Ensuring Compliance: Achieve and Maintain Regulatory Standards in Long Term Care Facilities with Vital Sign Monitoring

Achieving skilled nursing facility compliance is a persistent challenge for many senior care administrators and managers. This isn't because administrators prefer to operate in a noncompliant state. It's usually because of how difficult it can be to get a facility on the right track. Compliance standards vary from location to location and can be tough to decipher. They also may require resources your facility simply doesn’t have.

If you're in a leadership position at a long-term care facility, chances are you know the importance of abiding by regulatory standards. They are in place to keep your residents healthy and thriving, and non-compliance could put you on the receiving end of serious enforcement measures like fines, penalties, or even facility closure orders. Over time, these sanctions have grown in severity, and this trend is expected to continue. Plus, residents of non-compliant facilities have a higher probability of negative health consequences.  

Though your compliance situation may seem bleak, obtaining the right knowledge can open your facility up to new and promising possibilities. And that's where we can help. Whether you've been working towards compliance for a while or are a newer facility trying to find your footing, this guide will be invaluable to you.

We'll share how to achieve and maintain compliance in your facility with vital sign monitoring. We'll cover topics like how to learn about compliance rules, the nursing home compliance resources available to you, why vital sign monitoring is necessary for compliance, and how to get help with vital sign monitoring.

Learn About Applicable Skilled Nursing Facility Compliance Information

Jumping right into vital sign monitoring without a good understanding of compliance regulations is pointless. The first step to achieving senior care compliance is to learn all you can about the rules and regulations that apply to your facility.

Assuming you don't have a significant background in compliance law, we recommend speaking with a lawyer or legal professional to do some groundwork. Ask them for an assessment and a report breaking down the laws applicable to your specific community.

During this process, ensure that the professional considers local and federal regulators, including the Centers for Medicare and Medicaid Services (CMS). This is especially important if your facility operates in the United States or you want to be contracted with CMS and receive reimbursement for covered residents.

You need to know the compliance laws forward and backward to decipher what is expected of your staff and facility.

Don't have the funding for a professional? Put on your detective hat and get to researching on your own. Be very thorough and reach out for legal assistance whenever you're stumped or need guidance. Sometimes, you can call a legal professional and ask a question for a low fee (or even for free). Remember that there are things that you could miss or misinterpret without the necessary training. So, it is best to get a professional on the job.

What Happens If You Fail to Comply

It's never pleasant to think about what would happen if your facility were found to be non-compliant. But it pays to be informed. Non-compliant facilities in North America could face one or more of the following issues* (whether they knew about the rule or not):

• Citations for violations.
• Fines commensurate with the violation.
• A cap on your resident admission numbers
• Suspension or revocation of your nursing home license, certification, etc.
• The closure of your facility.
• Transfer of your residents.
• Directed plan of action.
• Termination of your contracts with federal or state agencies.

*This isn't a full list of sanctions. The governing body, the specific offence, and your facility’s location are a few factors determining the specific sanctions on the table.

On the first offence, you may be given a chance to fix the problem or retrain your staff, though this isn't guaranteed.

Compliance Resources for Long-Term Care Facility Administrators

Becoming compliant is obviously the right thing to do, but there’s no denying that it’s arduous. You'll struggle to achieve and maintain compliance if you don't have the right resources in place.

Nursing Home/Healthcare News Outlets

Laws and regulations aren’t static; just as the world changes, so do resident needs and concerns. And the laws will be updated here and there to reflect that. You can stay in the know by subscribing to healthcare/nursing home news outlets. Here are a few reputable ones in both America and Canada:

• Skilled Nursing News
• CMS Blog
• American Medical Association Blog
• Federal News Network
• Health and Human Services News
• Agency for Healthcare Research and Quality News
• Canada Government Website
• Canadian Medical Association News
• Global News Canada

Regulators normally give skilled nursing facilities a grace period to adjust and become compliant with new compliance rules. But the sooner you know about the legislation, the more time you must pivot or tweak your policies, procedures, goals, etc. Be sure to only follow official news outlets, as there's a lot of noise on the internet — some outlets are unreliable, prompting the need for additional research on reputable sites.

