An Administrator’s Best Friend

Here is a picture of a nursing home administrator’s best friend.  No, not my dog!  It’s the watermelon book sitting behind him. (Although, my Boston Terrier, Maverick,  ranks right up there, too!)

The Long Term Care Survey book, F-tag book, or any other name you might call it is commonly referred to as the “Watermelon Book” in our circles.  It’s called the watermelon book because of the color scheme being red and black on the outside with a section of green pages on the inside.  It gives you a complete list of all the federal regulations by F tag number, major changes that took place, the survey protocol, survey procedures, including how to determine immediate jeopardy and scope & severity, a copy of the guidance to the surveyors, and exhibits of commonly used survey forms.  It is, in fact, your cheat sheet to a great survey.

There is one thing that you must do.  Read the book.  Cover to cover.  And, then read it again.  Everytime you read the watermelon book, you will come across something new, something you had forgotten, or something that maybe you just skimmed over the first time.

To have successful surveys, you must maintain compliance with the regulations within this book – year round.  And, you must know your regs better than your surveyors.  Many administrators and DONs alike get very stressed out during their survey.  The mere mention of the word STATE sends chills through them.  And, why wouldn’t it?  Our entire survey process is flawed.  I regularly encounter surveyors who have never had the responsibility of running a facility or even managing a group of people in healthcare in any shape or form.  In fact, they usually have never worked in a nursing home.  The ones who have, well, many of them didn’t make it in our world, so they left to be surveyors.  So, some of them do, but as a whole, they don’t understand long term care or any aspect of the actual operations of a facility.  Their training generally sucks!  (Hey, what can I say?  Our training isn’t anything to brag about, either.  Most of my training in the AIT consisted of actually running a large building without much guidance – trial by fire!)  I could preach a sermon on the qualifications I believe one needs in order to be an effective surveyor, but that’s another post.  You still must know the regs better than the surveyors.  To keep down the stress, think of survey as if it were a game.  What’s the best way to win a game?  To know the rules.  The watermelon book is your rule book.

Learn your regs, study one a day.  Make your team learn them, too.  Your department heads and key personnel need access to this information even more than you do.  How can you hold a Dietary Manager responsible for F-371, kitchen sanitation, when she has never had the opportunity to read the regulation and has never had access to the watermelon book?  How can you expect a Social Services Director to ensure proper discharge planning is done when she has never been shown what is required by CMS?  Even your Wound Treatment Nurse will be more confident and more effective after reading F-314.

I actually make a copy of tags relevant to each department and distribute to the department heads.  I then ensure that I have enough watermelon books inhouse to have one in my office, one in the DON’s office, and two or three accessible to department heads and staff.  We regularly inservice our frontline staff on the regs, but I also have my department heads and key personnel take the watermelon book and research an F-tag so they can explain it in the next day’s morning meeting.  One F-tag per day and the next department heads brings a different tag the next day.  It works great and many of my department heads say they have learned something they did not know before hearing it explained in the morning meeting F-tag review.

Give it a try and let me know how it works for you.

By the way, if you’d like to purchase a copy of The Long Term Care Survey manual long term care survey manual feel free to click HERE to visit the NURSING HOME PRO’S AMAZON MALL.

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6 Responses to “An Administrator’s Best Friend”

  • streaming on

    lovely dog, it’s realy great to chare with us his picure

  • Mark on

    Thanks, streaming. It wasn’t easy to get him to be still long enough to snap the photo, lol. I was waving a dog treat in the air above him.

  • Diabetes Care Specialist on

    I guess that’s one way to get em to sit still. Too bad we can’t get everyone as interested in learning the regs as your pup is in the treat. I like your ideas on distribution though.

  • Thanks for a good read. I will be returning.

  • eodugger on

    I did the sane thing when I started 3 years ago. I made a copy of the regs relevant to each department and I had each of them bring one of the tags to each department head meeting. My staff enjoyed it and they too stated that they learned a whole lot!!! So thanks for sharing that information with everyone because it really helps!!

  • Mark on

    No problem eodugger! You’re exactly right. It’s amazing when you realize how much your department heads don’t know about the regs when we have to live and breathe them.


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