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Residential Citation Update: April 2024

Posted May 24, 20248 min Read

Regulatory & Clinical

The Indiana Department of Health reports the following survey activity for the month of April 2024:  

  • Complaint Investigations: 28   
  • Recertification: 7 
  • State Resident: 24 
  • Post Survey Revisit: 0 

There was a total of 82 Residential tags and of those, nine were Offense tags. 

The Offense tags are as follows:  

  • Tag 241 (4 times) – Health Service Offense – The administration of medications and the provision of residential nursing care shall be as ordered by the resident’s physician and shall be supervised by a licensed nurse on the premises or on call as follows: 1) Medication shall be administered by licensed nursing personnel or qualified medication aides.  
  • Tag 052 (2 times) – Residents’ Rights Offense – Residents have the right to be free from 1) sexual abuse; 2) physical abuse; 3) mental abuse; 4) corporal punishment; 5) neglect; and 6) involuntary seclusion.  
  • Tag 406 (2 times) – Infection Control Offense – The facility must establish and maintain an infection control practice designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of diseases and infection.  
  • Tag 242 (1 time) – Health Services Offense – The resident shall be observed for effects of medications. Documentation of any undesirable effects shall be contained in the clinical record. The physician shall be notified immediately if undesirable effects occur, and such notification shall be documented in the clinical record.  

The top residential tags are as follows:  

  • Tag 273 (10 times) – Food and Nutritional Services Deficiency – All food preparation and serving areas (excluding areas in residents’ units) are maintained in accordance with state and local sanitation and safe food handling standards, including 410 IAC 7-24. 
  • Tag 217 (7 times) — Following completion of an evaluation, the facility, using appropriately trained staff members, shall identify and document the services to be provided by the facility, as follows: 1) The services offered to the individual resident shall be appropriate to the: A) scope; B) frequency; C) need; and (D) preference; of the resident. 2) The services offered shall be reviewed and revised as appropriate and discussed by the resident and facility as needs or desires change. Either the facility or the resident may request a service plan review. 3) The agreed upon service plan shall be signed and dated by the resident, and a copy of the service plan shall be given to the resident upon request. 4) No identification and documentation of services provided is needed if evaluations after the initial evaluation indicate no need for a change in services. %) If administration of medications or the provision of residential nursing services, or both, is needed, a license nurse shall be involved in identification and documentation of the services to be provided.  
  • Tag 045 (5 times) – Residents’ Rights Deficiency – (6) Before an interfacility or discharge occurs, the facility must, on a form prescribed by the department, do the following: A) Notify the resident of the transfer or discharge and the reasons for the move, in writing, and in a language and manner that the resident understands. The health facility must place a copy of the notice in the resident’s clinical record and transmit a copy to the following: i) the resident. ii) A family member of the resident if known. iii) The resident’s legal representative if known. iv) The local long term care ombudsman program (for involuntary relocations or discharges only) v) The person or agency responsible for the resident’s placement, maintenance, and care in the facility. vi) In situations where the resident is developmentally disabled, the regional office of the division of disability, aging, and rehabilitative services, who may assist with placement decision. vii) The resident’s physician when the transfer or discharge is necessary under subdivision (4)(c), (4)(D), (4)(F). B) Record the reasons in the resident’s clinical record C0 Include in the notice the items described in subdivision (9). (7) Except when specified in subdivision (8), the notice of transfer or discharge required under subdivision (6) must be made by the facility at least thirty (30) days before the resident is transferred or discharged. 8) Notice may be made as soon as practicable before transfer or discharge when: A) the safety of individuals in the facility would be endangered; B) the health of individuals in the facility would be endangered; C) The resident’s health improves sufficiently to allow a more immediate transfer or discharge; D) an immediate transfer or discharge is required by the resident’s urgent medical needs; or E) a resident has not resided in the facility for thirty  (30) days. 
  • Tag 090 (5 times) – Administration and Management – The administrator is responsible for managing the facility. The responsibilities of the administrator shall include but are not limited to the following: 1) Informing the division within twenty-four hours of becoming aware of an unusual occurrence that directly threatens the welfare, safety, or health of a resident.  
  • Tag 298 (5 times) – Pharmaceutical Service – A consultant pharmacist shall be employed, or under contract, and shall: A) be responsible for the duties as specified in 856 IAC 1-7; B) review the drug handling and storage practices in the facility; C) provide consultation on methods and procedures of ordering, storing, administering and disposing of drugs as well as medication record keeping;  D) report, in writing, to the administrator or his or her designee and any irregularities in dispensing or administration of drugs; and E) review the drug regimen of each resident receiving these services at least once every sixty  (60) days. 


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