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I/J on the Rise in Recent Care Center Surveys

The Minnesota Department of Health (MDH), on last week’s statewide regulatory call, reviewed top deficiency trends for nursing homes and focus areas to be targeted during CMS oversite surveys. MDH highlighted the increase in deficiencies on both complaint and survey being cited at Immediate Jeopardy level (I/J) in 2019. 

From Jan. 1, 2019 – Feb. 20, 2019, 14 I/Js were cited. A majority were the result of complaint investigations. Some of the areas identified that resulted in I/Js in 2019 are:

Free of Abuse and Neglect:

  • Suspicious bruising in groin, breast and neck area not identified, reported or investigated
  • Rough handling by staff
  • Inappropriate physical touch and yelling at resident

Free of Accident Hazards/Supervision/Devices (also #1 deficiency cited at I/J on standard and complaint survey and #1 deficiency cited at G on complaints, #2 deficiency cited at G on standard surveys in 2018)

  • Transfer with a mechanical lift – straps not properly connected to sling and sling too large
  • Failure to supervise residents at risk for falls, repeated self-transfers resulting in falls with multiple fractures
  • Smoking while using oxygen

Treatment/Services to Prevent/Heal Pressure Ulcers (also #1 deficiency cited at G on standard surveys in 2018)

  • Did not provide treatment for prevention of stage 3-4 pressure ulcers

Quality of Care

  • Did not notify the physician for a resident with bloody stools and on Coumadin resulting in hospitalization and transfusion 

MDH also summarized the top 2018 tags related to surveys, complaints, and E tags.  A complete breakdown of deficiencies with a scope of D, G and J are posted on the MDH website.  Here is a sampling of that data.

Top 10 tags - Minnesota Standard Surveys 2018

Standard Survey – Any F Codes

Tag #

Tag Description

# Citations

F0880

Infection Prevention & Control

166

F0689

Free of Accident Hazards/Supervision/Devices

105

F0686

Treatment/Svcs to Prevent/Heal Pressure Ulcer

93

F0684

Quality of Care

88

F0677

ADL Care Provided for Dependent Resident

86

F0609

Reporting of Alleged Violations

79

F0761

Label/Store Drugs and Biologicals

64

F0550

Resident Rights/Exercise of Rights

62

F0688

Increase/Prevent Decrease in ROM/Mobility

60

F0641

Accuracy of Assessments

54

 

Top 10 tags - Minnesota Complaint Surveys 2018

Complaint Surveys – Any F Codes

Tag #

Tag Description

# Citations

F0689

Free of Accident Hazards/Supervision/Devices

17

F0609

Reporting of Alleged Violations

16

F0600

Free from Abuse and Neglect

13

F0226

Develop/Implement abuse/Neglect, etc. policies

10

F0323

Free of Accident Hazards/Supervision/Devices

9

F0225

Investigate/Report Allegations/individuals

9

F0760

Residents are Free from Significant Med Errors

9

F0610

Investigate/Prevent/Correct Alleged Violation

8

F0684

Quality of Care

8

F0686

Treatment/Svcs to Prevent/Heal Pressure Ulcer

7

 

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