SMART Update

F-Tag 309, Quality of Care, continues to be a frequently cited F Tag in Virginia with an underlying trend of "not following physician orders” as the leading reason for the deficiencies.  The trend stretches across multiple areas of care, including medication administration, monitoring vital signs, administration of treatments, restorative nursing, nutrition, etc.

In reviewing 2567 Deficiency Reports contained in VHCA’s SMART database, it is noteworthy that 25 of the 55 surveys included citations for Quality of Care at F-309.  Of these, 60% of the citations included a specific violation related to physician orders not followed and more than 80% a result of medications not being administered per order.  Reasons for deficiencies cited included medication omissions, medications not discontinued when ordered, medication errors and others related to not following parameters for administration.

Other reasons for citations at F309 included deficiencies based on orders for devices not being applied [i.e. alarms, TED hose, etc.] and those related to vital signs not being obtained per order.  Other deficiencies were associated with not following orders for diabetic management and obtaining consults timely.   

Help VHCA keep members updated with survey outcomes, customized reports of survey trends across the state and VHCA districts, as well as benchmarking opportunities within your organization by sending your 2567s to be included in VHCA’s SMART database.  The SMART database helps assist members with a resource to prepare for and improve outcomes in the long term care survey.  We encourage members to take advantage of SMART to view and analyze current trends and patterns of citations in Virginia’s nursing facility survey process.  If you have not yet forwarded your survey reports to Mary Chiles, please email them to her or send copies to her at Chiles Healthcare Consulting, 1908 Maple Shade Lane, Richmond, Virginia 23227.