CMS Manual System - Louisiana Department of Health and Hospitals

More documents

Recommendations

Info

2 Gardner, S.E. & Frantz, R.A. (2003). Wound Bioburden. In Baranoski, S. & Ayello, E.A. (Eds.), Wound Care Essentials: Practice Principles. Philadelphia, PA: Lippincott, Williams, & Wilkins. 3 Ayello, E.A. & Cuddigan, J.E. (2004). Debridement: Controlling the Necrotic/Cellular Burden. Advances in Skin and Wound Care, 17(2), 66-75. 4 Bergstrom N., Bennett, M.A., Carlson, C.E., et al. (1994). Treatment of Pressure Ulcers in Adults (Publication 95-0652). Clinical Practice Guideline, 15, Rockville, MD: U.S. Department of Health and Human Services, Agency for Health Care Policy and Research. 5 Thompson, P.D. & Smith, D.J. (1994). What is Infection? American Journal of Surgery, 167, 7-11. 6 Ayello, E.A., Baranoski, S., Kerstein, M.D., & Cuddigan, J. (2003). Wound Debridement. In Baranoski. S. & Ayello, E.A. (Eds.) Wound Care Essentials: Practice Principles. Philadelphia, PA: Lippincott Williams & Wilkins 7 Bergstrom, N., et al. (1994). Clinical Practice Guideline, 15. 8 Ayello & Cuddigan. (2004). Advances in Skin and Wound Care, 66-75. 9 Sherman, R.A. (1998). Maggot Debridement in Modern Medicine. Infections in Medicine, 15(9), 651-656. 10 Piper, B. (2000). Mechanical Forces: Pressure, Shear, and Friction. In Bryant, R.A. (Ed.) Acute and Chronic Wounds. Nursing Management (2 nd ed., pp. 221-264). St.Louis, MO: Mosby. 11 Kosiak, M. (1961). Etiology of Decubitus Ulcers. Archives of Physical Medicine and Rehabilitation, 42, 19-29. 12 Frequently Asked Questions: Pressure Ulcer Staging and Assessment, Question 202 (2000, July 28). Retrieved July 1, 2004 from http://www.npuap.org/archive/stagingdefinition.htm. 13 Lyder, C., Yu C., Emerling, J., Empleo-Frazier, O., Mangat, R., Stevenson, D. & McKay, J. (1999). Evaluating the Predictive Validity of the Braden Scale for Pressure Ulcer Risk in Blacks and Latino/Hispanic Elders. Applied Nursing Research, 12, 60-68. 14 Lyder, C. (2003). Pressure Ulcer Prevention and Management. Journal of the American Medical Association, 289, 223-226.
15 Fuhrer M., Garber S., Rintola D., Clearman R., Hart K. (1993). Pressure Ulcers in Community-resident persons with spinal cord injury: Prevalence and Risk Factors. Archives of Physical Medicine Rehabilitation, 74, 1172-1177. 16 Cuddigan, Ayello, Sussman, & Baranoski S. (Eds.). (2001). NPUAP Monograph, 153. 17 Ayello, E.A., Braden, B. (May-June 2002). How and Why to do Pressure Ulcer Risk Assessment. Advances in Skin and Wound Care, 15(3), 125-32. 18 Bergstrom, N. & Braden, B.A. (1992). A Prospective Study of Pressure Sore Risk Among Institutionalized Elderly. Journal of the American Geriatric Society, 40(8), 747-758. 19 Gosnell S.J. (1973). An Assessment Tool to Identify Pressure Sores. Nursing Research, 22(1), 55-59. 20 Bergstrom, N., Braden, B., Kemp, M., Champagne, M., Ruby, E. (1998). Predicting Pressure Ulcer Risk: A Multistate Study of the PredictiveValidity of the Braden Scale. Nursing Research, 47(5), 261-269. 21 Bergstrom N. & Braden, B.A. (1992). Journal of the American Geriatric Society, 747- 758. 22 Braden, B. (2001). Risk Assessment in Pressure Ulcer Prevention. In Krasner, D.L., Rodeheaver, G.T., Sibbeald, R.G. (Eds.) Chronic Wound Care: A Clinical Source Book for Healthcare Professionals (3 rd ed., pp. 641-651). Wayne, PA: HMP Communications Pub. 23 Ayello, E.A., Baranoski, S., Lyder, C.H., Cuddigan, J. (2003). Pressure Ulcers. In Baranoski S. & Ayello, E.A. (Eds.) Wound Care Essentials: Practice Principles (pp. 245). Philadelphia, PA: Lippincott Williams & Wilkins. 24 Cuddigan, J., Ayello, E.A., Sussman, C., & Baranoski, S. (Eds.). (2001). NPUAP Monograph, 27 & 168. 