Going Through Survey is Like Going Through a Speed Trap
Going through an annual certification survey for a director of nursing or administrator of a nursing home is the equivalent of going through a speed trap. No matter how well you care for your residents throughout the year, if the surveyors find an issue during their visit, the facility is likely to get a deficiency. The job of surveyors is to ensure that a facility is compliant with minimal standards for certification, and their process is based on a sampling approach. It can be inferred that finding a problem in a sample of residents can mean that the same problem occurs in the facility as a whole. They do not have the time or resources to validate that assumption with a review of each and every resident. It is the responsibility of the surveyors to the government and to consumers to ensure that these standards are met. This can be compared with the analogy of the police officer who catches you in a speed trap. He or she does not know how good or bad a driver you are or have been. All they know for certain is that at a given point in time they caught you not being a good driver.
If you keep this concept in mind, it will help you prepare for the annual certification survey and hopefully go through it successfully. To start with, you must be a good driver to reduce your chances of getting caught in a speed trap. While even the best drivers occasionally get caught speeding, their chances of getting caught are much less than those who speed all the time and don't care. The same is true of surviving the survey-- you must give good care to reduce your chances of getting a deficiency. All the survey preparation in the world is not going to help you if you really do have quality of care issues. And if you do have serious quality of care issues, for the sake of your residents and the reputation of the industry, you probably should get deficiencies.
There are ways of avoiding getting caught in speed traps. These include keeping an eye on your speedometer, using cruise control, using a radar detector, and asking your driving companion to remind you if you get over the speed limit. Likewise, you can avoid deficiencies during a survey by monitoring the care you deliver throughout the year with a good QA program, by keeping track of your quality indicator reports and your triggers/flags, by scanning the professional environment (other facilities, trade associations, etc.) for information on latest trends in surveys, and by having an consultant perform a mock survey review to see how the care looks to an objective set of eyes.
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