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Date ArticleType
3/20/2017 Regulatory
January 2017 Residential Care Citations

The ISDH conducted ten surveys in the month of January. There was a total of twenty-eight residential tags with eight of twenty-eight being offensive tags. The Deficiency Free Survey Report was not available for IHCA/INCAL to review, however IHCA/INCAL will distribute information as it is made available.

Four tags were cited for 052 – Resident Rights Offense for failure to protect and promote the resident right to be free from any physical or chemical restraint imposed for purpose of discipline or convenience. Four tags were cited for 0241 – Health Services Offense for failure to administer medications and provide nursing care as ordered by the resident’s physician and/or supervised by a licensed nurse on the premises or on call as follows: (1) Medications shall be administered by a licensed nurse or qualified medication aide. The top non-offensive tags were as follows:

Tag 090 – Administration and Management – for failure of the administrator to inform the division within twenty-four (24) hours of becoming aware of an unusual occurrence that directly threatened the welfare, safety or health of a resident. Notice of unusual occurrences may be made by telephone, followed by a written report, or by written report that is faxed or sent by electronic mail to the division within twenty-four (24) hour time period. Unusual occurrences include, but are not limited to: (A) epidemic out breaks (B) poisonings (C) fires; or (D) major accidents. If the division cannot be reached, a call shall be made to the emergency telephone number published by the division. Requirements of this tag also include administrator responsibility to ensure prompt arrangements or assistance with provision of medical, dental, podiatry, or nursing care or other health care services as requested by the resident or the resident’s representative. Obtaining director approval prior to admission of individuals under the age of eighteen (18). The administrator must also maintain, on the premises, an accurate record of actual time worked that indicates employees full name, dates and hours worked during the past twelve (12) months. Administrator responsibility to include posting of results of the most recent annual survey of the facility conducted by the state surveyors and the plan of correction in effect with respect to the facility, and any subsequent surveys. The results must be available for examination in the facility and in a place readily accessible to residents. A notice must be posted of the availability. Surveys conducted by the division must be maintained and available, to the public upon request for a period of two (2) years. Tag 006 – Scope of Residential Care was cited for failure of the facility to discharge the resident for one of the following reasons: (1) is a danger to the resident or others; (2) requires twenty-four (24) hour per day comprehensive nursing care or comprehensive nursing oversight; (3) requires less than twenty-four (24) hours per day comprehensive nursing care, comprehensive nursing oversight or rehabilitation therapies and has not entered into a contract with an appropriately licensed provider of the resident’s choice to provide those services; (4) is not medically stable; or (5) meets at least two (2) of the following three (3) criteria unless the resident is medically stable and the facility can meet the needs of the resident; (A) Require total assistance with eating. (B) Requires total assistance with toileting. (C)Requires total assistance with transferring. Tag 086 – Administration and management was cited for failure to be in compliance with all applicable laws and to ensure the delegation of any authority by the licensee does not diminish the responsibilities of the licensee. Tag 0246 – Health Services Deficiency for failure to ensure PRN medication were administered by a qualified medication aide (QMA) upon required authorization by a licensed nurse or physician. The QMA must receive appropriate authorization for each administration of a PRN medication. All contacts with a licensed nurse or physician not on the premises must be documented in the nursing notes indicating the date and time of the contact. Tag 0273 – Food and Nutritional Services was cited for failure to ensure all food preparation areas (excluding areas in the resident units) are maintained in accordance with state and local sanitation and safe food handling standards. Pharmaceutical Services tag 0304 was cited for failure of the facility to ensure medication/treatment cabinets or rooms were locked at all appropriate times and/or scheduled II drugs were stored and secured appropriately.

If you have any questions or would like assistance, contact Lori Davenport at ldavenport@ihca.org.