25 Ferguson, R., O‘Connor, P., Crabtree, B., Batchelor A., Mitchell J., Coppola, D. (1993). Serum Albumin and Pre-albumin as Predictors of Hospitalized Elderly Nursing Home Patients. Journal of the American Geriatric Society, 41, 545-549. 26 Covinsky, K.E., Covinsky, K.H., Palmer, R.M., & Sehgal, A.R. (2002). Serum Albumin Concentration and Clinical Assessments of Nutritional Status in Hospitalized Older People: Different Sides of Different Coins? Journal of the American Geriatric Society, 50, 631-637. 27 Maklebust, J. & Sieggreen, M. (2001). Pressure Ulcers: Guidelines for Prevention and
Page 1 and 2:
CMS Manual System Pub. 100-07 State
Page 3 and 4:
State Operations Manual Appendix PP
Page 5 and 6:
§483.25(n) Influenza and Pneumococ
Page 7 and 8:
(including eligibility, coverage, c
Page 9 and 10:
___________________________________
Page 11 and 12:
Procedures §483.10(a)(3) and (4) D
Page 13 and 14:
―Advance directive‖ means a wri
Page 15 and 16:
§483.10(b)(5) -- The facility must
Page 17 and 18:
Provide written information concern
Page 19 and 20:
___________________________________
Page 21 and 22:
§483.10(c)(3) Deposit of Funds (i)
Page 23 and 24:
Were limits placed on amounts that
Page 25 and 26:
___________________________________
Page 27 and 28:
(B) Dietary services as required at
Page 29 and 30:
medical service that is recognized
Page 31 and 32:
satisfactorily resolved by discussi
Page 33 and 34:
(i) Transfer to another health care
Page 35 and 36:
Interpretive Guidelines §483.10(g)
Page 37 and 38:
(ii) Any representative of the Stat
Page 39 and 40:
___________________________________
Page 41 and 42:
efore the resident may exercise tha
Page 43 and 44:
§483.12(a) Transfer, and Discharge
Page 45 and 46:
§483.10(o), Tag F177, addresses th
Page 47 and 48:
Look for changes in source of payme
Page 49 and 50:
How to notify the ombudsman (name,
Page 51 and 52:
___________________________________
Page 53 and 54:
Interpretive Guidelines §483.12(d)
Page 55 and 56:
Interpretive Guidelines §483.12(d)
Page 57 and 58:
―Convenience‖ is defined as any
Page 59 and 60:
order reflecting the presence of a
Page 61 and 62:
consistently implemented. Determine
Page 63 and 64:
monitored separation from other Res
Page 65 and 66:
to prevent occurrences, monitoring
Page 67 and 68:
injurious behaviors, residents with
Page 69 and 70:
A certified nurse aide found guilty
Page 71 and 72:
o Day-to-day use of plastic cutlery
Page 73 and 74:
for the resident‘s safety. For ex
Page 75 and 76:
If a facility changes its policy to
Page 77 and 78:
___________________________________
Page 79 and 80:
Staff should strive to reasonably a
Page 81 and 82:
egarding medical information. The f
Page 83 and 84:
The report stated that, ―Resident
Page 85 and 86:
If not contraindicated, modifying t
Page 87 and 88:
o Visual interaction and to compens
Page 89 and 90:
For residents from diverse ethnic o
Page 91 and 92:
Encouraging volunteer-type work tha
Page 93 and 94:
12 Christenson, M.A. (1996). Enviro
Page 95 and 96:
selected this activity. The Nationa
Page 97 and 98:
Interview the social services staff
Page 99 and 100:
Identifies how the facility will pr
Page 101 and 102:
o Determine if the facility has acc
Page 103 and 104:
(ii) Has 2 years of experience in a
Page 105 and 106:
Once the team has completed its inv
Page 107 and 108:
___________________________________
Page 109 and 110:
transportation services that are no
Page 111 and 112:
F252 (Rev. 66, Issued: 10-01-10, Ef
Page 113 and 114:
Although this Tag can be used for i
Page 115 and 116:
___________________________________
Page 117 and 118:
___________________________________
Page 119 and 120:
