Nursing Home Work Plan

I. Introduction

A. Purpose

The purpose of this Nursing Home Work Plan is to provide a comprehensive framework for the effective management and operation of [Nursing Home Name]. By delineating roles, responsibilities, and procedures, this plan aims to ensure the delivery of high-quality care to residents while maintaining compliance with regulatory standards and promoting a safe and nurturing environment.

B. Scope

This work plan encompasses all facets of nursing home operations, including resident care, staff management, facility maintenance, administrative tasks, and emergency preparedness. It serves as a guiding document for all staff members involved in the day-to-day functioning of the nursing home.

II. Resident Care

A. Assessment and Care Planning

Task Description	Responsible Party	Timeline
Conduct initial assessments for all residents	Registered Nurse	Upon admission
Develop individualized care plans based on assessments	Interdisciplinary Team (including RN, LPN, and Social Worker)	Within 72 hours of admission
Review and update care plans regularly	Interdisciplinary Team	Every 90 days or as needed based on changes in resident's condition

• Upon admission to [Nursing Home Name], all residents undergo comprehensive assessments conducted by registered nurses to evaluate their physical, cognitive, and psychosocial needs. These assessments inform the development of individualized care plans tailored to each resident's preferences and requirements.

• The interdisciplinary team, consisting of registered nurses, licensed practical nurses, and a social worker, collaborates to develop care plans within 72 hours of admission. These plans outline specific interventions and goals aimed at optimizing the resident's health and well-being.

• Care plans are reviewed and updated regularly, at least every 90 days or more frequently as needed based on changes in the resident's condition or preferences. The interdisciplinary team reassesses the resident's needs and adjusts care plans accordingly to ensure they remain relevant and effective.

B. Medication Management

Task Description	Responsible Party	Timeline
Establish medication administration protocols	Director of Nursing	Upon admission
Document medication administration and resident responses	Certified Medication Aides (CMAs)	Immediately after administration
Conduct regular medication reviews	Pharmacist, Director of Nursing	Quarterly

• The Director of Nursing is responsible for establishing protocols for the safe administration of medications in accordance with state regulations and nursing home policies. These protocols outline procedures for medication storage, preparation, administration, and documentation.

• Certified Medication Aides (CMAs) are tasked with administering medications to residents as prescribed by their healthcare providers. CMAs document each medication administered and note any observed responses or adverse reactions immediately following administration.

• To ensure the safety and efficacy of medication regimens, a pharmacist collaborates with the Director of Nursing to conduct quarterly medication reviews. During these reviews, they assess residents' medication profiles for potential drug interactions, side effects, or duplications and make recommendations for adjustments as needed.

III. Staff Management

A. Recruitment and Training

Task Description	Responsible Party	Timeline
Develop job descriptions for vacant positions	Human Resources Department	[Upon Need]
Advertise job openings through appropriate channels	Human Resources Department	[Upon Need]
Screen and review applications	Human Resources Department	[Upon Receipt]
Conduct interviews and select candidates	Department Managers	[Upon Application Review]
Conduct orientation for new hires	Human Resources Department	Within 1 week of hire
Provide ongoing training and development opportunities	Department Managers	Ongoing

• The Human Resources Department is responsible for developing job descriptions for vacant positions based on the nursing home's staffing needs and regulatory requirements. These job descriptions outline the roles, responsibilities, and qualifications necessary for each position.

• Job openings are advertised through appropriate channels, such as online job boards, local newspapers, professional associations, and recruitment agencies, to attract qualified candidates.

• The Human Resources Department screens and reviews applications received for each position, ensuring that applicants meet the minimum qualifications and possess the required credentials and experience.

• Department managers conduct interviews with selected candidates to assess their suitability for the position based on their skills, experience, and fit with the organizational culture.

• Upon selecting candidates, department managers collaborate with the Human Resources Department to extend job offers and facilitate the onboarding process. New hires participate in orientation sessions conducted by the Human Resources Department to familiarize them with nursing home policies, procedures, and expectations.

• Department managers provide ongoing training and development opportunities to staff members to enhance their skills, knowledge, and competencies. Training programs may include courses on resident care techniques, infection control practices, emergency procedures, and professional development seminars.

