Blog - Senior Care Solutions

Staff-2022

02/Jun/2023

It’s easy for leaders to get stuck in the day to day to do lists and get wrapped up in meeting after meeting, but it’s so important to take time to interact with your team and try to bring “fun” to work each day. Here are a few ideas to try with your team.

1. Conduct your daily stand-up meeting or weekly team meeting outside or in a new location to change it up.

2. Have lunch as a team once per month, whether everyone brings their own lunch, you order in or have a potluck style lunch! I challenge you not to discuss work over your team lunch and to really take the time to be present with your team and build relationships with them.

3. Go for team walks! Fresh air, sunshine and exercise have so many positive benefits. It could be as simple as a walk around the block or building just to get team members out of their office and reset for the rest of their day. Put this on your team calendar a few times a week with a meeting location and see who can join you.

4. Make your daily stand-up meetings fun! Start the meeting with an interactive question and have each team member provide a response: What’s your favorite restaurant? Favorite vacation location? Favorite season? What is something you’re looking forward to? Or bring a Bluetooth speaker and play some music to start out the meeting.

5. Monthly team building activity – team scavenger hunt, bring in baby picture and guess who is who, team baking/cooking competition – example: who makes the best chocolate chip cookies? Ask your team for ideas and plan them out for the year.

It’s so crucial as a leader to set an example for your team. Show them that you encourage and support having fun at work! Show them you’re taking the time to invest in them beyond the work tasks. I encourage you to set aside 10 minutes this week to brainstorm and plan out 3 new ideas to try with your team. Keep it simple!!

Staff-2022

04/Apr/2023

How is your organization dealing with the shortage of healthcare talent?
In addition to permanent staff, many healthcare organizations need to rely on supplemental staff to maintain adequate staff levels. Supplemental staffing can offer various options, including emergency coverage, single shifts, block booking, or extended contracts. Assignment dates and lengths can vary, depending on your needs. Your organization may also use a combination of these options at different times and in different situations. If you are using supplemental staffing in your facility, keep the following valuable tips in mind.

1. Accreditation
Since not all staffing agencies are created equally, you will want to ensure they meet certain criteria before partnering with them. First, verify the agency in consideration is properly registered with the MDH Supplemental Nurse Services Agency. Next, read the reviews and testimonials to better understand the agency’s capabilities and what to expect when making the organization a trusted partner.

2. Personnel Record
When a facility contracts with a supplemental staffing agency, those individuals must meet the same requirements required for personnel employed by the facility. Therefore, the supplemental staff should be treated as employees of the facility. As such, facility management should request a copy of the employee’s background study, TB testing, licensure verification, and completed required educationand training records. Finally, records should be maintained for each supplemental staff member employed at your facility. Minnesota
Department of Health has been targeting supplemental staff employee records during surveys. Make sure you are prepared.

3. Agency Orientation
Like your facility employees, agency individuals need to be appropriately orientated to your site to help ensure quality care to residents and teamwork among staff. Create a supplemental staff orientation checklist to review with a new agency employee. Include topics such as:

> orientation to residents and care plans

> equipment use

> medication system

> communication system

> infection control practices

> emergency procedures

> policies and procedures, including vulnerable adult

It is helpful to have all this content in a central binder. Have a designated facility staff member responsible for the supplemental staff to report directly to should they have questions or need further support.

The Bottom Line
As the staffing shortage looms, the need for proper staffing is critical to help prevent staff burnout and maintain quality resident care. With more healthcare facilities beginning to understand the importance of having a multi-faceted approach to staffing and MDH focusing on contracted staff, leaders need to become more knowledgeable about the different types of staffing agencies and factors to consider to best fit their needs.

For more information on Supplemental Staffing Suport contact us at Consult@srcaresolutions.net.

Staff-2022

10/Oct/2022

There are no requirements in facilities for coffee temperature. The preferred temperature for brewing is 195 degrees or greater -— but it only takes 1 second for a serious burn to occur from liquids starting at 155 degrees.

The issue with turning the temperature down is that the coffee doesn’t brew as well and people complain about the
flavor -— we can’t turn the coffee machines down low enough to be safe without sacrificing quality. So, the answer is to eliminate the risk of burns by taking preventative steps: locking machines, moving the machines, making public coffee only available in air pots, using travel mugs with spill-resistant lids, etc.

If burns are happening from coffee pots -— leave pots open in the kitchen after filling, before covering and putting in resident reach or add ice cubes to the pot to achieve a safer, yet still palatable temperature.