Intent §483.20 To provide the faci
Page 121 and 122:
(vii) Psychosocial well-being ―Ps
Page 123 and 124:
___________________________________
Page 125 and 126:
Resident‘s decision making change
Page 127 and 128:
___________________________________
Page 129 and 130:
(i) Admission assessment. (ii) Annu
Page 131 and 132:
Completing an assessment that is no
Page 133 and 134:
Interpretive Guidelines §483.20(h)
Page 135 and 136:
Submitting correction(s) to informa
Page 137 and 138:
If the resident has refused treatme
Page 139 and 140:
. Do the dietitian and speech thera
Page 141 and 142:
Are physicians‘ orders carried ou
Page 143 and 144:
What types of pre-discharge prepara
Page 145 and 146:
If the resident‘s PAS report indi
Page 147 and 148:
Briefly review the assessment, care
Page 149 and 150:
and knowledge of the resident, shou
Page 151 and 152:
Determine whether the facility had
Page 153 and 154:
NOTE: Guidance regarding pressure u
Page 155 and 156:
The resident has the right to refus
Page 157 and 158:
others being hypersensitivity, idio
Page 159 and 160:
Examples of clinical resources avai
Page 161 and 162:
indicators which may represent pain
Page 163 and 164: • Impact of pain on quality of li
Page 165 and 166: National Center for Complementary a
Page 167 and 168: 3 National Center for Complementary
Page 169 and 170: The objective of this protocol is t
Page 171 and 172: How effective the interventions hav
Page 173 and 174: Nurse Interview. Interview a nurse
Page 175 and 176: Communicated with the health care p
Page 177 and 178: qualified persons with input from t
Page 179 and 180: of pain. First, the team must rule
Page 181 and 182: The resident experienced daily or l
Page 183 and 184: Extensive Assistance - While reside
Page 185 and 186: Procedures: §483.25(a)(1)(ii) Dete
Page 187 and 188: Identify if resident triggers CAAs
Page 189 and 190: USE OF SPEECH, LANGUAGE, OR OTHER F
Page 191 and 192: ___________________________________
Page 193 and 194: Probes: §483.25(b) Identify if res
Page 195 and 196: ―Debridement‖- Debridement is t
Page 197 and 198: OVERVIEW A pressure ulcer can occur
Page 199 and 200: procedures, during prolonged ambula
Page 201 and 202: Assessment of a resident‘s skin c
Page 203 and 204: Both urine and feces contain substa
Page 205 and 206: use of lifting devices for repositi
Page 207 and 208: in accord with resident‘s overall
Page 209 and 210: Whether pain, if present, is being
Page 211 and 212: Some clinicians utilize validated i
Page 213: generally impairs wound healing, se
Page 217 and 218: of Localized Chronic Wound Infectio
Page 219 and 220: Previously unidentified open areas;
Page 221 and 222: complications including reassessmen
Page 223 and 224: If not, the development of the pres
Page 225 and 226: o Determine if the care plan was pe
Page 227 and 228: Examples of possible avoidable nega
Page 229 and 230: (Rev. 66, Issued: 10-01-10, Effecti
Page 231 and 232: later stages of dementia, diabetes,
Page 233 and 234: the resident‘s concerns and offer
Page 235 and 236: Functional and cognitive capabiliti
Page 237 and 238: toileting and response to specific
Page 239 and 240: cognitive deficit—provided that t
Page 241 and 242: the epidermis (comparable to a deep
Page 243 and 244: adequate. Based on the resident‘s
Page 245 and 246: Follow-Up of UTIs rectal temperatur
Page 247 and 248: 9 Maki, D.G. & Tambyah, P.A. (2001)
Page 249 and 250: Whether the resident is on a schedu
Page 251 and 252: catheter/continence services. Reque
Page 253 and 254: Defines the catheter, tubing and ba
Page 255 and 256: If the attending physician is unava
Page 257 and 258: Assess, prevent (to the extent poss
