PLAN OF CORRECTION AND PREVENTION OF SKILLED NURSING FACILITY DEFICIENCIES
PLAN OF CORRECTION AND PREVENTION OF SKILLED NURSING FACILITY DEFICIENCIES

PLAN OF CORRECTION AND PREVENTION OF SKILLED NURSING FACILITY DEFICIENCIES

SURVEYS, DEFICIENCIES AND F-TAGS

  • The Department of Health and Human Services is responsible for the comprehensive inspecting and reporting of identified deficiencies within long-term care facilities (this is a requirement for Medicare and Medicaid funding)
  • A statement of deficiency document uses a federal tag numbering system that addresses the degree to which a facility meets minimal federal standards
  • F-tags correspond to specific stipulations within the Code of Federal Regulations
  • Facilities that receive F-tags are required to display them in a public location within the facility and reported on federal websites and databases

F-TAG 686 (FORMERLY F-TAG 314) DIRECTLY RELATED TO WOUND CARE : WHAT IS F-TAG 686?

42CFR 483.25 (b)(1) – Quality of Care
Pressure Sores (Ulcers)
Treatment/Svcs to Prevent/Heal Pressure Ulcers
Based on the comprehensive assessment of a resident, the facility must ensure that:

Refer all wound patients to your Vohra wound physician early for prevention

A resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable

AND

A resident who has a pressure ulcer receives care and services to promote healing and prevent additional ulcers.

WHAT OTHER F-TAGS ARE RELEVANT TO WOUND CARE?

F-TAG 580 (formerly F-Tag 157)

483.10 (g)(14) – Resident Rights
Notify of Changes (Injury/Decline/Room, Etc.)
A physician must be notified of any changes to wound health.

Your Vohra wound care physician is always available to your wound care nurse(s).

Current initiatives increase availability for higher acuity patients and admits.

Standardized referral program addresses any changes or newly developed wounds immediately.


F-TAG 658 (formerly F-TAG 281)

483.21(b)(3) – Comprehensive Resident-Centered Care Plans
Services provided meet professional standards.
Correct wound dressings must be used on different wound types.

Vohra wound physicians are highly trained specialists with an extensive LTC wound dressing database.

Unmatched clinical and industry knowledge and experience.

Proven superior outcomes at low cost.

Education on our facility portal specific to the dressings we have chosen, giving the WCN further insight and on-the-job, continuous learning.


F-TAG 710 (formerly F-TAG 385)

483.30(a)(1)(2) – Physician Services
Services provided meet professional standards.
Resident's Care Supervised by a Physician.
Adequate physician supervision must be provided for SNF wounds.

Your Vohra wound physician rounds weekly and will see all your wound and skin referrals.

Standardized wound care program so all wounds are superbly cared for with robust documentation to reduce legal risk associated with arbitrary referral criteria.

Vohra clinicians base frequency of visits on clinically-determined medical necessity and with intelligent resource utilization.


F-TAG 841 (formerly F-TAG 501)

483.70(h)(1)(2) – Administration
Responsibilities of Medical Director.
The medical director must be involved in the wound care program.

Your Vohra wound physician will communicate often and effectively with the entire facility team.

Vohra clinicians are highly engaged in the SNF’s care delivery team and system.


F-TAGS ALSO HAVE A “SCOPE”

F-TAG SCOPE SEVERITY GRID
The scope of an F-Tag is determined by the surveyor when reviewing the medical record.
Scope and severity play a role in the determination of deficiencies.

"UNAVOIDABILITY" OF WOUNDS

Facilities should ensure that policies and procedures are consistent with current standards of practice.
To demonstrate compliance for residents with pressure ulcers, the facility must show the pressure ulcer was unavoidable by documenting all of the following actions:
  • Evaluate the resident’s clinical condition and pressure ulcer risk factors
  • Define and implement interventions that are consistent with resident needs, goals and recognized standards of practice
  • Monitor and evaluate the impact of interventions
  • Revise the approaches as appropriate

services consistent with professional standards of practice to promote the prevention of all types of wounds, promote the healing of all types of wounds (including infection) and prevent additional wounds from occurring 3

Required demonstration of "unavoidability" supported and bolstered by the actions and strength of the your Vohra wound physician’s documentation and by the full implementation of the Vohra Wound Care Program.

UTILIZE THE ROBUST VOHRA WOUND CARE PROGRAM

Research by the Centers for Medicare/Medicaid Services (CMS) and the Office of the Inspector general (OIG) supports the direct link between continuing education and the quality of care, and staff retention.3 Surveyors will interview nursing assistants to determine whether they know what, when and to whom to report changes in skin condition. 1
WE ARE COMPLETELY ALIGNED WITH THE MISSION OF THE VERY REGULATORY AGENCIES THAT GOVERN THE SNF.
To demonstrate compliance for residents with pressure ulcers, the facility must show the pressure ulcer was unavoidable by documenting all of the following actions:
  • On-demand access to wound and skin care education
  • Vohra Center of Excellence Program
  • Vohra Wound Care Certification Program
  • Get your Vohra wound care physician onboard with your wound patients early

THE VOHRA COMPREHENSIVE WOUND CARE PARTNERSHIP PROGRAM

PLAN OF CORRECTION AND PREVENTION OF SKILLED NURSING FACILITY DEFICIENCIES

1. CMS Manual System, Pub. 100-07 State Operations Provider Certification, appendix PP, F-Tag 314 Current Guidance to Surveyors.

2. Nursing Home Pro (December, 2009). Scope and Severity – How Nursing Homes are Really Graded. Retrieved from http://www.nursinghomepro.com/33/scope-severity-how-nursing-homes-are-really-graded/

3. CMS Manual System, Pub. 100-07 State Operations Provider Certification, appendix PP for Phase 2, F-Tag Revisions, and Related issues, F-Tag 686 Current Guidance to Surveyors.