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Judy Morgan, MBA, RD will be presenting an MDS 3.0 Section K webinar through QCHF on September 7th. Click here for more information.  QCHF Registration form available here.
Survey Success Stories Wanted
Do you have a story to tell regarding "Survey Success"? What have you done to make a positive difference in "Survey"? What can you share with others about  "Survey Success"? HMC RDs have no doubt witnessed steps and tips that have helped facilities through survey. Your input is valuable and will be considered for an upcoming RDNews Issue.
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Food For Thought
Diet Manual Survey Alert!
Check the dates on the Diet Manuals at each of your Nursing Stations. More info coming in HMC monthly industry newsletter next week.
Please send your menu related questions to me via
 
Janet M Redemail or call the office 916-364-5300.  
Janet Montano, RD Director of Menu Services
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Editor Judy Morgan, MBA, RDPlease send your RDNews comments, suggestions & questions to  Judy Morgan, MBA, RD
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Issue: 80August 24, 2010
Greetings!        
This issue reviews some tips for professional behavior during a Department of Health survey or complaint investigation.
Professional Behavior in a Survey
If the RD is in the facility during a survey, the normal workday routine will likely not be followed. The RD's oversight during some of the survey may help with survey success. 
RD CDM CHEF
  • Stay one step ahead and do a thorough kitchen walk through with the DSS first thing in the morning at a time when the surveyors have not yet begun to do the in depth dietary review and meal observation.
  • Identify any areas needing cleaning, food storage corrections, check for temperature/sanitizer logs, cool down temperature logs, staff cross contamination issues and address concerns with staff immediately; provide mini-inservices to correct any potential deficiencies.
  • Once surveyors are in the kitchen, the DSS and/or RD should stay with them and observe what they observe; direct dietary staff as needed to correct any problems immediately and discreetly so as not to bring attention to the surveyors.
  • Determine which residents are being reviewed by the survey team and review those chartsSurvey Documentation for appropriate, current nutritional care documentation, care plans, weight variance IDT notes, etc.
  • Monitor meal service and dining rooms; assist with correcting any problems as possible such as food preference accuracy, diet and table service accuracy in the dining room.  
RD Tip
Surveyors often want to discuss a resident's nutritional care or dietary issues with the Consultant Dietitian. Communicating with a surveyor is a very delicate balancing act that requires integrity and diplomacy. The facility is our client and the HMC RD's role should be to assist them to a positive survey outcome. Keep in mind these HMC company policies when you are requested to communicate with a surveyor:

  • Always have a facility representative (usually Administrator or Director of Nurses) present during any discussions with a surveyor.
  • Do not volunteer information unless a specific question is addressed: you may ask questions to clarify the information the surveyor is requesting.
  • Do not discuss a resident without first reviewing their medical record and familiarizing yourself with existing documentation.
  • Do not discuss issues discovered in a survey with surveyors on the phone; politely decline to discuss issues on the phone due to company policy to have a facility representative present.
  • Do not give surveyors any reports, policies or documents unless approved by the administrator.
  • Remember the Report Card is an internal management tool for quality improvement and the results are not citable by the surveyors: they may only review if approved by the administrator, or a blank copy may be suggested to the administrator to show the tool is in place for quality improvement monitoring.
  • If asked to give your opinion or to comment on a practice, refer back to facility policy and procedure or HMC policy and procedure and known facts.

     
Dear Dietitian
HMC policy requires the RD to notify the HMC corporate office of a client's annual survey or complaint investigation involving dietary or nutrition services. Please contact the office as well if the client is involved in a dietary issue scheduled to be heard by the Department of Public Health Citation Review Conference. Contact Senior staff if you have any questions during a survey or need assistance with formulating responses to questions or Plan of Correction after the survey. Refer to your Dietitian Procedure Manual's "Annual Survey And Relationship With Department of Health Services" page for more details on expectations during surveys. 

Sincerely,
 
Judy Morgan, MBA, RD
HM Composite