Top Ten Nursing Home Health Deficiencies

Nursing homes in the United States are inspected every 15 months or less to ensure that all federal regulations are followed in the deliverance of care. According to the Department of Health and Human Services, state regulators inspect the physical environment, infection control, medical care, rehabilitative care, nursing care, dietary services, activity services, sanitation, and social interaction. A citation occurs when a facility's care or environment falls short of federal standards. The Centers for Medicaid and Medicare Services outline 190 probable deficiencies. The deficiencies fall under the categories of laboratory/radiology services, administration, physical environment, infection control, pharmacy services, dental services, rehabilitative services, physician services, resident rights, admission/transfer/discharge rights, resident behavior/facility practices, quality of life, resident assessment, quality of care, dietary services, and nursing services. The Henry J. Kaiser Family Foundation lists the following deficiencies in 2008 as the 10 most frequently cited practices:
  1. Nursing and Documentation

    • 1. Quality of care

      Quality of care concerns the insurance that all services provide care that is specifically defined by federal regulations

      2. Pressure sores

      Citations that address the care required to manage or prevent open sores (pressure sores).

      3. Infection control

      Staff adheres to policies and procedures to address infection control issues such as blood borne pathogens, cleanliness, or infectious disease.

      4. Comprehensive care plans

      The care plan describes an accurate program of care for the patient.

      5. Clinical records

      The patient record accurately reflects all services and care provided to the patient.

      6. Unnecessary drugs

      All drugs ordered by the physician on a PRN (as needed) or routine basis will follow regulations set forth by the individual state board of nursing.

    Environment

    • 7. Accident and Environment

      All accidents and environmental hazards are reported and managed in accordance to regulations.

      8. Housekeeping

      Nursing homes provide a clean, orderly, and safe environment to patients.

    Miscellaneous

    • 9. Food sanitation

      Food is stored, prepared and handled in a sanitary manner.

      10. Professional standards

      All services provided follow individual program specifications to ensure consistency in care.

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