Armed and dangerous: surveys come equipped with cameras under new photographic evidence guidelines.On September 29, 2006, CMS (1) See content management system and color management system.
(2) (Conversational Monitor System) Software that provides interactive communications for IBM's VM operating system. released principles for the use of photography during nursing home surveys. Although photography has always been a valid method of collecting information during surveys, there has been little emphasis placed on this method until now.
With the publication of Survey and Certification Letter 06-33 to state survey agency directors, it seems the federal government is now encouraging state survey agencies to integrate this method of data collection into their procedures.
The use of photography, however, remains the decision of the state survey agency and is not yet required. When a survey agency begins collecting photographic evidence, it is likely to occur initially during complaint investigations, especially those alleging abuse or neglect. Previously it occurred during routine annual surveys.
The principles for the use of photography provided to states by CMS are said to offer basic assistance to surveyors who want to collect photographic evidence during inspections. Each state survey agency is also expected to develop its own policies for the use of photography during surveys. The principles are outlined in the box on p. 9.
If your state survey agency chooses to include photography as a method of information collection during surveys, it is important that you work with your long-term care long-term care (LTC),
n the provision of medical, social, and personal care services on a recurring or continuing basis to persons with chronic physical or mental disorders. associations to encourage the state agency to release its respective policy on photographic evidence. It is reasonable for you to know what to expect from surveyors whose procedures include photographic evidence.
Don't be intimidated in·tim·i·date
tr.v. in·tim·i·dat·ed, in·tim·i·dat·ing, in·tim·i·dates
1. To make timid; fill with fear.
2. To coerce or inhibit by or as if by threats.
Surveyors with cameras will likely boost feelings of intimidation during survey time for everyone in your facility. Observe the following to prepare your staff, your residents, and your residents' families for the possibility that surveyors will show up with cameras:
1. Educate your staff first. Your team will likely receive questions about this practice from residents and families, and they should be able to respond appropriately the first time they are asked without referring the question to someone else. This type of response provides a sense of security that all of your residents and families should feel when they or their loved ones loved ones npl → seres mpl queridos
loved ones npl → proches mpl et amis chers
loved ones love npl are in your care. Your staff should do the following:
* Know the survey procedures. Surveyors know what you are supposed to be doing; your staff members should also know what they should be doing.
* During a survey, observe the surveyors and make notes. Everyone should be involved in this activity when not being directly observed by a surveyor. Collect the notes each day for a survey file.
* Provide accurate and clinically factual documentation. If documentation is a problem in your facility, work on improving it. Inconsistencies between photographs and documentation can be very damaging. Additionally, poor or inaccurate documentation may lead surveyors to problem areas within your facility.
2. Educate your residents next. Begin by meeting with the resident council officers to explain these photographic principles. Solicit their advice and participation on how best to proceed with communicating the information to other residents in your facility. When providing information to other residents, remember the following:
* Be calm and reassuring
* Stick to the facts while explaining the principles of photographic evidence
* Avoid opinions, emotions, or attitudes, as these can be damaging
* Emphasize the confidentiality of photographs and that residents' refusal to be photographed is acceptable without consequences
* Provide plenty of time for questions and concerns
* Realize there maybe a delayed response while residents think about this information
* Be alert and sensitive to the feelings of individual residents; some may be uncomfortable voicing concerns or may need to voice concerns in private
3. Educate your residents' families afterward af·ter·ward also af·ter·wards
At a later time; subsequently.
Adv. 1. afterward - happening at a time subsequent to a reference time; "he apologized subsequently"; "he's going to the store but he'll be back here . When providing information regarding photographic evidence to families, remember the following:
* Use the same basic methods outlined above for residents
* Realize that the reaction of families will be different based primarily on two things:
--Their feelings about placement of a loved one in a long-term care facility long-term care facility
See skilled nursing facility.
--Their confidence and trust in the caregivers (past or present)
* Answer questions directly, honestly, and sincerely
It might be best to discuss photographic evidence with residents and families at the same time, as the subject will certainly generate conversation. This should be a judgment call for the facility, depending entirely on the individual circumstances of its residents and their families.
What's more, having a consent release form for residents and families to read and ponder Ponder - A non-strict polymorphic, functional language by Jon Fairbairn <email@example.com>.
