Question

Overview

Unfortunately, studies suggest over 90% of the staff members working in SNFs have no idea of how the facility is?assigned deficiencies?(usually called tags or F-tags) or what the letter grade it receives actually means (NursingHomePro, n.d., Scope and severity). As future health care leaders and potential consumers of LTC services, you are going to change that statistic!

Procedure

Using what you have learned in this lesson, review the following deficiencies and determine severity, scope, and sanctions.

First, determine the severity of each deficiency on a scale of 1–4.

Think back to the two questions asked in the lesson that are used to help determine severity and use these questions to guide your answer regarding severity:

Question #1: Is there immediate jeopardy, meaning is the resident's life or safety at risk?

Question #2: Is there actual physical, mental, or emotional harm to the resident?

Next, determine the scope of each deficiency and assign a letter (A–L).

Then determine the sanction, including

whether a Directed Plan of Correction (PoC) is required, optional, or not required as a sanction for each deficiency;

the required sanctions for each deficiency; and

the optional sanctions for each deficiency.

The following two tables may be helpful to you in determining your answer.

Table 7.3. Scope, Severity, and Sanctions (repeated from this lesson)

-	Scope: Isolated	Scope: Pattern	Scope: Widespread
Severity Level 4: Immediate jeopardy to a resident's health or safety	J PoC Category 3 required Category 1, 2 optional	K PoC Category 3 required Category 1, 2 optional	L PoC Category 3 required Category 1, 2 optional
Severity Level 3: Actual harm that is not immediate jeopardy	G PoC Category 2 required Category 1 optional	H PoC Category 2 required Category 1 optional	I PoC Category 2 required Category 1 and temporary management optional
Severity Level 2: Minimal harm or potential for harm	D PoC Category 1 required Category 2 optional	E PoC Category 1 required Category 2 optional	F PoC Category 2 required Category 2 optional
Severity Level 1: No actual harm with potential for minimal negative impact	A No PoC No remedies	B PoC	C PoC

Table 7.2. Sanctions (repeated from this lesson)

Category One	Category Two	Category Three
Directed Plan of Correction (PoC) State monitoring Directed in-servicing	Denial of payments for new admissions Denial of payments for all residents Termination of CMS agreement Temporary management by a designated state administrator Civil monetary penalties	Temporary management Termination of CMS agreement Civil monetary penalties

Deficiency #7

A CNA was providing care to a resident in a single room. The CNA closed the resident’s door but failed to pull the privacy curtain while providing care. A few minutes into the care, a visitor knocked on the door and, without hesitation, the CNA yelled to the visitor to come in. The privacy current was not pulled prior to entry by the visitor and the resident was still exposed at the time.

Flag this Question

Question 37

What is the severity of deficiency #7? (choose one answer)

level 4

level 3

level 2

level 1

Flag this Question

Question 38

What is the scope of deficiency #7? (choose one answer)

isolated

pattern

widespread

Flag this Question

Question 39

Based on the scope and severity you determined above, what is the letter category for deficiency #7?

L

K

J

I

H

G

F

E

D

C

B

A

Flag this Question

Question 40

Is a Directed Plan of Correction (PoC) required, optional, or not required as a sanction for deficiency #7? (choose one answer)

PoC required

PoC optional

No PoC

Flag this Question

Question 41

What are the required sanctions for deficiency #7? (choose one answer)

Category 3 (possible sanctions include temporary management, termination of CMS agreement, civil monetary penalties)

Category 2 (possible sanctions include denial of payments for new admissions, denial of payments for all residents, termination of CMS agreement, temporary management by a designated state administrator, civil monetary penalties)

Category 1 (possible sanctions include directed plan of correction, state monitoring, directed in-servicing)

No remedies required

Flag this Question

Question 42

What are the optional sanctions for deficiency #7? (you may choose more than one answer)

Category 3 (possible sanctions include temporary management, termination of CMS agreement, civil monetary penalties)

Category 2 (possible sanctions include denial of payments for new admissions, denial of payments for all residents, termination of CMS agreement, temporary management by a designated state administrator, civil monetary penalties)

Category 1 (possible sanctions include directed plan of correction, state monitoring, directed in-servicing)

No remedies

Flag this Question

Deficiency #8

One resident reported to the surveyor that five residents were in the activity room watching the NHL Stanley Cup Series. The game was still going strong at 11 p.m. Before the game ended, all five residents were wheeled back to their rooms and put in bed. One CNA informed the resident that third shift required all residents be in bed prior to the shift start. All of the residents missed the end of the game.

Flag this Question

Question 43

What is the severity of deficiency #8? (choose one answer)

level 4

level 3

level 2

level 1

Flag this Question

Question 44

What is the scope of deficiency #8? (choose one answer)

isolated

pattern

widespread

Flag this Question

Question 45

Based on the scope and severity you determined above, what is the letter category for deficiency #8?

L

K

J

I

H

G

F

E

D

C

B

A

Flag this Question

Question 46

Is a Directed Plan of Correction (PoC) required, optional, or not required as a sanction for deficiency #8? (choose one answer)

PoC required

PoC optional

No PoC

Flag this Question

Question 47

What are the required sanctions for deficiency #8? (choose one answer)

Category 3 (possible sanctions include temporary management, termination of CMS agreement, civil monetary penalties)

Category 2 (possible sanctions include denial of payments for new admissions, denial of payments for all residents, termination of CMS agreement, temporary management by a designated state administrator, civil monetary penalties)

Category 1 (possible sanctions include directed plan of correction, state monitoring, directed in-servicing)

No remedies required

Flag this Question

Question 48

What are the optional sanctions for deficiency #8? (you may choose more than one answer)

Category 3 (possible sanctions include temporary management, termination of CMS agreement, civil monetary penalties)

Category 2 (possible sanctions include denial of payments for new admissions, denial of payments for all residents, termination of CMS agreement, temporary management by a designated state administrator, civil monetary penalties)

Category 1 (possible sanctions include directed plan of correction, state monitoring, directed in-servicing)

No remedies

Answer 1

Question 1: Yes immediate jeopardy meaning is the resident's life or safety at risk..
Question 2: there is no actual,physical,mental or emotional harm to the resident..
Deficiency 7:
Question 37: Level 4 immediate jeopardy to a resident's health or safety.
Question 38: Widespread
question 39: J
question 40: POC required
Question 41: Category 1(possible sanctions include directed plan of correction,state monitoring,directed in-servicing)
Question 42: category 1 and category 3
deficiency:8
Question 43: Level 1
Question 44: pattern
Question 45: A
Question 46: No poc
question 47: no remedies required
question 48:Category 3 and no remedies