Russell Regional Hospital Ltcu

Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

Provide and implement an infection prevention and control program.

Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.

Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.

Not hire anyone with a finding of abuse, neglect, exploitation, or theft.

Respond appropriately to all alleged violations.

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Ensure each resident’s drug regimen must be free from unnecessary drugs.

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

Develop and implement policies and procedures for flu and pneumonia vaccinations.

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.

Provide and implement an infection prevention and control program.

Ensure each resident receives an accurate assessment.

Provide care by qualified persons according to each resident's written plan of care.

Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

Provide appropriate pressure ulcer care and prevent new ulcers from developing.