Page 259 and 260: perform relevant activities of dail
Page 261 and 262: Requires immediate correction, as t
Page 263 and 264: The failures of the facility to pro
Page 265 and 266:
Identify if resident triggers CAAs
Page 267 and 268:
Probes: §483.25(f)(1) For sampled
Page 269 and 270:
___________________________________
Page 271 and 272:
Using universal precautions and cle
Page 273 and 274:
Monitor the effectiveness of the
Page 275 and 276:
Directs resources to address safety
Page 277 and 278:
Monitoring is the process of evalua
Page 279 and 280:
those (e.g., disease, environment)
Page 281 and 282:
Addressing the factors for the fall
Page 283 and 284:
155°F 148°F 140°F 133°F 127°F
Page 285 and 286:
NOTE: The Safe Medical Devices Act
Page 287 and 288:
ENDNOTES 1 Centers for Medicare & M
Page 289 and 290:
Use To evaluate whether the facilit
Page 291 and 292:
2. Interview The adequacy of the su
Page 293 and 294:
Changes in condition such as the ab
Page 295 and 296:
Noncompliance for F323 After comple
Page 297 and 298:
Once the survey team has completed
Page 299 and 300:
Unsafe wandering and/or elopement t
Page 301 and 302:
Severity Level 1 Considerations: No
Page 303 and 304:
―Qualified dietitian‖ refers to
Page 305 and 306:
Current standards of practice recom
Page 307 and 308:
dry mouth, and diseases of the orop
Page 309 and 310:
Based on analysis of relevant infor
Page 311 and 312:
For many residents (including overw
Page 313 and 314:
In deciding whether and how to inte
Page 315 and 316:
End-of-Life Resident choices and cl
Page 317 and 318:
11 Chouinard, J. (2000). Dysphagia
Page 319 and 320:
Objectives Use INVESTIGATIVE PROTOC
Page 321 and 322:
Nutrition interventions, such as sn
Page 323 and 324:
Whether the facility identified res
Page 325 and 326:
Review of Facility Practices Relate
Page 327 and 328:
42 CFR §483.20(b)(1), Tag F272, Co
Page 329 and 330:
DEFICIENCY CATEGORIZATION (Part IV,
Page 331 and 332:
If immediate jeopardy has been rule
Page 333 and 334:
Intent §483.25(j) The intent of th
Page 335 and 336:
Is proper administration technique
Page 337 and 338:
§483.25(k)(5) Standard: Tracheal S
Page 339 and 340:
(v) In the presence of adverse cons
Page 341 and 342:
physical actions such as: pacing, c
Page 343 and 344:
o Support decisions about modifying
Page 345 and 346:
individual with dementia, to improv
Page 347 and 348:
Medication management is based in t
Page 349 and 350:
Whether the signs, symptoms, or rel
Page 351 and 352:
o Pain; o Chronic psychiatric illne
Page 353 and 354:
Common Conditions/ Symptoms Example
Page 355 and 356:
Identifying the essential informati
Page 357 and 358:
necessarily indicate a need for dos
Page 359 and 360:
Sometimes, the decision about wheth
Page 361 and 362:
The continued use is in accordance
Page 363 and 364:
J., & Bates, D.W. (2005). Incidence
Page 365 and 366:
(NSAIDs) Medication Issues and Conc
Page 367 and 368:
Antibiotics Medication Issues and C
Page 369 and 370:
Medication Issues and Concerns prim
Page 371 and 372:
Medication Issues and Concerns Mono
Page 373 and 374:
chlorpropamide glyburide Antifungal
Page 375 and 376:
Medication Issues and Concerns MAO
Page 377 and 378:
Medication Issues and Concerns days
Page 379 and 380:
Medication Issues and Concerns Medi
Page 381 and 382:
uspirone Medication Issues and Conc
Page 383 and 384:
Medication Issues and Concerns amio
Page 385 and 386:
Medication Issues and Concerns Angi
Page 387 and 388:
Nitrates, e.g., Medication Issues a
Page 389 and 390:
Medication Issues and Concerns Anti
Page 391 and 392:
Medication Issues and Concerns esom
Page 393 and 394:
Medication Issues and Concerns laxa
Page 395 and 396:
Medication Issues and Concerns Resp
