Six things Assisted Living Facilities can do to Avoid Citations during State Inspections

iCareManager January 13, 2020
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Providing assisted living and senior care facilities to residents come with a huge responsibility for effectively managing their emotional, physical and psychological well-being. As such, it is a regulated industry.

Unannounced State inspections and visits are quite common. Failure to meet compliance results in citations. Typical violations include administration of medication; daily care; food quality; employee health; and emergency plans. If you get cited, it becomes a permanent part of your record and can be looked up by your potential clients and their families when they are selecting a facility for themselves or their loved ones.

You may not be able to completely avoid being cited, however, you can reduce the chances if you plan everything properly from the get-go. Sometimes the cited issues are minor and can easily be fixed. If you’re proactive, you should be able to resolve those issues quickly. The problem typically happens if you have neglected areas in your facility that get cited often or for major infractions.

Each state in the US regulates assisted living differently, and at times with varying laws and regulations related to compliance and quality. Each state issues a license to a facility after an inspection, typically conducted annually or semiannually. This process is overseen by a state’s department of health or department of social services. Inspection teams include nurses, social workers, sanitarians and public health officials. Before their inspection reports are generated, they may observe the resident’s care and general operations, review your facility’s essential services, look at your records, and survey your staff. The services they review would include assistance with activities of daily living, meals, housekeeping and resident assessments.

Here are some tips on how to be prepared for this:

1- Start with the Ideal Staff

The turnaround in healthcare-related jobs is high, especially in assisted living facilities. When new staff members are constantly joining, it can become difficult to keep track of who is doing what, where they are doing it, and when it needs to be done.

To avoid these issues, start by hiring the best possible people for the job. To narrow down the people who work at your facility to only the best, you need to invest in a solid starting process. This should involve a background check and a thorough interview. You want to speak to people who have worked with this person before. Ask a lot of questions. Taking the time to properly vet an employee now could reduce the risks of negligence or non-compliance later.

2- Invest in Training

If you want your staff to know how to treat people, how to perform tasks the right way, and when they need to speak up, educate them. The more you teach them, the less likely you are to struggle with any type of compliance issue. Even if the state decides to show up on a bad day where you have no prep time, you are still more likely to be in compliance. It may seem difficult to put that much investment into a new employee, but if you properly vetted your employee to begin with, it should be an employee who has the intention of sticking around for a long time.

Also, keep the educational opportunities ongoing. People are more likely to stick with a job that they feel has growth potential. The more training an employee gets the more valuable they become and more important they feel. Each educational opportunity can also lead to increased chances of raises, which also help prevent your turnover from being so high. People love being in a position where they are valued. The more you can help your employees feel special, the more devoted and loyal most will remain to their jobs.

You also need to make sure that you educate all of your employees on the types of negligence they may witness. If they know what to look for, they know when to step in if someone is falling behind on how they care for a resident. You do not want to breed an environment of secrecy. Instead, you want a culture where people always do what is in the best interest of the resident and the facility. Residents must come first. Neglect does not always show up by means of a bruise or bedsore. This is important information for staffers to have, especially those who are new to the job.

3- Allow Staff to Support One Another

Only people who live or work in this type of field understand how hard it can be. Some residents are miserable with all caregivers simply because they do not understand what is going on. Other times, the expectations some families have are simply unattainable. Yet still, some cases are simply emotionally draining. To keep people on point when on the job, allow them to have time to support each other during these trials. It allows for bonds to be made, people to join forces towards common goals, and for residents to not see or feel the effects of an overwhelming job.

4- Everything That Goes On in Your Facility Should Have Secondary Checks

People make mistakes. That is part of what makes us human. In order to combat these mistakes, you can start by putting a secondary check on everything that gets done. This means having someone go through and double-check doctor’s orders, verifying rooms were clean, and even someone going back through to make sure everything was put into a resident’s family medical history properly.

The more eyes you have on the tasks you have going on each day, the less likely something is to get missed or neglected. When in doubt, check and double-check. Invest in software applications that can do some of these checks for humans. It helps eliminate the risk of human error in the process.

5- Document Everything, No Matter How Small, In a Legible Manner

It is vital for any type of assisted living facility to have documentation of everything that goes on. That way, if someone was to fall, for instance, and it would go to court, you can be sure that your facility is compliant and that the facts can be used to prove the case. Hopefully, your facility is never involved in any type of lawsuit issue or citation for problematic care. However, if you are, having documents that anyone can read could be your saving grace. Using a reliable software program for paperless documentation is the way to go in the future.

6- Put Someone in Charge of Compliance

While this is not always possible to do on its own, take at least one long-term, full-time employee and educate them about compliance. Make it their responsibility to always be on the lookout for compliance issues. If you have the budget, hire someone who does only this. If not, then make sure the designation is given to someone who truly loves the company and wants to see it succeed. Have them go around each day and look for obvious problems first. Then, let them delve deeper into potential issues that the state would look for. That way, even if the state randomly shows up, you should be good.