I/J on the Rise in Recent Care Center Surveys

Posted on February 26, 2019 by Sue Boyd

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