Bringing Housekeeping Up to State Survey Standards.

This housekeeping professional offers make-or-break guidelines 

In today's long-term care environment, housekeeping is one of the most undervalued elements in facility operations. Housekeeping not only shapes visitors' critical first impression of your facility, it shoulders much of the responsibility for your state inspection and certification results. In reality, the depth and professionalism of your housekeeping operation could be the decisive factor in whether the state will continue to fund your facility, or close its doors for good.

Yet, because facility directors are often consumed by more pressing concerns, cleaning and maintenance can be treated as a superficial business responsibility. For example, housekeeping staffs generally believe that when floors look clean, they are clean.

Ask yourself whether your housekeeping function can withstand detailed scrutiny. Can your day-to-day cleaning and maintenance hold up to unscheduled inspection, or is your facility just "surface clean"?

Barstow Veterans Home (in Barstow, Calif.) recently acknowledged the difference. In December 1999, after a state inspection, Barstow found it would need to upgrade its overall housekeeping function to retain its state funding. The facility was meeting state standards for care of its residents and maintenance of its physical plant, but its beneath-the-surface upkeep was clearly falling short. Steve Jacobs, chief of plant operations, retained our company to re-engineer the facility's housekeeping operation, based on 10 basic tenets:

1. Trust. Is there a bond of trust between housekeeping and facility management? Facility management must be confident that housekeeping understands the special demands of long-term care and can deliver the high standard of maintenance critical to resident care and certification.

2. Expectations. What are management's expectations and how will standards be set? Don't assume that your housekeeping goals are self-evident. Standards should be defined at the outset, and specifics should be itemized in an area by-area management plan, down to such details as whether trash receptacles must be washed as well as emptied, or whether file cabinet surfaces should be polished.

3. Professionalism. Are housekeeping staff trained professionals? They should be rigorously trained in environmental service and risk control and fully under stand long-term care cleaning and maintenance compliance issues. Training should be ongoing, with graduated responsibility for demonstrated expertise at benchmark levels.

4. Needs assessment. What is the state of your facility's cleaning and maintenance and where, specifically, are improvements needed? The needs assessment should include an area-by-area walk-through by housekeeping and facility management.

5. Staffing. How should staffing be structured? The housekeeping team might combine permanent maintenance staff with a rotation of functional specialists, depending on the outcome of your needs assessment. Staff can also be cross-trained, to improve their "buy-in" into the housekeeping mission and to ensure vacation coverage.

6. Scheduling. How should services be scheduled? The frequency and rotation of specific services in each area will be determined by your needs assessment and operational environment. Once these factors are determined, a rigid service schedule should be maintained to ensure that your facility adheres to the required standard.

7. Risk control. Housekeeping staff should be thoroughly trained in risk control and injury prevention techniques to ensure the safety of residents, visitors and personnel. Universal precautions must be employed to prevent contamination by infectious blood and body fluids.

8. Quality assurance. How will performance be measured? Quality assurance can combine standardized reporting with visual inspection and/or analysis of progress or problems. It can be performed by facility management and/or the housekeeping director.

9. Efficiency and 10. Cost-effectiveness. Many facilities have the misconception that managing housekeeping internally is always most efficient and cost-effective. In deciding what makes most sense, consider such factors as timeliness, industry experience and purchasing power, and the costs of recruiting and training and of employee benefits and overtime.

Having adopted these 10 standards, Barstow passed state reinspection with out a hitch and with state funding intact. Continued adherence should ensure that housekeeping will be a strong point in future surveys.

Don Tucker is vice-president and general manager of Pedus Care Service, Los An- geles, California.