SNF

General Facility Information – Section 1

Provide a response to each item listed below and adjust spacing as needed for your responses.

SNF Provider Name:

City and State of the SNF:

Number of Certified Beds:

Ownership Type:

Health Inspection Details from CMS Compare Website -Section 1

Provide a response using the View Inspection Results, View Staffing Levels, and View Quality Measures information from the CMS Compare Website. Adjust spacing as needed for your responses.

Date of Most Recent Inspection:

Total Number of Health Citations:

Number of Complaint from the Past 3 Years:

Average Number of Residents per Day:

Total Number of Licensed Nurse Staff Hours per Resident per Day:

Registered Nurse Hours per Resident per Day:

Physical Therapist Staff Hours per Resident per Day:

Select 1 Detail that You Found the Most Interesting about this SNF on the CMS Compare Website and Provide the Information Below:

CMS 5-Star Ratings

Overall Rating

Health Inspection

Staffing

Quality of Resident Care

Note: Use the Section 1 information, along with any other relevant details, from the CMS Compare Site on your selected facility to complete the rounding questions in Section 3.

CMS 1567 Report: F-Tag Selection Information– Section 2

Provide a response to each item listed below and adjust spacing as needed for your responses.

F-Tag Citation 1 Information

F-Tag Number and Tag Title:

Code of Federal Regulations (Regulatory Reference):

Level of Harm (as stated on 2567):

Residents Affected (as stated on 2567):

F-Tag Citation 2 Information

F-Tag Number and Tag Title:

Code of Federal Regulations (Regulatory Reference):

Level of Harm (as stated on 2567):

Residents Affected (as stated on 2567):

Example of SNF Citation (F-Tag) Information:

(Information can be located under ID Prefix Tag on the 2567 and by using the CMS SNF F Tags List within the assignment prompt.)

F-Tag Number and Tag Title: F572 -Notice of Rights and Rules

Code of Federal Regulations (Regulatory Reference): 483.10 Resident Rights

Level of Harm (as stated on 2567): Minimal harm or potential for actual harm

Residents Affected (as stated on 2567): Few

Compare Your Selected SNF to 2 Other SNFs: Submit as Part of the Assignment

· Remember to Select 2 Comparable SNFs to your selected SNF (3 SNFs in total), up to a 200-mile radius, using the compare function on the CMS Compare Site.

· You can use the Print function on the CMS Compare website and save the information in PDF format to include the information in your submission. See example PDF in assignment prompt.

Section 3 - Questions to Consider Before Conducting Facility Rounds

Provide a response to question listed below and adjust spacing as needed for your responses.

1) Identify one to three leaders that will conduct rounds with you for your 2567 deficiencies, include their titles and/or department and/or role:

2) Provide two questions to ask your LTC residents and/or short-term stay patients during your rounds. One question must be based on the F-Tag citation as a way to identify how your facility can improve.

3) Provide at least one question to ask your employees during your rounds. These questions should be positive, engaging, and promote an excellent workplace experience while focusing on providing the highest quality of care delivery.

Section 3 - Rounding Experience Simulation

Visualize your SNF as though you are rounding with your leadership team, consider your F-tag citations, and provide a response with supporting external scholarly evidence, as needed, for each question. Adjust spacing as needed for your responses.

1) Based on your first citation discussed in Section 2, and based on your research regarding your F-Tag citation, what will be two to three items that you will look for during your rounds and why?

2) Based on your second citation discussed in Section 2, and based on your research regarding your F-Tag citation, what will be two to three items that you will look for during your rounds and why?

3) Describe in one to two paragraphs, how you will identify other areas of concern during your rounds? Be sure to include a specific process on how you will note such potential areas of concern.

Section 3 - QAPI Tool for Rounding Follow-Up Leadership Meeting

Provide a response to each question below, adjust spacing as needed, and be sure to include scholarly external evidence.

1) You are going to redesign your QAPI Program. Your first step will be to identify your QAPI Steering Committee. Identify the SNF Department Leaders that will be on your QAPI steering committee.

Information from the QAPI at a Glance Guide from CMS and the AHRQ to assist you with the question presented above (Agency for Healthcare Research, 2021):

Here are some ways leadership can take action:

Develop a steering committee, a team that will provide QAPI leadership: The steering committee has overall responsibility to develop and modify the plan, review information, and set priorities for PIPs. The steering committee charters teams to work on particular problems. It reviews results and determines the next steps. The steering committee must learn and use systems thinking—a nursing home has many competing interests and needs.

Top leadership such as the Administrator and the Director of Nursing must be part of this structure.

It is also important to have a medical director who is actively engaged in QAPI. It is possible to adapt your Quality Assurance committee to become your “Steering committee” to oversee QAPI. For this to work, the QA Committee may need to meet more often, include more people, and establish permanent and time-limited workgroups that report to it (p.9).

2) Based on the two F-Tags that you presented in Section 2, describe what some of the potential best practices are to resolve your citations, ways you want to approach these deficiencies to prevent them in the future, or provide other relevant information to addressing these areas of concern. Your response should be two to three paragraphs long and include scholarly supporting external evidence.

3) Based on your SNF rounding simulation, in one to two paragraphs, share your thoughts on this experience include items such as benefits, challenges, new knowledge obtained, greatest learning opportunity, or any other factor that you would like to share from an AIT student viewpoint.