The Survey

The Kansas Department of Aging and Disabilities Services (KDADS) is responsible for licensing, certification, and evaluation of long term care facilities in the state of Kansas that receive financial assistance from Medicare or Medicaid.  They oversee LTC homes to ensure that they are compliant with the standards laid out by OBRA and that the residents are receiving safe, quality care.  Since this is a shared goal for both KDADS and the LTC, they should be viewed as partners rather than adversaries.

 The survey process

LTC homes are surveyed every 9-15 months by a team of registered nurses employed by KDADS.  They can arrive unannounced in your facility at any time of day or night, any day of the week, holidays included. In addition to this annual surprise visit, surveyors may appear any time in between if a complaint has been made or there has been a report that needs to be investigated.  The surveyors will watch the staff perform all aspects of care.  A good CNA is already in the habit of doing their job correctly, so they can perform their jobs like it's any other day as if the surveyors aren't watching.  That being said, the CNA shouldn't ignore the surveyors.  It is good to be friendly, smile, and even introduce yourself.  Remember, they are human too.

In addition to watching the staff perform care, they may also interview them.  They may ask questions about what they would do in various situations, how would they handle it if they witnessed abuse, or where is the MSDS located?  The best way to prepare for this interview is to pay attention to the location of such things as your MSDS, the lock out tag out box, fire extinguishers, and the phone number of the Ombudsman before surveyors arrive in your facility!  If the CNA doesn't know the answer, they should never say, "I don't know."  If they really don't know, they should refer the surveyor to someone who does.  They at least want to know that the staff know where to go or who to ask in case they are actually in that situation. 

Deficiencies

It usually takes several days before the survey is complete.  By this time they have combed through charts, visited with staff, watched the nurses pass medications, watched the CNA's provide direct care, and even checked the refrigerator to make sure all of the food is dated.  At the end of the survey, the surveyors will hold a meeting with the department heads and go over any issues they saw during the survey.  These issues are called deficiencies, although some may refer to them as "tags".  Each time a surveyor sees something in error they will determine its severity, or how serious the matter was, and decide if the error was a one time fluke, or if it happened several times with several people creating a pattern.  The surveyors will discuss their findings with the department heads and the results will be posted for the public.

A lot is riding on a good survey for the LTC.  If the LTC has a good survey, their reputation will be upheld and families will want to bring their loved ones to their LTC as well as staff will want to work there.  In addition to better census and staff satisfaction, it also effects their funding and lowers their insurance premiums.  A bad survey could lead to an LTC being barred from having new admissions, prevent students from doing clinicals in their facility, and sometimes the financial loss can lead to an LTC closing their doors for good.

Once the surveyors have finished, the LTC then has some time to make a corrective plan to address the problems the surveyors found.  This will likely result in policy and procedure changes and staff education.  Depending on the severity of the deficiencies, the surveyors may return to see if the LTC is following the new plan of corrections and the errors have actually been resolved.  The result of the survey usually ends with better care for the residents.