 Regulatory Guides for Senior Care Facilities

Certain governing bodies, federal programs (CMS, for example), and certifying organizations have created and distributed regulatory guides to assist administrators with compliance. These guides may contain a list of laws in layman's terms and guidance on how to comply with the rules. Here's a regulatory guide from CMS that may clear some things up for you.

Your local or federal government may have also published such a guide on their official website — it's worth a look. Just be sure to verify the date of publication; if the guide is outdated, it won't be helpful, considering the nature of changing laws. If there's no publication date (which would be rare), look for the date the information was last updated. You should be able to find it near the top or bottom of the document.   

Compliance Roadmaps

Compliance guidance books and e-books are published to help facility managers move through the compliance world with more confidence. You may come across compliance cheat sheets, books, and specific works focused on tackling very specific compliance problems. Reading these will help with compliance in general.

Healthcare Technology

Advanced healthcare equipment and programs are being brought to market to make nursing home administrators' jobs easier, thereby improving care quality and compliance in nursing homes. Technologies include Electronic Health Records (EHR) systems, remote/Bluetooth-enabled vital sign monitoring technologies, compliance management software, and more. To find the right solutions, think about the facility’s current situation, workflows, and financial capabilities. 

Why Proper Vital Sign Monitoring is Key to Compliance for LTC Facilities 

If you haven't fully tapped into vital sign monitoring for your facility, the time to do so is now. You can't afford to waste another moment because proper vital sign monitoring is key to compliance for an LTC facility.

Proper Vital Sign Monitoring is an Involved Process

Vital sign monitoring not only means checking residents' vitals to get a picture of their health state, it means much more. Though regular vitals measurements are a big part of compliance for senior care facilities, it's far from the only aspect to consider. Here are some other essential vital sign monitoring functions that should be on every administrator's radar:

• Correctly documenting residents’ vital sign measurements and remeasuring in the case of unexpected results. Your EHR system comes in handy here, but only if your charting procedures are iron-clad and your team follows them consistently.
• Drafting and distributing vital sign measurement procedures to enhance accuracy and reliability. Your team cannot adhere to policies they haven't been informed of. Post the procedures around your community, make them viewable online, and have a contact available to answer questions your team may have about them.
• Ensuring the security of resident health information. Through physical measures (shredding or locking up documentation as necessary), camera surveillance, strong passwords, antivirus software, and secure programs. This requires an all-hands-on-deck effort with multiple layers of security for maximum protection.
• Training and retraining staff as necessary. This will foster confidence and build competence across your community. Even if a team member's first compliance training session went well, they might need a quick refresher session down the line to keep them sharp. This goes for everyone on your team.
• Doing routine quality checks and audits based on vital sign data. Even if your facility can obtain full compliance at one point, things could very easily fall off the rails — errors in measurements, failing to follow facility procedures, and documentation errors are common in nursing homes. The practical next step would be to correct any issues as needed, but you won't be able to identify these issues if you're not doing continual audits and checks. Typically, these audits involve examining vital sign data for outliers and trends, speaking to residents and their families, and reviewing patient records. Each case will be different, but the information you uncover will be invaluable to your residents and the facility.
• Keeping the doors of communication wide open across your facility. Vital sign data offers insights that may require clinical professionals to make swift changes to your residents’ care plans. Interdisciplinary teams will need to collaborate to make proactive changes in the best interests of your residents. You can enable this with easy communication protocols in place.

Vital sign monitoring isn't a one-time task to check off your to-do list. It's an ongoing process spanning from data analysis to quality checks to training and much more. And the best, most compliant nursing facilities have a handle on these aspects of vital signs monitoring.