B. Scheduling and Staffing Levels

Task Description	Responsible Party	Timeline
Develop staffing schedules based on resident needs	Nursing Supervisor	Weekly
Monitor staffing levels and adjust schedules as needed	Nursing Supervisor	Daily
Address staffing shortages through temporary staffing agencies or overtime shifts	Department Managers	[Upon Staffing Shortages]

• The Nursing Supervisor is responsible for developing staffing schedules that meet the needs of residents while adhering to regulatory staffing requirements. Schedules are created weekly and take into account factors such as resident acuity, census, and staff availability.

• The Nursing Supervisor monitors staffing levels daily and adjusts schedules as needed to ensure adequate coverage for all shifts. This may involve reallocating staff, calling in additional resources, or adjusting staff assignments based on workload and resident needs.

• In the event of staffing shortages, department managers collaborate with temporary staffing agencies or authorize overtime shifts to maintain appropriate staffing levels and ensure the safety and well-being of residents.

C. Performance Management

Task Description	Responsible Party	Timeline
Establish performance expectations and job standards	Department Managers	[Upon Hire]
Provide regular feedback and coaching to staff members	Department Managers	Ongoing
Conduct formal performance evaluations	Department Managers	Annually
Address performance issues and provide support for improvement	Department Managers	As needed

• Department managers are responsible for establishing clear performance expectations and job standards for staff members upon hire. These expectations are communicated effectively and aligned with the nursing home's mission, vision, and values.

• Department managers provide regular feedback and coaching to staff members to recognize their achievements, address performance gaps, and support their professional growth and development. Feedback is provided in a timely and constructive manner to promote continuous improvement.

• Formal performance evaluations are conducted annually to assess staff performance against established goals and job standards. These evaluations provide an opportunity for staff members to receive feedback on their performance, identify strengths and areas for improvement, and set goals for the upcoming year.

• Department managers address performance issues promptly and provide support and resources to help staff members improve their performance. This may involve additional training, coaching, or mentoring, as well as disciplinary action if necessary.

IV. Facility Maintenance

A. Environmental Safety

The Maintenance Supervisor is responsible for conducting regular inspections of the facility to identify potential safety hazards and risks. These inspections cover areas such as:

• Building structure: Inspection of walls, ceilings, floors, doors, and windows for signs of damage, deterioration, or structural weaknesses.

• Electrical systems: Evaluation of electrical wiring, outlets, switches, and appliances to ensure compliance with safety standards and prevent electrical hazards.

• Plumbing systems: Inspection of pipes, faucets, toilets, and water heaters for leaks, clogs, or other issues that may pose health or safety risks.

Based on the findings of the inspections, the Maintenance Supervisor develops and implements corrective action plans to address identified safety hazards and risks. This may involve repairs, replacements, or modifications to the facility infrastructure or systems.

In addition to routine inspections, the nursing home maintains emergency preparedness plans to address potential safety risks, such as fires, severe weather, and infectious disease outbreaks. These plans outline procedures for evacuations, sheltering in place, communication, and coordination with emergency response agencies.

B. Equipment Maintenance

The Maintenance Supervisor establishes a schedule for routine maintenance and servicing of medical equipment, assistive devices, and facility machinery. This schedule includes:

• Regular inspections: Scheduled inspections of equipment to identify signs of wear, damage, or malfunction that may affect performance or safety.

• Preventive maintenance: Routine maintenance tasks, such as lubrication, calibration, and cleaning, to keep equipment in optimal working condition and extend its lifespan.

• Repairs and replacements: Prompt repair or replacement of faulty equipment to minimize downtime and ensure uninterrupted resident care services.

Maintenance staff members are trained on the proper use and maintenance of equipment to ensure compliance with manufacturer specifications and safety standards. Training includes instruction on equipment operation, maintenance procedures, troubleshooting techniques, and safety precautions.

The Maintenance Supervisor maintains records of equipment maintenance activities, including inspection reports, service logs, and repair records. These records document compliance with regulatory requirements, demonstrate due diligence in equipment maintenance, and facilitate traceability in the event of equipment-related incidents or audits.

