5 Common Mistakes Auditors Look for and How to Avoid Them

For caregiving organizations, audits and inspections are a necessity. Unfortunately, because they are so routine, home healthcare and long-term care agencies may overlook mistakes that could otherwise be easily remedied.

“Best practices that are discussed with clients are to look at their workplace with the eyes of an outsider,” says Christina Boyle, Director of Client Risk Solutions at Glatfelter Healthcare Practice. “It’s easy to develop blind spots when you are used to a routine.” Boyle spoke with us recently to discuss how clients can better prepare for audits and inspections. Auditors inspect for overall safety, but there are key areas that they tend to focus on, including documentation and policy procedure. According to Boyle, some of the most common mistakes are also the simplest to correct.

5 Common Inspection Violations

1. Documentation

Consistency is key when it comes to documentation. Auditors will check to see if the physician’s orders match the patient’s chart. Items such as home visit frequency and care orders must match as well. Boyle says that medication reconciliation is a common area where caregivers can get tripped up. “Often, it’s as simple as asking the patient if they have been taking any over-the-counter medications, like Neosporin or Advil.” Ensuring that these OTC medications are listed on the patient’s chart and reconciled as changes occur can help avoid a violation during inspection, says Boyle.

For helpful tips on documentation and reconciliation, watch our video, Documentation: It’s Not Bigger Than You.

Along with documentation of patient care, auditors may also look at the organization’s policies. “It’s not enough to have a policy,” warns Boyle, “You also have to follow it.” While many healthcare providers have written policies to safeguard against violations and liability claims, some do not always adhere to their own standards.

2. Fall Risks

The first step to avoiding a patent fall, and a possible inspection violation, is to perform a fall risk assessment. Whether an elderly patient is living in a long-term care facility or their home, fall risk assessments should be performed early on and on a regular basis.

While healthcare facilities typically have equipment, as well as multiple staff and procedures to help prevent patient falls, home care providers have less control over their patients’ living environment. Even though home healthcare agencies cannot remove every threat within a patient’s home, they can educate patients and families on better preventing fall risks. These include loose rugs, electrical cords and even pets. “Many patients do not realize that their small dog could lead to a big fall,” Boyle says.

Does that mean that Fido has to go? “No,” laughs Boyle, “But it might mean that he will need basic command training or to be placed in a crate during certain times of the day.” Again, the end decision lies with the owner, but auditors will want to see that providers have discussed the risk and educated the client on possible solutions.

For more information on preventing patient falls, read our risk communique: Fall Prevention and Management.

3. Fire and Electrical Panels

In an emergency, the last thing you need is an obstacle course preventing you from accessing life-saving equipment. Yet, due to storage constraints, sometimes auditors find facilities place boxes or other objects in front of fire and electrical panels. For the safety of patients and caregivers, these panels must remain unobstructed at all times. “Mark the area with red tape and signs, if you have to,” suggests Boyle. “Anything to get the attention of someone who would otherwise put a barrier in that area.”

Check out our Fire Prevention Checklist for more fire safety tips.

4. Oxygen Tanks

If your patients use free-standing oxygen tanks, auditors will look for two key factors: stability and availability. Are the oxygen tanks in a stable stand, base or cart? Could they easily be knocked down? Are they stored with proper ventilation? “Oxygen tanks are sometimes heavy, but if knocked down or dropped they could become airborne projectiles and a danger to patients and staff,” warns Boyle.

As far as availability, auditors are checking to see that empty tanks are clearly labeled and kept separate from full ones. “Often times, facilities are dinged because someone simply forgot to remove the empty tank after replacing it,” says Boyle.

For more safety information on oxygen tanks, read our risk communique: Best Practices for Resident Smoking and Oxygen Safety.

5. Depression Screenings

It has become common practice for healthcare providers to screen patients for depression during intake. However, some caregiving organizations may not always follow up with a care plan. If an auditor sees that a patient has indicated symptoms for depression or other mental health concerns, but does not see an active plan to address it, the organization could be found in violation.

“Like medication reconciliation, this can affect hospice and home care due to a miscommunication between the primary care provider (PCP) and the organization,” explains Boyle. “Perhaps there is a treatment plan in place, but since it is being handled by the PCP, the hospice or home healthcare organization doesn’t have it in their records.” Upon intake and per facility policy ensure that depression screening is not missed while doing a head to toe comprehensive assessment.

Inspections are unavoidable, but violations and incidents may not be. By regularly assessing your workplace for risk, you can help promote patient safety and avoid these common mistakes.

If you are unsure of where to start, check out these risk resources or reach out to Christina Boyle directly. Christina helps our healthcare clients identify and mitigate risks, so that they can focus on providing excellent patient care.