F689 Falls – Are You Proactive or Reactive?
Best Practices for Compliance
CMS has developed a Quality in Focus Program as a resource for all long-term care facilities in the country. One must appreciate the efforts made to promote safety in LTC facilities while also educating the general public about why regulations in a nursing facility are seemingly strict, rigid, and often restrictive. Using the Quality in Focus as the foundation, Polaris Group will highlight best practices during our 2024 series to help mitigate civil money penalties and lower high scope and severity citations.
F689: Free of Accident Hazards/Supervision/Devices
This month we are looking at F689: Free of Accident Hazards/Supervision/Devices - more specifically, falls. Research has shown that 75% of nursing home residents fall each year, which is twice the rate at which older adults fall when living outside of nursing homes. While it is recognized that individuals living in nursing homes typically represent the most vulnerable and elderly demographic, the industry holds the highest accountability for ensuring the safety of the elderly population.
F689 Falls – Are You Proactive or Reactive?
One of the most impactful events in the long-term care industry is a fall which is often associated with a negative outcome. Prevention strategies should emphasize education, training, creating safer environments, prioritizing fall-related research, and establishing effective policies to reduce risk.
Statistics related to falls:
- Muscle weakness and gait problems account for about 24% of nursing home falls (SOM)
- Environmental hazards cause 16% to 27% of falls for residents. (SOM)
- Falls are the second leading cause of accidental or unintentional injury deaths worldwide. (WHO)
- Adults older than 65 years of age suffer the greatest number of fatal falls. (WHO)
Four to Avoid the Floor
In addition to the plentiful standard fall prevention interventions, here are “Four to Avoid the Floor” interventions worth considering.
What does your morning meeting agenda look like?
- Do you have a morning meeting to identify changes in the past 24 hours and identify action steps for those changes?
- Do you have an afternoon meeting that reviews the progress of action steps identified in the morning meeting?
- Does your IDT attend all meetings? If not, should they be?
- Do you stick to the agenda to ensure the meeting is 15-30 minutes in length?
What is the layout of the resident room compared to their previous living arrangement?
- Do you ask the resident and/or family what side of the bed they slept on?
- Where was the bathroom located compared to where it is now?
- Did they sleep with a night light or listen to soft music?
- Did they need to use the bathroom during the night?
- Do you know the answers to the resident's previous routine?
Does your facility have an “Answering Call Lights is Everyone’s Responsibility” mentality?
- If the general consensus is that answering call lights is the responsibility of the nursing department, you’re shortchanging yourself and your residents.
- With housekeeping cleaning the room every day, are they looking around for potential risks that may cause an accident? Do they make sure the call light is within reach?
- Laundry is delivering clean clothes every day, are they looking around for issues that may present problems? Do they make sure the call light is within reach?
- The maintenance team is often in resident rooms to repair or replace something, are they trained to look around for potential issues? Do they make sure the call light is within reach?
Do you have a “Guardian Angel Rounds” program?
65% -75% of complaints made to State Survey Agencies are the result of unhappy residents and/or family members. A Guardian Angel program is designed to be proactive, improve facility communication, and foster positive relationships. A Guardian Angel Rounds program can look something like:
- Someone assigned to visit the resident and connect with the POA weekly or biweekly.
- Someone assigned to take 15 minutes while visiting the resident to look at the resident's room. Some items you may notice are the floor rug brought in recently by the family, the extension cord placed across the floor beside the resident’s chair, the food left out on the nightstand that is uncovered and should be refrigerated, etc.
Polaris Consultants are equipped with the tools to help your workload, keep your residents safe, and improve overall morale in your facility. We have morning meeting agendas, Guardian Angel Rounds audit tools, and Falls Prevention webinars available for your success. Contact us today for further information about how to customize tools for your facility!