V. Administrative Tasks

A. Recordkeeping and Documentation

Task Description	Responsible Party	Timeline
Maintain electronic health records (EHR)	Health Information Management Department	Ongoing
Document resident assessments, care plans, and interventions	Nursing Staff	Immediately
Record significant events, incidents, and interventions	Nursing Staff, Administrative Staff	Immediately
Ensure confidentiality and security of resident information	HIPAA Compliance Officer	Ongoing

The Health Information Management (HIM) Department is responsible for maintaining electronic health records (EHR) for all residents. This includes:

• Creating and updating resident records to reflect assessments, care plans, progress notes, and other relevant documentation.

• Ensuring the accuracy, completeness, and integrity of EHR data through regular audits and quality assurance measures.

• Providing secure access to EHRs for authorized staff members while maintaining confidentiality and compliance with HIPAA regulations.

Nursing staff members are responsible for documenting resident assessments, care plans, and interventions in the EHR system immediately after completion. This documentation includes:

• Comprehensive assessments conducted upon admission and at regular intervals to evaluate residents' health status, functional abilities, and care needs.

• Individualized care plans developed in collaboration with residents, families, and healthcare providers to address identified needs, preferences, and goals.

• Documentation of interventions, treatments, medications administered, and resident responses to care interventions to ensure continuity of care and communication among interdisciplinary team members.

In addition to routine documentation, nursing staff and administrative personnel are responsible for recording significant events, incidents, and interventions as they occur. This includes:

• Notifying appropriate personnel and documenting incidents such as falls, medication errors, resident injuries, or behavioral disturbances promptly and accurately.

• Recording interventions implemented to address incidents, including assessments, interventions, communications with healthcare providers, and follow-up actions taken to prevent recurrence.

The HIPAA Compliance Officer is responsible for ensuring the confidentiality and security of resident information in compliance with HIPAA regulations. This includes:

• Providing staff training on HIPAA policies and procedures, including privacy practices, security safeguards, and breach reporting requirements.

• Conducting regular audits and assessments to monitor compliance with HIPAA standards and identify areas for improvement or corrective action.

• Investigating and addressing any reported breaches or violations of HIPAA regulations, including notification of affected individuals, regulatory agencies, and other stakeholders as required.

VI. Conclusion

A. Continuous Improvement

Task Description	Responsible Party	Timeline
Conduct quality improvement (QI) initiatives	Quality Improvement Committee	Ongoing
Solicit feedback from residents, families, and staff members	Administration, Resident Council, Staff Meetings	Regularly
Implement process improvements based on feedback and QI findings	Department Managers, Quality Improvement Committee	As Needed

The Quality Improvement (QI) Committee is responsible for leading and coordinating quality improvement initiatives to enhance the overall quality of care and services provided at [Nursing Home Name]. This includes:

• Identifying opportunities for improvement through data analysis, performance monitoring, and feedback from residents, families, and staff members.

• Developing and implementing action plans to address identified areas for improvement, such as reducing medication errors, improving resident satisfaction, or enhancing infection control practices.

• Monitoring the effectiveness of QI initiatives through ongoing data collection, measurement, and evaluation to ensure sustained improvements in resident outcomes and organizational performance.

[Nursing Home Name] actively solicits feedback from residents, families, and staff members to identify opportunities for improvement and ensure alignment with resident preferences and expectations. This feedback is gathered through various channels, including:

• Resident and family satisfaction surveys conducted regularly to assess perceptions of care quality, communication, and overall satisfaction with services.

• Resident council meetings, family forums, and staff meetings where feedback and suggestions for improvement are solicited, discussed, and addressed.

• Informal feedback mechanisms such as suggestion boxes, comment cards, and open-door policies that encourage open communication and engagement among stakeholders.

Based on feedback received and QI findings, department managers and the QI Committee collaborate to implement process improvements and best practices that enhance resident care and organizational efficiency. This may include:

• Revising policies, procedures, and protocols to reflect best practices and incorporate resident preferences and feedback.

• Providing additional staff training and resources to address identified areas for improvement and promote a culture of continuous learning and excellence.

• Monitoring the impact of process improvements through ongoing performance measurement and evaluation to ensure sustained progress and positive outcomes for residents and stakeholders.

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