Time and Temperature for Water to Cause a Serious Burn in a Healthy Adult
155ºF 68ºC 1 second
140ºF 60ºC 5 seconds
127ºF 52ºC 1 minute
120ºF 48ºC 5 minutes
100ºF 38ºC safe bathing temp

For more information on health and safety practices visit our website at srcaresolutions.net.

Staff-2022

30/Aug/2022

From the desk of Julie —

It’s hard to believe a year has passed since the Minnesota Department of Health (MDH) introduced new assisted living regulations. To date, there have been 346 survey results posted by MDH. The average number of deficiencies per survey is approximately 14. The top five most common survey deficiencies cited following a state survey were:

1. Tag 0810: 144G.45 Subd. 2 (b)-(f) Fire protection and physical environment – Fire Safety and Evacuation Plans, Training, and Drills (79% of surveys)
Common problems identified:

No evidence employees were trained on fire safety and evacuation plans upon hire and twice per year
No evidence of a plan or policy/procedure to make available annual fire safety and evacuation training for residents able to assist in their own evacuation
Fire/evacuation drills were not planned or documented
Failure to ensure fire safety and evacuation plans were readily available to residents, staff, and visitors
Failure to identify residents who may need additional assistance for evacuations

2. Tag 0480: 144G.41 Subdivision 1. (13) (i) (B) facility is not following the Minnesota Food Code, Ch. 4626; Completed by EH – (75% of surveys)
Common problems identified:

Inaccurate refrigerator temperature or no thermometer to check the temperature
TCS food not date-labeled or stored past date
No method to verify sanitizing solution (test strips) or no solution available
No certified food protection manager is employed or being shared across multiple communities
No proof staff had been trained in vomit or fecal matter cleanup procedures, and no PPE or cleanup kit made readily available
Improper food storage – dry goods on the floor, food stored on the floor of the walk-in cooler, raw foods not on the lowest level of the refrigerator
Unkempt kitchen area – rusty shelves, soiled mugs, slime on ice machine, light bulbs burned out, grease on the floor, floor drain missing a cover

3. Tag 0680: 144G.42 Subd. 10 – Disaster planning and emergency preparedness plan – (60% of surveys)
Common problems identified:

No prominent signage or postings regarding the facility’s emergency plan at the facility entrance, in the hallways, in the dining area, or the living areas
Emergency exit diagrams were not posted on each floor
Emergency preparedness staff training (on hire and twice annually) was not planned or documented
Emergency drills were not planned or documented
Hazard Vulnerability Analysis lacking analysis of potential vulnerabilities
Emergency Preparedness Plan failed to describe the population served by the facility, the process for cooperation with state and local officials, and policies and procedures for sheltering in place

4. Tag 0800: 144G.45 Subd. 2 (a) Physical environment – Good Repair and Condition – (48% of surveys)
Common problems identified:

Emergency lights or regular lights that do not work
Doors held open by wedges or that do not latch properly
Exit doors blocked
Inadequate unobstructed space below sprinkler heads
Loose or missing handrails
Flooring – cracked or missing tiles, worn or torn carpeting
Windows in secured unit missing stoppers to restrict resident elopement
Windows in sleeping rooms that are too small.

5. Tag 0780: 144G.45 Subd. 2. (a) (1) Fire protection and physical environment – Smoke Alarms – (42% of surveys)
Common problems identified:

Unplugged smoke alarms
Smoke alarms not installed where required
Disconnected or disabled smoke alarms
Smoke alarms with dead batteries or expired (more than10 years old)
Smoke alarms that were not interconnected within a unit
Obstructed sprinkler heads or covered in lint
Use of unfused and unapproved power strips and multiplug adapters

* Data obtained from Care Providers of Minnesota

What this means for you:
Be prepared for when the state arrives at your facility. As you can see, most of the top deficiencies are areas new to the assisted living license – food code and environmental. Make sure your maintenance and kitchen staff understand the new regulations. Have your maintenance team conduct environmental inspections to ensure that your facility is in good condition and that the emergency plan is up to code. Make sure to have a Certified Food Protection Manager and that there is always a person in charge. Managers should conduct routine audits of kitchens and staff to ensure proper food safety.

For assistance with updating your documents please visit our website at srcaresolutions.net.

Julie Dietz, RN, PHN
Senior Assisted Living Consultant
julie.dietz@srcaresolutions.net

Senior Care Solutions

21/Jul/2022

From the desk of Julie —

Are you complying with recently passed changes to Minnesota’s long-term care consultation services statute?Many of the provisions affecting assisted living licensees, become effective August 1, 2022.