How Vital Sign Monitoring Helps with Compliance in Skilled Nursing Facilities

By this point, you may have a basic idea of how vital sign monitoring and compliance are related, but we'll get a little deeper into it here. There are several ways that vital sign monitoring helps to push your facility toward compliance, and they include:

• Boosting quality of care by preventing adverse resident health events. When vital sign monitoring is effectively and proactively done, your facility will be able to stop routine resident issues from turning into emergencies or fatalities. With this increased capacity to care for residents, you'll be in better shape from a compliance perspective.
• Saving time on administrative tasks, enabling nurses to provide more direct care to residents. On average, nurses spend more than half of their shifts on documentation and administrative tasks rather than providing direct resident care. To improve resident care in LTC settings, CMS and other regulators set minimum direct care requirements, often framed as a minimum amount of direct care per resident per day or hours per resident day (HPRD). Through smart, effective vital sign monitoring utilizing recent technologies, your staff can spend more time providing direct care as required for compliance.
• Having the ability to track your facility's progress against compliance goals. Looking at your vital sign data over time can help you gauge the effectiveness of any actions you're taking. Imagine a scenario where you decide to make a staffing change for the betterment of the residents and to meet compliance rules. If you have been accurately and continually tracking your residents' vitals, you can compare vitals before and after the change to find out whether that was a good decision and determine what to do next.
• Knowing when nursing professionals require additional vital signs training or when a full-blown staffing change is needed. Vital sign equipment, systems, and processes are always changing, and this sometimes calls for additional training. When looking at the vital sign data, you may see that a certain group of patients have abnormally high blood pressure readings at a certain time of day. This could mean that the nurse looking after them at that time could use some retraining. Accurate vital sign measurements are a huge part of compliance.

*This is not an exhaustive list of ways that vital sign monitoring and compliance are intertwined.

Get Help with Vital Sign Monitoring for Your Facility

Vital sign monitoring is no easy task, regardless of the size of your facility. There are so many moving parts that the average team can't handle it without help. That's precisely why nursing home compliance solutions like VitalLink exist.

VitalLink is a game-changing vitals monitoring solution designed to help senior care administrators elevate resident care quality and crush compliance initiatives. It utilizes Bluetooth technology and advanced software engineering to produce the following benefits:

• Easy and quick syncing of vital sign data. Vitals measurements automatically sync from Bluetooth vitals equipment to the VitalLink system application which you'll easily integrate with your existing EHR system. This means less time spent on data entry, less room for manual errors, and enhanced vitals monitoring workflows. 
• Real-time alerts that allow for quicker interventions by your clinical staff. Accurate data will be in one central location for easy interdisciplinary communication and collaboration. This reduces confusion, potentially speeding up resident intervention times.
• Ability to set personalized health check protocols for each resident. This lends itself well to facilities striving to provide high-quality person-centred care. Nursing homes without the digital infrastructure in place often struggle to provide cookie-cutter care, much less personalized care plans.
• Secure vitals documentation. VitalLink is compliant with the Personal Information Protection Act (PIPA), the Personal Information Protection and Electronic Documents Act (PIPEDA), and the Health Insurance Portability and Accountability Act (HIPAA). If you're lagging on compliance, VitalLink can help you catch up.

Get up and running in just a few steps:

1. Integrate VitalLink with your existing EHR system.
2. Connect your Bluetooth devices to the VitalLink software.
3. Take vitals measurements, update any resident data, and sync the data to your existing EHR system.
4. Set up your vitals thresholds, protocol reminders, real-time alerts, and more.

Nursing Home Compliance is Within Reach

So, there you have it — how to achieve and maintain regulatory standards in long-term care facilities with vital sign monitoring. Know that every facility's journey will be different from the next. So, we urge you to keep an open mind and educate yourself on compliance at every turn. It also helps tremendously to incorporate the best technological solutions into your staff and management workflows. VitalLink is one such solution that every senior care administrator should consider.