Does Your Facility Have a Legal "Safety Net" For Wound Care Documentation?
June 18, 2015
By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC
Substandard documentation tops the list of mistakes for long-term care facilities. It involves "all hands in the chart" so to speak. This encompasses all disciplines, from the nursing assistant to the physician. Discrepancies and gaps in documentation put your facility at risk of litigation. Impeccable documentation is essential in defending any case. Your facility must have a "safety net" in place. This "safety net" consists of educating staff about the importance of timely and detailed documentation not only for the facility, but for their license. Often times, clinicians are not aware of the legal repercussions of their actions. Surveyors will also consider other related Federal Tags (F-Tags) during investigations for compliance.
F-Tag 314 Compliance: An Example of Unavoidable Pressure Ulcer Documentation
April 7, 2016
By Terri Kolenich, RN, CWCA, AAPWCA
It has been a long week. The CMS state survey team entered your facility Sunday afternoon at 2pm. Thursday is finally here and the state survey exit meeting is only minutes away. Your heart is heavy and your mind is occupied with thoughts of an in-house acquired, stage IV pressure ulcer. The surveyor observed your dressing change and reviewed every bit of documentation pertaining to this stage IV pressure ulcer. The burning in your gut has completely convinced your brain that your facility will receive the dreaded F-Tag 314 because of this in-house acquired pressure ulcer.
Legal Perils and Pitfalls of Wound Care – Is That Ulcer Unavoidable or Not?
January 31, 2019
by Heidi H. Cross, MSN, RN, FNP-BC, CWON
"If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed sore, it is generally the fault not of the disease, but of the nursing." —Florence Nightingale
Ouch! What an indictment of nursing and, by extension, the facility in which the nurse works. We have a lot to thank Florence Nightingale for—a brilliant woman considered to be the founder of nursing and nursing standards and the first to ever put statistics to health care, among other valuable contributions.
Legal Perils and Pitfalls of Wound Care: Risk Factors for Unavoidable Ulcers
April 9, 2019
by Heidi H. Cross, MSN, RN, FNP-BC, CWON
According to the Agency for Healthcare Research and Quality, more than 17,000 lawsuits related to pressure ulcers (PUs) are filed annually in the United States, second only to wrongful death lawsuits. One of the greatest gifts to defense attorneys was when the Centers for Medicare & Medicaid Services (CMS) published F-Tag 314, finally acknowledging that some ulcers can occur despite best care. The facility essentially can maintain, “Hey, we did everything we were supposed to, and despite that, the patient developed that pressure ulcer”—that is, the ulcer was unavoidable. To prove unavoidability, proper documentation (proof) of best care needs to be in place, as well as documentation that all proper prevention and treatment measures were implemented.
The Hidden Challenges of Wound Care in Long-Term Care Facilities
December 10, 2015
By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC
In my role as a consultant and educator, I thought it would be interesting to acquire a handful of perspectives from wound care providers who work in the long-term care arena, and explore their responses.
What Wound Care Physicians Need to Know About Working in Long-Term Care
December 11, 2014
By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC
As a traveling wound care educator for physicians, I am observing many changes within the state survey process for long-term care. Wound care physicians working in long-term care are feeling the same anxiety that facility leaders and staff members are, as the time nears the window for an annual state survey.
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