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TABLE OF CONTENTS (Partial): ENSURING DIETARY STAFF COMPETENCIES, PREVENTING DEFICIENCIES & LAWSUITS

PART: 1 LAWSUITS, BECOMING A “CAPTAIN” IN THE LEGAL BATTLE, TO PREVENT DEFICIENCIES/LAWSUITS, ENSURING COMPETENCY OF STAFF 

WHY DO ATTORNEYS SUE FACILITIES?

ATTORNEY PERSPECTIVE/QUESTION: WHAT CAN WE DO TO CHANGE NURSING HOME CONDUCT?
ARTICLE :MINIMIZING THE RISKS OF CHOKING DEATH IN NURSING HOME RESIDENTS 

ARTICLE: LESSONS FROM NURSING HOME DYSPHAGIA MALPRACTICE LITIGATION
ARTICLE: PATIENT CHOKES TO DEATH AFTER HOSPITAL FEEDS HER SANDWICH SHE CAN’T EAT
ARTICLE: WAR HERO DIED AFTER CHOKING ON HOSPITAL FOOD HE WASN’T MEANT TO EAT

ARTICLE: CHOKING DEATHS IN HOSPITAL DOWN TO SOFT FOOD CONFUSION

ARTICLE: TOOTHLESS PATIENT CHOKES TO DEATH AFTER NURSING HOME STAFF IGNORES DOCTOR’S ORDER
ARTICLE: DEHYDRATION AND MALNUTRITION IN NURSING HOMES

ARTICLE: NURSING HOME NEGLECT INDICATION IN MINNESOTA: MALNUTRITION

CASE STUDY OF A PLAINTIFF: FAMILY AGAINST A DEFENDANT: “CARE CENTER” FOR FAILURE TO PREVENT A CHOKING DEATH ON FRENCH TOAST (Author was expert witness for Care Center)

CASE STUDY OF A RECENT LAWSUIT (PLAINTIFF IS FACILITY) AGAINST THE STATE AGENCY (CA DEPT OF PUBLIC HEALTH) FOR CITING A STATE TITLE 22 DIRECT PROXIMATE “CAUSE” OF DEATH DUE TO CHOKING (QUESADILLA ON MECHANICAL SOFT DIET), REQUESTING A REDUCTION OF THE $100,OOO  LEVEL AA CITATION TO LEVEL A ($2,000 to $20,000) (AUTHOR WAS EXPERT WITNESS FOR FACILITY)

CASE STUDY OF A RECENT LAWSUIT (PLAINTIFF IS A FAMILY) AGAINST ASSISTED LIVING FACILITY (DEFENDANT) FOR MALNUTRITION/DEHYDRATION, AND FAILURE TO PROVIDE ADEQUATE STAFF TRAINING (FOR MECHANICAL SOFT DIET) AND PROVISION OF NUTRITION CARE (Author was expert witness for family)

PART II: FOR COMPLIANCE AND “COMPETENT” STAFF: KNOW REGULATIONS (FEDERAL AND LOCAL STATE) AND PROFESSIONAL STANDARDS OF PRACTICE  IN ORDER TO ESTABLISH EFFECTIVE SYSTEMS OF TRAINING, COMPETENCY, MONITORING AND QAPI

ACCESSING CMS REGULATIONS (ALL LEVELS OF CARE),  HOSPITAL REGULATIONS, SURVEY PROCESS (HELPFUL TO LTC/NURSING HOMES AND OTHER LEVELS OF CARE)

SELF EVALUATION FOR AREAS OF IMPROVEMENT, BASED UPON CMS HOSPITAL PATIENT SAFETY INITIATIVE

LTC/NURSING HOME REGULATIONS, SURVEY PROCESS (RECENT REVISION IS VERY APPLICABLE AND HELPFUL FOR HOSPITAL AND AL LEADERSHIP) DETAILED CMS SURVEYOR “PATHWAYS”

F 540, 550 ABUSE, CONSIDERED “NEGLECT” IF STAFF ARE NOT COMPETENT IN DELIVERY OF CARE, RESIDENT RIGHTS

F 658:  QUALIFIED PERSONS (FOLLOWING ACCEPTED CURRENT STANDARDS OF PRACTICE IN INDUSTRY)

WHAT IF A SURVEYOR IDENTIFIES A DEFICIENCY PRACTICE, AND THE FACILITY STAFF DISAGREE AND CAN PRODUCE EVIDENCE/REFERENCES THAT THEIR PRACTICE IS AN ACCEPTABLE STANDARD OF PRACTICE?

