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LTC FTag 676
| Question | Answer |
|---|---|
| What is Ftag 676 (483.24) all about, what does it cover? | Based on Comprehensive assessment of a resident's needs & choices facility must provide necessary care & services to ensure a resident's abilities in ADLs don't diminish unless circumstances of a clinical condition was unavoidable. |
| What are the areas Ftag 676 ADLs cover, name five... | Hygiene Mobility Elimination Dining Communication |
| Give an example of what would you cite as Hygiene substandard quality of care. | Example: A resident who required extensive bathing assistance was scheduled to receive seven showers in a specific month, but the bathing record report showed he only had been showered twice. |
| Give an example of what would you cite as Mobility substandard quality of care. | A cognitively impaired resident had a decline in ambulation over 9-month's, leading to resident being unable to walk. Neither the Quarterly MDS or Dr’s notes addressed a clinical rationale as to why resident was no longer able to ambulate. |
| Give an example of what would you cite as Elimination substandard quality of care. | A resident assessed as requiring a 1 person assistance for toileting & mobility told surveyor that it was hard to get assistance b/c staff didn't answer his call light in a timely enough fashion to assist him with toileting needs & emptying his urinal. |
| Give an example of what would you cite as Dining substandard quality of care | Resident needing extensive assist w/ eating observed trying 5 times unsuccessfully to feed himself. During this time a nurse brought a.m. meds, no assistance offered. Resident observed to eat 5% of meal, w/o assistance. |
| Give an example of what would you cite as Communication substandard quality of care | Resident doesn’t speak English & not provided a way to communicate his needs. Interview of staff disclosed speaking slowly to resident was not helpful nor was use of a communication board on wall. There currently is a large language barrier not addressed. |
| How does a surveyor gather the majority of information for this Ftag? | By visually observing situations & following up with interviews of both the resident/staff & documentation review. |
| Where does the breakdown happen that leads to substandard quality of care and results in a citation of Ftag 676? | Because staff aren’t routinely monitoring that PoC is being carried out OR, documentation doesn’t show care/services were provided. |
| If the residents' ADLs do diminish how would the surveyor be able to tell if this decline was unavoidable? | They should be able to review the medical record, interview staff & identify that any loss was unavoidable & not reflective of an inadequate systems or poor compliance with PoC. |
| True or False: It is not uncommon for a survey to highlight the need for a facility to review its systems related to a cited Ftag? | True: It is the responsibility to provide the necessary care & services for a resident to maintain or improve their ability to carry out ADLs. |
| True or False: A resident experiencing depression and an excess reduction in ADL function should not be cited under this Ftag? | False: Depression is a potential cause of excess disability & therapeutic interventions should be initiated. Follow up if resident shows S/S of depression even if not indicated on MDS. |
Created by:
Debra Bernier 1
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