Here is a summary of the key changes —

Changes to the Assisted Living Bill of Rights. Modifies the assisted living bill of rights regarding personal treatment and privacy. “Residents have the right to consideration of their privacy, individuality, and cultural identity as related to their social, religious, and psychological well-being. Staff must respect the privacy of a resident’s space by knocking on the door and seeking consent before entering, except in an emergency unless otherwise documented in the resident’s service plan.”

B. Modifies the additional language that must be provided with the assisted living bill of rights. “If you want to report suspected abuse, neglect, or financial exploitation, you may contact the Minnesota Adult Abuse Reporting Center (MAARC). If you have a complaint about the facility or person providing your services, you may contact the Office of Health Facility Complaints, Minnesota Department of Health. If you would like to request advocacy services, you may contact the Office of Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health and Developmental Disabilities.”

Changes to the grievance policy. Removes the requirement in the posted grievance policy to post the contact information for regional ombudsman.

B. Adds a requirement in the posted grievance policy to state that if an individual has a complaint about the facility or person providing services, the individual may contact the Office of Health Facility Complaints at the Minnesota Department of Health.

Changes to the assisted living contract. Modifies information that must be included in an assisted living contract, to require “a delineation of the grounds under which residents may have housing terminated or be subject to emergency relocation.”

B. Also requires the facility’s health facility identification number, rather than license number, to be included on the contract in a conspicuous place and manner.

Most areas of 144G that currently reference the Office of Ombudsman for Long-Term Care will now also be required to reference the Office of Ombudsman for Mental Health & Developmental Disabilities. Documents needs to include the following language:“You may contact the Ombudsman for Long-Term Care for questions about your rights as an assisted living facility resident and to request advocacy services. As an assisted living facility resident, you may contact the Ombudsman for Mental Health and Developmental Disabilities to request advocacy regarding your rights, concerns, or questions on issues relating to services for mental health, developmental disabilities, or chemical dependency.”

Documents impacted by the new language:• Notice to residents (144G.20 Subd.12)• Resident transfer plans regarding final revocation, refusal to renew, or suspension of license (144G.20 Subd. 15)• Notice regarding a meeting to discuss a resident’s termination (144G.52 Subd.2)• Included as part of the content of notice of termination (144G.52 Subd.8)• Included as part of the content of emergency relocation (144G.52 Subd.9)• Included as part of the content of nonrenewal of housing (144G.53(b))• Included as part of the content of a coordinate move (144G.55 Subd.1)• Included as part of the content of a transfer within the facility (144G.56 Subd.3)• Included as part of the content of a closure plan (144G.57 Subd.3)• Included as part of the resident notice regarding an approved closure plan (144G.57 subd.5)• Included as a required element of the service plan (144G.70 Subd.4)• Included in the updated assisted living bill of rights (144G.91 Subd.21)• Included as a reason to prohibit retaliation (contact with) regarding complaints (144G.92 Subd.1)• Included as information to be included with every assisted living contract (144g.93)

What this means for you:The new law will require administrators and nursing staff to once again update their notices, postings, and policies. Contracts and service plans will need to be modified, and a new bill of rights will need to be provided. For a full review of all the changes, see the attached link to the Minnesota Department of Health 06/16/2022 bulletin. HTTPS://content.govdelivery.com/accounts/MNMDH/bulletins/31c5092

For assistance with updating your documents please visit our website at srcaresolutions.net.

Julie Dietz, RN, PHNSenior Assisted Living ConsultantSenior Care Solutionsjulie.dietz@srcaresolutions.net

Staff-2022

21/Jun/2022

From the desk of Andrea —

The current staffing turnover and retention rates in skilled nursing homes and assisted living facilities, as well as the previous focus on infection control surveys has contributed to regulatory oversight during the COVID-19 pandemic. Immediate Jeopardy tags are on the rise, with an increasing number related to inappropriate use of slings. Factors to consider include appropriate sling size, documentation of sling size on the service/care plan and specific instruction easily available to ULP and CNAs. Additional consideration should consist of adequate supply and how the condition of a sling is determined for replacement.

Manufacturers have instruction and sizing charts available. It is recommended to keep these laminated and attached to the lift for easy reference and to verify appropriate sling size is in use. Routine audits should be conducted to ensure appropriate size selection and to ensure care/service plan matches the currently used sling. As a reminder, ensure equipment is cleaned thoroughly between resident rooms. While infection control remains a focal point in healthcare surveys, this is a reminder to shift the focus towards resident safety, which encompasses both clinical operation and infection prevention.

Andrea Raeker
Director of Administration
Senior Care Solutions

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