ISDH IJ/SSQC Update

December 2013 IJ/SSQC
One IJ was issued in December, and that tag was also SSQC.  The citation was issued from the alleged failure to initiate CPR for a resident that has a full code status.  The resident was found in the lavatory without respirations or pulse, and the LPN that found the resident did not initiate CPR even though she was aware of the resident’s code status.  This is the third citation in 2013 for this issue, with all three citations being issued since August 2013. Click here for the December citation.

2013 Summary
The past year saw some of the fewest IJ and SSQC citations in recent memory.  For the year there were 17 IJ events and 19 SSQC events in which 36 total tags were cited.  By comparison, in 2012 there were 30 IJ events and 28 SSQC events in which 44 total tags were cited, and in 2011 there were 47 IJ events and 50 SSQC events in which 84 total tags were cited.

 

The leading citations for 2013 were F225 and F226, with 7 citations each.  The primary reason for the citation of F225 was alleged failure to timely report allegations of abuse or failure to thoroughly investigate such allegations.  F226, accompanying F225, due to the facility’s policy and procedure requiring timely reporting and thorough investigation.  That said, there were a few citations of F225 and F226 for alleged failure to prevent abuse from occurring.  The third most cited tag was F323 with 6 citations.  Citations of F323 were related to inadequate supervision to protect other residents from sexually inappropriate advances and aggressive resident behaviors, inadequate supervision leading to resident falls, inadequate supervision leading to elopement, and failure to maintain safe water temperatures.  The next most cited tag was F309, cited 4 times.  One of the citations was issued for alleged failure to ensure medications were administered as ordered by the physician, and three of the citations were issued for alleged failure to initiate CPR for residents that were full code.

 

To review a summary of all 2013 IJ and SSQC citations, click here.