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Ftag of the Week – F659 Qualified Persons

This week’s “Ftag of the Week” on the CMSCG Blog is F659 Qualified Persons, which is part of the Comprehensive Resident Centered Care Plans regulatory group. This requirement is part of the care planning group because it requires that the services that have been set out in the comprehensive care plan (CCP) to be provided by the facility are provided by qualified staff in accordance with the individual resident’s plan of care. Staff are required, per the Interpretive Guidance (IG) to have “the skills, experience and knowledge to do a particular task or activity,” including licensure/certifications as necessary. It also states that non-compliance with this regulation creates a situation where a resident is at risk for more than minimum harm, so Level 1 severity is not applicable if F659 is to be cited.

F659 can be cited for a wide range of deficient practices related to staff not doing what they were supposed to do in order to follow the plan of care. This includes things such as med administration, not ensure residents are wearing TEDs, not providing pressure-relieving devices as ordered, or assistance with transfers.  There is a great example of a Level 2 deficiency under this tag related to an observation of a staff member taking and reporting abnormal BPs. It was determined that the staff member was using the wrong size BP cuff so incorrect BP readings were being reported. It is as simple as that – using the wrong piece of equipment can result in a deficient practice being identified. You can see how it all ties together with skills and competencies that your staff should have been trained to do based on their assigned job duties.

This tag is being cited twice as frequently on standard surveys under the LTCSP as it is on complaint surveys. It has also been cited at an immediate jeopardy level several times, with about an even mix of citations between standard and complaint surveys. What you also need to keep in mind is that beginning 11/28/19 (Phase 3) the culturally-competent and trauma-informed component of this Ftag will be assessed. So start educating your staff now!

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