Residential Care Facility – September Deficiency and Offense Citation Update

There were 32 deficiency citations and 3 offense citations issued to Residential Care Facilities in September (click here for a summary of the September deficiency and offense citations).  A total of 8 citations were issued for Tag 217 concerning use of appropriately trained staff to complete resident evaluations and service plans, and review, revision and resident agreement with those evaluations and plans.  All but one of the citations were due to residents, or their representatives, not signing the service plan.  The ISDH interprets its regulation concerning service plans to require residents, or their representatives, to sign the service plan every time it is evaluated and whether or not changes are made to the service plan.  Service plans must, at a minimum, be updated semiannually or upon a substantial change in condition.  Tag 217 is now tied for 1st as the most often cited deficiency tag in 2013 (tied with Tag 273, concerning kitchen sanitation and food handling, which was cited 3 times in September; each have been cited 34 times in 2013).

September also saw 4 citations for Tag 117 concerning sufficient staffing, qualifications, and training.  This tag was cited 3 times in August as well, but only 4 other times in 2013 before the last two months.  This appears to  be the beginning of a trend and facilities should focus some attention to ensuring compliance.  In addition, Tag 241 continues to be cited with regularity for alleged failure to dispense medications with only either licensed nurses or QMAs. Lastly, the following were cited for the first time in 2013 at the deficiency level:  Tag 45 (resident notification regarding interfacility transfer); Tag 86 (compliance with all applicable laws); and Tag 118 (providing ADL assistance by unlicensed personnel that are not either a CNA or HHA).

Also in September, a facility was cited for F323 as past noncompliance due to the elopement of a resident with known elopement risk.  It appeared that the facility did not have a consistent plan for monitoring residents deemed high risk for elopement.  Lastly in September, a facility was cited F371 and F469 for failure to maintain a sanitary kitchen due to evidence of rodent activity.