Page 397 and 398:
Medication Issues and Concerns hygi
Page 399 and 400:
Medication Issues and Concerns All
Page 401 and 402:
iperiden trihexyphenidyl olanzapine
Page 403 and 404:
NOTE: This review is not intended t
Page 405 and 406:
If during the review, you identify
Page 407 and 408:
How he/she approaches the MRR proce
Page 409 and 410:
o Failure to monitor a medication c
Page 411 and 412:
42 CFR 483.20(b), F272, Comprehensi
Page 413 and 414:
Complications (such as diarrhea wit
Page 415 and 416:
NOTE: If Severity Level 3 (actual h
Page 417 and 418:
―Resident Condition‖ -- The res
Page 419 and 420:
Medication Errors Due to Failure to
Page 421 and 422:
Medications Administered with Enter
Page 423 and 424:
if the facility uses the ―recap
Page 425 and 426:
technique requires a comparison of
Page 427 and 428:
eaction to the vaccine than would h
Page 429 and 430:
o Persons who are 50 years of age o
Page 431 and 432:
Sampling: To determine if education
Page 433 and 434:
Processes to address issues that ar
Page 435 and 436:
The facility failed to document tha
Page 437 and 438:
Requires immediate correction as th
Page 439 and 440:
(ii) other nursing personnel. §483
Page 441 and 442:
(3) The State finds that, for any p
Page 443 and 444:
(A) Has only patients whose physici
Page 445 and 446:
For SNFs and SNF/NFs which may be w
Page 447 and 448:
Assessing special nutritional needs
Page 449 and 450:
Probes: §483.35(c)(1) Are resident
Page 451 and 452:
___________________________________
Page 453 and 454:
Interpretive Guidelines: §483.35(f
Page 455 and 456:
―Food Preparation‖ refers to th
Page 457 and 458:
for growth of harmful pathogens. Ba
Page 459 and 460:
Source of Primary Agents of Primary
Page 461 and 462:
Food Receiving and Storage When foo
Page 463 and 464:
specified below will either kill da
Page 465 and 466:
may consist of a combination of foo
Page 467 and 468:
at the manifold, which is the area
Page 469 and 470:
INVESTIGATIVE PROTOCOL SANITARY CON
Page 471 and 472:
2. Interview Observe that foods are
Page 473 and 474:
cooling, and ensure that PHF/TCS fo
Page 475 and 476:
2. Degree of harm (actual or potent
Page 477 and 478:
Severity Level 1 Considerations: No
Page 479 and 480:
Intent: §483.35(h) The intent of t
Page 481 and 482:
Whether they are assisting assigned
Page 483 and 484:
and drink. If concerns are identifi
Page 485 and 486:
Compliance with 42 CFR 483.35(h), F
Page 487 and 488:
eligibility to eat and drink with a
Page 489 and 490:
Examples of the facility‘s non-co
Page 491 and 492:
delegating and supervising follow-u
Page 493 and 494:
Probes: §483.40(b) Do services ord
Page 495 and 496:
For what reasons are residents sent
Page 497 and 498:
(2) Obtain the required services fr
Page 499 and 500:
Probes: §483.45(a)(1)(2) 1. For ph
Page 501 and 502:
a care plan must be developed, foll
Page 503 and 504:
Are residents missing teeth and may
Page 505 and 506:
Definitions are provided to clarify
Page 507 and 508:
The National Coordinating Council f
Page 509 and 510:
Establish procedures that address m
Page 511 and 512:
How the receipt of medications from
Page 513 and 514:
Documentation of actual disposition
Page 515 and 516:
the pharmaceutical services. Fourth
Page 517 and 518:
The facility‘s failure to involve
Page 519 and 520:
The facility in collaboration with
Page 521 and 522:
(2) The pharmacist must report any
Page 523 and 524:
errors, or other irregularities, an
Page 525 and 526:
NOTE: The surveyor‘s review of me
Page 527 and 528:
o Seizure activity; o Spontaneous o
Page 529 and 530:
Common Medication-Medication Intera
Page 531 and 532:
The identification of any irregular
Page 533 and 534:
aspects of pharmaceutical services.
