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Date ArticleType
6/9/2016 Regulatory
G/IJ/SSQC Citation Update

The Indiana State Department of Health conducted a total of 51 Recertification surveys for the month of April 2016. Of the 51 Recertification surveys 7 or 13.73 percent were deficiency free. There were a total of 22 G level federal tags cited in 22 locations throughout Indiana. The most frequently cited G level federals tags were for F309 (4 times), F314 (4 times) and F323 (4 times). F309 was cited for failure of the facility to provide medication ordered by the physician, failure of a facility to discover a resident with impaired skin integrity until the toes of the resident were black and draining and failure to notify the residents physician of the wound status resulting in maggot infestation of the wound and hospitalization. Another facility failed to provide necessary care and services, in that, a resident had a continued decline in the status of the right foot and leg resulting in hospitalization and amputation. Federal tag F314 was also cited for failure of the facility to ensure pressure ulcer interventions of bilateral off-loading boots were implemented for a resident identified at risk for pressure ulcer development to the feet and another facility failed to ensure pressure ulcer interventions were implemented to prevent a resident admitted without pressure ulcers from developing pressure ulcers to the right heel. Failure to assess pressure wounds and failure to provide consistent interventions and treatment to protect the worsening of the wound were also identified concerns. F323 was issued for failure to clarify what kind of assistance was required for transferring a resident resulting in laceration to the lower extremity requiring sutures to repair. Others facilities receiving F323 failed to ensure a resident was free from accidents when alarms, nonskid footwear and hip protectors were not in place resulting in a transfer to the hospital for treatment. One facility was cited for failure to complete a through root cause and analysis after multiple falls and failure to update care plan to reflect current fall interventions and failure to communicate instructions to direct care staff resulting in a hip fracture. Federal tag F333 was cited (3 times) for failure to ensure resident received the correct amount of Methadone (a liquid pain medication) which resulted in the use of Narcan (medication used to reverse the effects of a narcotic overdose. Two locations did not administer correct medications resulting in a change of mental status and transfer to the emergency room for treatment.

One facility received IJ/SSQC deficiency for F333 in the month of April, 2016. The facility failed to ensure portable oxygen tanks were stored at a safe distance from the heat of hair dryer and also failed to ensure a cognitively impaired resident was supervised at all times during medical appointments.

If you would like more information or have questions, please contact Lori Davenport at ldavenport@ihca.org. Detail related to each deficiency including how to prevent citations will be presented during the IHCA/INCAL Quarterly Compliance and Education on June 30 from 9-12 noon.