Facility Self-Assessment (Mock Survey) Tool - Nursing Home Help
Facility Self-Assessment (Mock Survey) Tool - Nursing Home Help Facility Self-Assessment (Mock Survey) Tool - Nursing Home Help
F-356 Posting Nursing Staff. 1. Data requirements: The facility must post the following information on a daily basis: a. Facility name; b. Current date; c. Total number and actual hours worked by the following categories of licensed and unlicensed nursing staff directly responsible for resident care per shift: - Registered nurses, - Licensed practical nurses or licensed vocational nurses. - Certified nurse aides, d. Resident census; 2. Posting requirements: a. Facility must post the nurse staffing date specified in paragraph (e)(1) of this section on a daily basis at the beginning of each shift. b. data must be posted as follows: - Clear and readable format, - In a prominent place readily accessible to residents and visitors. 3. Public access to posted nurse staffing data. 4. Facility data retention requirements. / / F-360 Dietary Services. The facility must provide each resident with a nourishing, palatable, well-balanced diet that meets the daily nutritional and special dietary needs of each resident. F-361 Staffing. The facility must employ a qualified dietitian either full-time, part-time, or on a consultant basis. F-362 Sufficient Staff. The facility must employ sufficient support personnel competent to carry out the functions of the dietary service. F-363 Menus and Nutritional Adequacy. 1. Meet the nutritional needs of resident in accordance with the recommended dietary allowances of the Food and Nutritional Board of the National Research Council, National Academy of Sciences; 2. Be prepared in advance; and 3. Be followed. DIETARY SERVICES / / / / / / / / 5.20
F-364 Food. Each resident receives and the facility provides: 1. Food prepared by methods that conserve nutritive value, flavor and appearance; 2. Food that is palatable, attractive, and at the proper temperature. F-365 Food Meets Individual Needs. Each resident receives and the facility provides food prepared in a form designed to meet individual needs. F-366 Substitutes Offered. Each resident receives and the facility provides substitutes offered of similar nutritive value to residents who refuse food served. F-367 Therapeutic Diets. Therapeutic diets must be prescribed by the attending physician. F-368 Frequency of Meals. 1. Each resident receives and the facility provides at least three meals daily, at regular times comparable to normal mealtimes in the community. 2. There must be no more than 14 hours between a substantial evening meal and breakfast the following day, except as provided in (4) below. 3. The facility must offer snacks at bedtime daily. 4. When a nourishing snack is provided at bedtime, up to 16 hours may elapse between a substantial evening meal and breakfast the following day if a resident group agrees to this meal span, and a nourishing snack is served. F-369 Assistive Devices. The facility must provide special eating equipment and utensils for residents who need them. F-371 Sanitary Conditions. The facility must store, prepare, distribute, and serve food under sanitary conditions. F-372 Dispose of Garbage & Refuse Properly. The facility must dispose of garbage and refuse properly. / / / / / / / / / / / / / / / / 5.21
- Page 1 and 2: Facility Self-Assessment (Mock Surv
- Page 3 and 4: LONG-TERM CARE SURVEY MANUAL PREPAR
- Page 5 and 6: Self-Assessment/Mock Survey Today,
- Page 7 and 8: 483.60 PHARMACY F-425 Pharmacy Serv
- Page 9 and 10: F-155 Refusal of Treatment. The res
- Page 11 and 12: deny or withdraw consent at any tim
- Page 13 and 14: F-223 Abuse. The resident has the r
- Page 15 and 16: F-252 Environment. The facility mus
- Page 17 and 18: F-285 Pre-Admission Screening for M
- Page 19 and 20: F-320 Adjustment Difficulty. The fa
- Page 21: F-353 Nursing Services/Sufficient S
- Page 25 and 26: F-390 Doctor Delegation of Tasks Pe
- Page 27 and 28: F-454 Physical Environment. The fac
- Page 29 and 30: F-494 Required Training NA. The fac
- Page 31 and 32: F-512 Transportation To/From. The f
- Page 33 and 34: QUALITY INDICATOR REPORT RESULTS QI
- Page 35 and 36: Process - Survey Tasks Survey Task
- Page 37 and 38: MEAL MONITOR ASSIGNMENT AND TIMES D
- Page 39 and 40: SURVEY SCOPE & SEVERITY GRID Append
- Page 41 and 42: DEPARTMENT OF HEALTH AND HUMAN SERV
- Page 43 and 44: RESIDENT REVIEW WORKSHEET (continue
- Page 45 and 46: DEPARTMENT OF HEALTH AND HUMAN SERV
- Page 47 and 48: FIRST IMPRESSIONS CHECKLIST Item to
- Page 49 and 50: ADMINISTRATION CHECKLIST Area Yes N
- Page 51 and 52: Instructions: 1. Complete review on
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- Page 55 and 56: PHYSICAL PLANT ROUNDS - INITIAL TOU
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- Page 59 and 60: FIRE DRILL GRID JAN FEB MAR APR MAY
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- Page 63 and 64: DEPARTMENT OF HEALTH AND HUMAN SERV
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- Page 69 and 70: INVESTIGATIVE PROTOCOL HYDRATION Ob
- Page 71 and 72: developed a care plan that includes
F-356 Posting <strong>Nursing</strong> Staff.<br />
1. Data requirements: The facility must post the<br />
following information on a daily basis:<br />
a. <strong>Facility</strong> name;<br />
b. Current date;<br />
c. Total number and actual hours worked by the<br />
following categories of licensed and unlicensed<br />
nursing staff directly responsible for resident care per<br />
shift:<br />
- Registered nurses,<br />
- Licensed practical nurses or licensed vocational<br />
nurses.<br />
- Certified nurse aides,<br />
d. Resident census;<br />
2. Posting requirements:<br />
a. <strong>Facility</strong> must post the nurse staffing date specified<br />
in paragraph (e)(1) of this section on a daily basis at<br />
the beginning of each shift.<br />
b. data must be posted as follows:<br />
- Clear and readable format,<br />
- In a prominent place readily accessible to<br />
residents and visitors.<br />
3. Public access to posted nurse staffing data.<br />
4. <strong>Facility</strong> data retention requirements.<br />
/ /<br />
F-360 Dietary Services. The facility must provide each<br />
resident with a nourishing, palatable, well-balanced<br />
diet that meets the daily nutritional and special dietary<br />
needs of each resident.<br />
F-361 Staffing. The facility must employ a qualified dietitian<br />
either full-time, part-time, or on a consultant basis.<br />
F-362 Sufficient Staff. The facility must employ sufficient<br />
support personnel competent to carry out the functions<br />
of the dietary service.<br />
F-363 Menus and Nutritional Adequacy.<br />
1. Meet the nutritional needs of resident in accordance<br />
with the recommended dietary allowances of the Food<br />
and Nutritional Board of the National Research<br />
Council, National Academy of Sciences;<br />
2. Be prepared in advance; and<br />
3. Be followed.<br />
DIETARY SERVICES<br />
/ /<br />
/ /<br />
/ /<br />
/ /<br />
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