Practice makes perfect for state surveyor visits

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Elizabeth Newman
Elizabeth Newman

When you think of “rehearsal,” probably what immediately comes to mind is a play, or perhaps a wedding.

But Jo Walters, RNC, CDONA, CDP, the wellness director at Blanchard House (an Assisted Living Concepts home) in Kenton, OH, wants that vision to be extended for long-term care nurses: A visit from state surveyors should be seen as a chance to “put on a show,” she says.

Walters emphasized executive staff must “put their best foot forward” for the surveyors while presenting “Real-Life Tips for Surviving Survey and Post-Survey” on Monday. The location was the National Association of Directors of Nursing Administration in Long-Term Care annual conference in Las Vegas, and the advice came off as a sound bet.

“You need to teach what not to say,” she explained. That means when the surveyor remarks to a certified nursing assistant, “I see there are two people on this unit today,” the answer should not be, “Well, normally we only have one, but they knew you were coming and I don't like that other aide.”

You're cringing, I know, but there are two factors at work in this scenario: a) employees get jittery and b) people often talk without thinking. That's a combination that can easily lead to disaster.

“You do not know what people will say when nervous,” Walters noted.

It might be tempting to think rehearsing takes too much time, or that your staff will know what to say.

But the biggest problem Walters sees is “a lack of preparation, before and after,” she told McKnight's.

Before the surveyor arrives, she recommends the DON wear a sign that says “surveyor” and walk through the facility. Teach employees to say, “I'll find out” if they don't know an answer to a question rather than, “I don't know.”

After the visit, the response to the survey should start immediately.

“A lot of times [DONs] do the plan of correction, but they don't practice it,” Walters says. “Full-time staff has to know, and to practice skills validation. You don't do it once.”

That plan of correction may mean, for example, that each clinical person has to do a med pass without an error or assist with a transfer three times, Walters explained. One way to do that is to have a large chart in a “war room” where each employee and task is color-coded and colored in as it is completed.

Encourage staff feedback, she advised.

“If staff says, ‘This isn't working,' don't get defensive. Listen to what they have to say,” Walters impressed.

It's good advice for anyone, but especially for those preparing for “opening curtain” at the surveyor show.

Note: You can learn more about preparing for a great survey by attending a July 23 webinar featuring William

William Vaughan, RN, Vice President, Education and Clinical Affairs, Remedi SeniorCare, which I will be moderating. Click back here for more details.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.