Ponder's type system is unusual. It is more powerful than the Hindley-Milner type system used by ML and Miranda and extended by Haskell. at the time of education may also be helpful. You should emphasize that the consent doesn't need to be signed until or unless the resident or legal surrogate surrogate n. 1) a person acting on behalf of another or a substitute, including a woman who gives birth to a baby of a mother who is unable to carry the child. 2) a judge in some states (notably New York) responsible only for probates, estates, and adoptions. wishes to do so, and that a signed consent form may be rescinded at any time the resident or legal surrogate chooses.
Just say no
When addressing CMS' principles of photographic evidence, I am repeatedly asked one question: "Isn't there any other way?"
Well, the answer is, "Yes." Noncompliance noncompliance
failure of the owner to follow instructions, particularly in administering medication as prescribed; a cause of a less than expected response to treatment.
noncompliance has been demonstrated for years without photographs. And remember, photography is to be used to "support a finding of noncompliance."
In other words Adv. 1. in other words - otherwise stated; "in other words, we are broke"
put differently , noncompliance should already be demonstrated and documented before surveyors take photographs. The photographs are supposed to be used to enhance the findings that have already been determined. So, for those residents who need reassurance REASSURANCE. When an insurer is desirous of lessening his liability, he may procure some other insurer to insure him from loss, for the insurance he has made this is called reassurance. that "no" is an acceptable answer, remember: It is okay for them to say no.
CMS' principles for the use of photographic evidence
> The camera and film used must be the property of the state.
> Photographs are to support written documentation of noncompliance.
> To the greatest degree possible, the surveyor is to obtain the resident's written permission before photographs are taken.
> An individual's refusal should always be respected.
> Regarding the photography of the rectal rectal /rec·tal/ (rek´tal) pertaining to the rectum.
Of, relating to, or situated near the rectum.
pertaining to the rectum. , genital genital /gen·i·tal/ (jen´i-t'l)
1. pertaining to reproduction, or to the reproductive organs.
2. (in the plural) the reproductive organs.
1. , or female breast area, the following apply:
* A member of the nursing staff must be present, and written consent must be obtained.
* If the resident is unable to give consent, the surrogate may give consent unless the surrogate is suspected of abusing the individual.
* If the resident is unable to give consent, and the legal surrogate is not present, the surveyor may use discretion.
* Only a surveyor who is a licensed nurse, physician assistant, or physician may take photographs of these areas.
> Surveyors should avoid taking photographs revealing identifying characteristics of the individual.
> A complete set of photographs must be obtained.
> A complete set contains at least three photographs, including the following:
* An overview of the entire scene.
* A mid-range photo with relevant objects in immediate surroundings.
* A close-up providing detail and measurements.
> All photographs must adhere to adhere to
verb 1. follow, keep, maintain, respect, observe, be true, fulfil, obey, heed, keep to, abide by, be loyal, mind, be constant, be faithful
2. these guidelines guidelines,
n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks. :
* They must be treated with the confidentiality of a medical record.
* They are to enhance, but not replace, written documentation.
* Photos require specific documentation in surveyor notes for each one taken, and photos cannot be modified.
* They should not be included in the CMS-2567 Statement of Deficiencies.
--Ellen J. Mullins, RN
Ellen J. Mullins, RN, BSN BSN
Bachelor of Science in Nursing , CRNAC, is the CEO (1) (Chief Executive Officer) The highest individual in command of an organization. Typically the president of the company, the CEO reports to the Chairman of the Board. of Integrity Health Care Solutions, LLC (Logical Link Control) See "LANs" under data link protocol.
LLC - Logical Link Control , in Montgomery, AL. Services for long-term care facilities include education, computer assistance, mock surveys, HIPAA (Health Insurance Portability & Accountability Act of 1996, Public Law 104-191) Also known as the "Kennedy-Kassebaum Act," this U.S. law protects employees' health insurance coverage when they change or lose their jobs (Title I) and provides standards for patient health, compliance, regulatory compliance, project development, and the analysis and evaluation of facility systems and processes. Mullins spent more than 13 years as a state surveyor, State RAI rai
A form of popular Algerian music combining traditional Arabic vocal styles with various elements of popular Western music and featuring outspoken, often controversial lyrics. Coordinator, and OASIS Education Coordinator for the State of Alabama. Contact her at 334/270-1199 or firstname.lastname@example.org.
BY ELLEN J. MULLINS, RN, BSN, CRNAC