Massachusetts State surveyors are scrutinizing the environment and training expectations for facilities who have a registered “Specialty Dementia Unit” in their facility. The focus on the physical environment during survey proves to be a deep dive into very specific parameters. In reading the guidelines, they may appear to be general in nature, but when surveyors are on site the attention to environmental standards is very specific. All Providers, regardless of the presence of a Specialty Unit in the facility, should read the Licensing for Long Term Care Facilities, Section 150.029, Physical Environment for Dementia Care Units, to prepare for Regulatory survey with this special focus population in mind. Dementia Focused Survey is not far down the road as a standard of practice, so these guidelines will allow facilities to expand the measures taken to promote safety and functional performance at the highest practical level.
Review the downloads included in this post with your team, specifically the environment and training guidelines so you can properly prepare for SURVEY.
Below are five tips for preparing for the Dementia Survey in Massachusetts (but other states should take note!).
1. These are Massachusetts regulations!
2. A facility cannot advertise and promote that they have a Dementia Specialty unit unless they meet all of the criteria outlined in download.
3. Areas of focus are not clearly outlined in the regs.
a. Surveyors measure the windows in each room (on the dementia unit) to see how far they could be opened.
i. "They should only open at the most 4 inches."
ii. See Section I, Safety, of 150.029 page 78 of the Licensing of Long-Term Care Facilities download. It does not specify a measured amount.
4. The Regulations define the training required for all relevant staff when the facility has this Specialty Unit.
a. All staff must have 8 hours of orientation as well as 4 hours annually.
b. This includes all departments that would be on the unit, not just nursing staff
c. Relevant staff members are defined as “…direct care workers, therapeutic activity directors and supervisors of direct care workers.”
d. Any missed staff at all, even one, will result in a tag!
e. Training must include some interactive opportunities and not simply watching a video.
f. The state is putting a huge emphasis on education if the facility has submitted to the state that they have this type of specialty unit.
5. In Section 150.029 of the Licensing for Long Term Care Facilities download there is guidance for the physical environment.
a. Focus on the finish (paint color) of the doorway in contrast to the color of the wall in the room.
b. See Section E, Finishes, on page 77 that discusses the expectation.
c. The guideline states high visual contrast for doorways and walls in high resident use areas.
Dementia care is a specialty area which supports focused training for all staff to maintain the safest and highest quality of care. The regulations provide some guidance, but Providers need to think beyond what is in black and white as the Surveyors are doing just that.
If you have questions about Dementia Surveys, please contact Harmony Healthcare International by clicking here or calling our office at (800) 530-4413.