AgendaRegulatory/Department UpdatesCompliance Trend ReportCompliance Tips: Deborah CateoraHot Topics:

Manager’s Corner: Cory Oace

Regulatory/Department Updates1. Be sure to notify OLRO for change of

Administrator2. Please be timely sending in license renewal

documentation.

New Employees:Sean Scott: Policy Analyst/Corrective Action

Cynthia Vargo: Surveyor Supervisor

Compliance Tips

Deborah Cateora

Deborah Cateora, BSN, RN

MULTIDRUG RESISTANT ORGANISMSMDROs:

Are infectious organisms that no longer respond to most antibiotics or antiviral medications, currently available;

CDC and state Health Departments are taking strong actions to reduce the transmission of drug resistant and multi-drug resistant infections organisms;

Continue to be a growing issue.

MULTIDRUG RESISTANT ORGANISMSEfforts to reduce the transmission of MDROs

include:Aggressive infection control training efforts;

andUse of the MDRO transfer form.

Reduction of infectious organisms non-MDROs and MDROs include:

Hand Hygiene; Respiratory Hygiene; and Appropriate use of Standard and Contact

Precautions.

MULTIDRUG RESISTANT ORGANISMSMore training will be available for caregivers

in all settings in October or November 2014.Effective January 1, 2014 a new law requires

certain facilities to fill out and/or provide a MDRO transfer form to another facility when an individual with a confirmed or suspected MDRO is being transferred to another facility.

MULTIDRUG RESISTANT ORGANISMSCurrently, ALFs/RCFs are not mandated to

create a form but if they receive a MDRO transfer form here is what needs to be done:Assure all appropriate standard precautions

are implemented at all times; Keep the MDRO transfer form with the

resident’s record;Provide a copy to any emergency personnel

(i.e. paramedics etc.) when treating and/or transporting the resident from their home;

MULTIDRUG RESISTANT ORGANISMS

Provide a copy to the facility when a resident is being transferred to the hospital, emergency room, ambulatory surgical center, nursing facility or another licensed or certified care setting; and

Notify the local health department within one working day of the date of transfer.

Example of MDRO transfer forms can be found at:https://public.health.oregon.gov/

DiseasesConditions/CommunicableDisease/HAI/Prevention/Pages/Interfacility-Communication.aspx.

RN DELEGATIONRN Delegation (Division 47) has specific

requirements regarding actions and documentation. Current issues that we see are:Only indicating the resident is “Stable and

Predictable”: This is a statement only and is not the

documentation that supports the statement. Forms that have a check box still have to have supporting data recorded in the residents’ record.

RN DELEGATIONStep-by-step instructions are not unique to the

individual resident: There must be resident specific information

regarding how the caregiver is to perform the task.Step-by-step instructions kept in a central

location: The step-by-step instructions are resident specific

and should be kept with the MAR for that resident.Not watching each caregiver perform the task

both on the initial and subsequent re-evaluations: Must be performed at the frequency ordered.

RN DELEGATIONRN not reviewing the MAR routinely for

medications or treatments specific to the delegated task;

Incoming RN not following the transfer of delegation as outlined in Division 45: The only potential time saver if, after reviewing the step-

by-step instructions, the incoming RN deems sufficient.Caregivers continue to perform delegated tasks

even after the RN has left or quit and the task has not been re-delegated;

Sliding scale information is not addressed adequately;

RN DELEGATIONRN not leaving sufficient instructions on when

to contact the delegating RN immediately; andNot specifying when the re-evaulation will be

completed. In 90 days or 180 days etc. is not sufficient must at minimum indicate the week of or an actual date.

Compliance Trend ReportTop Ten Citations: 4/1/2014-6/30/2014

1: 260 Service Plans (45)

2: 270 Change of Condition(45)

3: 280 Resident Health Services (36)

4: 303 Treatment Orders (32)

5:310 Medication administration (32)

6: 240 Food Sanitation (30)

7: 370 Staffing Training(29)

8: 252 Resident Move in and eval (27)9: 290 Resident Health Services (24)10: 160 Reasonable Precautions (21)999: Technical assistance (52)

Hot Topics

CBC Web Site:http://www.oregon.gov/dhs/licensing/cbc/Pages/index.aspx

Oregon.gov, type in CBC provider tools

Manager’s Corner

Cory Oace, Residential and Assisted Living Manager

Thanks so much!

Next News hour:October, 9th, 2014

Questions????CBCTeam@state.or.us

CBC web site Address:http://www.oregon.gov/dhs/spd/Pages/provtools/cbc/index.aspx