QUALITY OF CARE ROUNDS - Nursing Home Help

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Figure A.7Survey tag assignment (cont.)Tag descriptionDepartmentalresponsibilityTeammember nameCommentsF 454-456 Physical environment• Life safety code requirements• Emergency power system• Emergency generator for life support system• Equipment in safe operating conditionF 457-461 Resident rooms• No more than 4 residents per room• 80 square feet per resident in multiples rooms,100 square feet per resident in singles• Direct access to exit corridor• Adequate privacy• Window, floor above gradeF 462 Toilet facilities• Room contains or is near toilet facilitiesF 463 Resident call system• <strong>Nursing</strong> station is equipped for calls fromrooms and bathroomsF 464-469 Dining and resident activities• Rooms are well-lighted, well ventilated;adequate outside ventilation• Non-smoking areas identified• Adequately furnished• Sufficient space• Corridors have secure handrails• Effective pest-controlF 490 Administration• Effectively administeredF 491 Licensure• Under applicable state and local lawsF 492 Compliance with federal, state, andlocal laws and professional standards• Includes compliance with other HHS regulationsF 493 Governing body• Licensed by state• Responsible for management4.69
Figure A.7Survey tag assignment (cont.)Tag descriptionDepartmentalresponsibilityTeammember nameCommentsF 494-498 Training of nursing aides• Employee of more than 4 months hascompleted training• Apply same rules to temps• Meet competency requirements• Registry verification• 12 hours of inservice/yearF 499-507 Staff qualifications• Professional staff must be licensed, certified,or registered in accordance withapplicable state laws• Outside professional used for services thatcan’t be met with facility staff• Medical director• Timely laboratory service• Resident transportation providedF 508-513 Radiology and other diagnostic services• Meet the needs of residents• Meet applicable conditions of participation• Obtain services according to physicianorders, notify physician of finds• Provide transportation• File in clinical recordF 514-516 Clinical record• Complete, accurate, readily accessible,systematically organized• Contains sufficient information to identifythe resident• Contains record of assessments and careplans, services• Contains preadmission screening if requiredby state• Retained for specified period of time• Information protected from public, loss,destruction, unauthorized use4.70
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Quality ofCare RoundsUnlike the Moc
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RR SS PE IC EP F-Tag Observations S
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Exit lightsRESIDENT ROOMS “U”
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OTHER AREAS “U” “S” COMMENT
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Thawing foods put in refrigerator c
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SS follows upon discharge needs of
Page 20 and 21: - re-feeding/walk and dine- bowel/b
Page 22 and 23: Pumps/poles and equipment cleanWEIG
Page 24 and 25: No expired medications on handSharp
Page 26 and 27: Medical Director review of all repo
Page 28 and 29: MDS/CARE PLAN TRACKING FORMName: Ro
Page 30 and 31: HOT HOLDINGHot holding unit / steam
Page 32 and 33: Step ladders are sturdy and in good
Page 34 and 35: Yes No Buckets, tubs and pans are i
Page 36 and 37: Yes No Cleaning schedules posted an
Page 38 and 39: INFECTION CONTROL AND SAFETY SURVEI
Page 40 and 41: Yes No Electric cords for lights, r
Page 52 and 53: Yes No All wandering bracelets are
Page 54 and 55: Extended menusavailableDumpster lid
Page 56 and 57: Housekeeping Carts, Equipment, and
Page 58 and 59: Facility InspectionFacility _______
Page 60 and 61: Facility Inspection ReportPossibleA
Page 62 and 63: Facility Inspection ReportAREAScore
Page 64 and 65: Figure A.7Survey tag assignment (co
Page 72: Figure A.7Survey tag assignment (co
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