Supervision of Resident Policy

Supervision of Resident Policy

Effective Date: [Original NPP Date]
Revised Date: [Current Date]

Goal:
To provide staff monitoring of residents, as needed for resident safety and care needs.

Policy:

Definitions:

I. 1:1 Observation:
Constant observation of an individual resident by a facility (or agency contracted) staff member, with the staff member maintaining close proximity to the resident.

II. Constant Observation:
Constant visual observation of an individual resident by a facility (or agency contracted) staff member or auxiliary caregiver or volunteer, as designated by timeframes in the resident’s care plan.

III. Supervision:
Visual observation by a facility (or agency contracted) staff member of a resident.

Procedure:

I. If the facility has determined that a resident’s actions or behavior presents a risk of danger or harm to themselves, others, or property, the following procedures shall be implemented.

II. A decision shall be made by the Administrator, Director of Nursing &/or Nursing Supervisor as to whether an individual resident’s behavior necessitates 1:1 observation, constant observation, or supervision.

III. The resident’s attending physician and responsible party shall be notified of any change in the resident’s status.

IV. The resident’s 1:1 observation, constant observation, or supervision shall be documented in the medical record.

V. If a resident has been assessed by the facility as presenting a risk of harm or injury to self or others, the facility must seek consultation from the facility’s consulting psychiatrist to determine whether:

1. The resident’s current condition can be managed within the facility, or
2. Emergency transfer to a more suitable institution (i.e., psychiatric hospital, general hospital emergency department) is necessary.

VI. If the resident has been assessed by the facility as presenting a risk of harm or injury to self or others, the resident should be placed on 1:1 observation until seen by a physician (M.D. or Psychiatrist) OR an order is obtained for transfer to the emergency department for a psychiatric evaluation. When the resident returns from the emergency department or inpatient psychiatric hospitalization, the hospital discharge documentation should reflect that the resident is NOT a danger to self or others.

References:

• Centers for Medicare & Medicaid Services. State Operations Manual, Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. [Link to current CMS SOM]
• CMS Requirements of Participation for Long-Term Care Facilities. [Link to current guidelines]