tags”.
The Federal regulations help bring consistency to care provided to residents of nursing homes. Nursing Homes must comply with the regulations, and the nursing homes are supposed to be surveyed for compliance to the Federal regulations on an average of every 9 to 15 months. Some states do well in meeting that goal, others do not do so well.
If a facility is found to not be in compliance with a regulation, they will receive a “deficiency”. They have to then write a plan of correction, which means they must explain how they are going to correct the problem and ensure it never happens again. After the facility sends in their plan of correction, the state agency reviews it and determines if it is acceptable. If it is not acceptable, the facility must re-write it. For some facilities just seeing the plan of correction in writing is good enough, but for other, a “re-visit” is planned. Much of this is dependent on the severity and scope of the problems in the facility.
If a facility continues to not be in compliance, they can be put into a “decertification track” meaning that they will lose the opportunity to receive Medicare and Medicaid monies to pay for resident care. This is serious, so facilities do try to maintain their certification. They can also lose their state license to operate if the fail to comply with regulations.
Facilities are given ample time to comply. Although the surveyors are not “consultants” to the nursing homes, the nursing homes do have many avenues to pursue to help them become compliant with regulations.
So what should you do if you or a loved one needs to enter a nursing facility? There are many sites, such as Nursing Home Surveyor, that can help you explore the good and bad so you know where the good ones are and avoid the “not so good”. It is important that you take the time to read the history of the facility you are considering, and read the most recent surveys. One of the regulations requires the nursing home to post their most recent surveys in a public place so the public and the residents of the facility have easy access to the results. This is often the main lobby.
Be safe and be informed!
JL
Jenn is a state surveyor and invites you to visit her blog at: www.nursinghomesurveyor.com for more help and information about the survey/investigation process.
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The Justice Department is investigating the quality of care at the Minneapolis Veterans Home in Minnesota. "Essentially they want to know if the civil rights of residents mights have been violated by not getting the care they should have," said Gil Acevedo, deputy commissioner of the Minnesota Department of Veterans affairs, that operates the facility.