Page 535 and 536:
The pharmacist‘s MRR failed to id
Page 537 and 538:
(3) Determines that drug records ar
Page 539 and 540:
During a medication pass, medicatio
Page 541 and 542:
This requirement has several aspect
Page 543 and 544:
Determine whether the noncompliance
Page 545 and 546:
§483.65 Infection Control The faci
Page 547 and 548:
―Contact precautions‖ are measu
Page 549 and 550:
Critical aspects of the infection p
Page 551 and 552:
Conducting data analysis to help de
Page 553 and 554:
observations of staff practices and
Page 555 and 556:
Complications from invasive diagnos
Page 557 and 558:
Airborne transmission can occur by
Page 559 and 560:
After removing gloves or aprons; an
Page 561 and 562:
Depending on the situation, options
Page 563 and 564:
tears or holes be replaced. It is r
Page 565 and 566:
ENDNOTES 68 Siegel, J.D., Rhinehart
Page 567 and 568:
Guidelines for environmental infect
Page 570 and 571:
INVESTIGATIVE PROTOCOL FOR INFECTIO
Page 572 and 573:
Multiple use items (e.g., shower ch
Page 574 and 575:
Interview the Designated Infection
Page 576 and 577:
Utilize infection precautions to mi
Page 578 and 579:
Properly implement transmission bas
Page 580 and 581:
influenza in residents on another,
Page 582 and 583:
§483.70(a)(6)(ii) The dispensers a
Page 584 and 585:
Additional guidance is available in
Page 586 and 587:
§483.70(d)(1)(i) Accommodate no mo
Page 588 and 589:
Procedures: §483.70(d)(1)(iv) Ther
Page 590 and 591:
Interpretive Guidelines: §483.70(d
Page 592 and 593:
centralized nursing station, this c
Page 594 and 595:
Are spaces adaptable for all intend
Page 596 and 597:
defined as substandard quality of c
Page 598 and 599:
(ii) Responsible for the management
Page 600 and 601:
Probes: §483.75(e)(2 - 4) During a
Page 602 and 603:
1919(e)(2)(A) of the Act the facili
Page 604 and 605:
Interpretive Guidelines: §483.75(f
Page 606 and 607:
The medical director helps the faci
Page 608 and 609:
MEDICAL DIRECTION The facility is r
Page 610 and 611:
The medical director is responsible
Page 612 and 613:
REFERENCES 1 Pattee JJ, Otteson OJ.
Page 614 and 615:
support with ventilators, intraveno
Page 616 and 617:
The medical director provides input
Page 618 and 619:
V. DEFICIENCY CATEGORIZATION (Part
Page 620 and 621:
NOTE: If immediate jeopardy has bee
Page 622 and 623:
Intent: §483.75(j)(1) The intent o
Page 624 and 625:
Probes: §483.75(j)(1)(i) - (iv) Ar
Page 626 and 627:
An inability to order radiological
Page 628 and 629:
There is a written policy, at the h
Page 630 and 631:
If there is a problem with confiden
Page 632 and 633:
(i) Residents will be transferred f
Page 634 and 635:
Preventing deviation from care proc
Page 636 and 637:
Meetings of the QAA committee must
Page 638 and 639:
INVESTIGATIVE PROTOCOL QUALITY ASSE
Page 640 and 641:
The assigned surveyor should interv
Page 642 and 643:
2. Degree of harm (actual or potent
Page 644 and 645:
The facility‘s QAA committee meet
Page 646 and 647:
R04SOM 11/12/2004 Guidance to Surve
Page 648 and 649:
e. Special Care Fl19____ Receiving
Page 650 and 651:
Form CMS-672 (10/10) ReSIDent CenSu
Page 652 and 653:
Form CMS-672 (10/10) ReSIDent CenSu
Page 654 and 655:
DEPARTMENT OF HEALTH AND HUMAN SERV
Page 656 and 657:
22. Psychoactive Medications: If th
Page 658 and 659:
16. Weight Change/Nutrition/Swallow
Page 660 and 661:
RESIDENT REVIEW WORKSHEET (continue
Page 662:
RESIDENT REVIEW WORKSHEET (continue
show all

CMS Manual System - Louisiana Department of Health and Hospitals

Create successful ePaper yourself

Delete template?

Save as template?