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The Federal Regulations related to Pressure Sores in Nursing homes are found at CFR 483.25(c). This is commonly referred to as F-Tag 314. These regulations state:

  • Based on the comprehensive assessment of a resident, the facility must ensure that–
    • (1) A resident who enters the facility without pressure sores does not develop pressure sores unless the individual?s clinical condition demonstrates that they were unavoidable; and
    • (2) A resident having pressure sores receives necessary treatment and services to promote healing, prevent infection and prevent new sores from developing.

The more accepted term for Pressure Sores is Pressure Ulcers. The State Operations Manual has interpretive guidelines to surveyors which refers to the term Pressure Ulcers.

What do these regulations mean? They mean the nursing home is to be sure the resident does not develop pressure sores unless it was “clinically unavoidable”.

It also means the nursing home must provide care and services to:

  • Promote the prevention of pressure sore development;
  • Promote the healing of pressure ulcers that are present (including prevention of?infection if possible); and
  • Prevent development of additional pressure ulcers.

What does it mean to be avoidable or unavoidable?

To put the pressure ulcer(s) into one of these two categories the following measures are reviewed to see if the facility did them or not:

  • Evaluation of the resident’s clinical condition and pressure ulcer risk factors
  • Definition and implementation of interventions that are consistent with resident needs, resident goals, and recognized standards of practice
  • Monitoring and evaluation of the impact of the interventions
  • Revision of the interventions as appropriate

If the facility fails to do even one of these then the pressure ulcer is considered avoidable. It could have been prevented or healed. Facilities have a duty to the resdient to ensure they do everything they can to avoid pressure ulcers or to heal those already present.

If the facility does all of the actions listed and yet the pressure ulcer occurs, then it is considered unavoidable. The facility did all it could do but the pressure sore developed anyway. This can sometimes happen.

We will discuss more about pressure ulcers and what the Nursing Home and Hospital Surveyors look for as they do a survey or investigation in a nursing home.

Keep Safe!

JL

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