IN REGULATION: WHO IS ULTIMATELY RESPONSIBLE TO ENSURE THAT STAFF ARE TRAINED, COMPETENT AND FOLLOWING APPROVED STANDARDS IN INDUSTRY? THE DIETITIAN

ESTABLISHING PRACTICE STANDARDS AND COMPETENCIES FOR DIETITAN AND DIETARY MANAGER

QAPI ON ESTABLISHING NEW DYSPHAGIA STANDARDS (IDDSI) AND EFFECTIVE SYSTEMS

EVERY FACILITY SHOULD BE PREPARED TO PROVIDE THE NEEDS OF RESIDENTS WITH  THE NEW DYSPHAGIA DIETS (MODIFIED TEXTURE AND LIQUID.)

REVIEWING THE REGULATORY REQUIREMENTS ON RESIDENT RIGHTS (TO REFUSE AN ORDERED DIET), AND FACILITY RESPONSIBILITIES (F TAGS ARE FROM REVISION 11/22/17)

ROLE OF THE CERTIFIED DIETARY MANAGER IN PERSON DIRECTED CARE (POSITION PAPER ANFP, DEVELOPED BY THIS AUTHOR)

HONORING CULTURAL AND ETHNIC PREFERENCES, INCLUDING VEGETARIAN AND VEGAN CHOICES

CA SENATE BILL (SB) 1138: FOOD OPTIONS: PLANT-BASED MEALS (ALL FACILITIES LETTER, CDPH): NOW REQUIRED IN HEALTHCARE

ESTABLISHING A QAPI FOR ENSURING VEGETARIAN AND VEGAN DIETS HAVE EQUIVALENT MENU OFFERINGS AND MEET RESIDENT PREFERENCES

PART III: UNDERSTANDING THE TRAINING OF A SURVEYOR AS INVESTIGATOR, PREPARING TO BE A WITNESS

LEARN TO THINK LIKE A SURVEYOR: TAKE THE BASIC HEALTH FACILITY SURVEYOR COURSE: INTRODUCTION TO SURVEYING FOR LONG TERM CARE (PRINCIPLES OF DOCUMENTATION): ONLINE COURSE FOR NEW SURVEYORS ON HOW TO INVESTIGATE DEFENSIBLE DEFICIENCIES, DETERMINE DEFICIENCIES, AND TO WRITE THEM

LEARN TO BE AN EFFECTIVE WITNESS (IN DEPOSITIONS, IN TRIALS) : PREPARATION, CMS DEFINES 20 POINTS, STATEMENTS TO AVOID; LEARN WHAT CAN BE DEMANDED DURING DEPOSITIONS, TRIALS: ALL EMAIL AND CELL PHONE COMMUNICATIONS

PART IV: EFFECTIVE FNS SYSTEMS

ESTABLISHING EFFECTIVE POLICIES AND PROCEDURES
CHECKLISTS FOR COMPETENCY

PART V: SANITATION

ARTICLE: Food Poisoning in Nursing Home Lawsuit – Elderly Care Claims

“HUDDLE” HIGH RISK TOPICS

QAPI PERFORMANCE IMPROVEMENT PROJECT: EMPLOYEE HEALTH AND PREVENTING FOOD BORNE ILLNESS SYMPTOMS/EXPOSURES

REVISED FEDERAL REGULATIONS AND CMS MEMO FOR OUTSIDE FOOD & RIGHTS