SMQT- Fraud & Abuse
The Abuse Prohibition Review is a de-
termination of whether the facility has
both DEVELOPED & OPERATIONAL-
IZED policies and procedures designed
to protect residents from the following:
- Abuse
- Neglect
- Involuntary seclusion
- Misappropriation of their property
ABUSE PROHIBITION REVIEW: De- This includes policies and procedures
scription for:
- Hiring practices
- Training
- Ongoing supervision for employees and
volunteers who provide services
- Reporting and investigation of allega-
tions and occurrences that may indicate
abuse
ABUSE PROHIBITION REVIEW: Gener-
al Procedures
, SMQT- Fraud & Abuse
General Procedures:
The review includes components of the
facility's policies and procedures as con-
tained in the Guidance to Surveyors.
These include policies and procedures
for:
- Screening of potential hirees (or em-
ployees)
- Training of employees (both for new
employees and ongoing training for all
employees)
- Prevention policies and procedures
- Identification of possible incidents or
allegations that need (or require) inves-
tigation
- Investigation of incidents and allega-
tions
- Protection of residents during investiga-
tions
- Reporting of incidents, investigations,
and facility response to their investiga-
tions
- The general procedure for the Abuse
Prohibition Review is to use/follow the
Abuse Prohibition Investigative Protocol
to complete the task.
ANSWER:
The general objective of the Abuse Pro-
hibition Review is to determine if the fa-
cility has BOTH developed & operational-
, SMQT- Fraud & Abuse
ized policies & procedures that PROHIB-
IT
QUIZ QUESTION: 1) abuse
What is the general objective of the 2) neglect
Abuse Prohibition Review? 3) involuntary seclusion
4) misappropriation of property for all
residents.
The investigative protocol for abuse pro-
hibition is to be used in EVERY long term
care standard survey.
This protocol requires your team to per-
form certain procedures. They are as fol-
lows:
- Obtain and review policies and proce-
dures
Investigative Protocol for Abuse Prohibi- - Interview the responsible individual(s)
tion
- Request written evidence
- Interview several residents and families
- Interview at least FIVE direct care staff
persons
- Interview at least THREE front line su-
pervisors
- Obtain a list of recently hired employees
Investigative Protocol for Abuse Prohibi-
tion
1) Obtain & Review Policies & Proce-
dures
The Abuse Prohibition Review is a de-
termination of whether the facility has
both DEVELOPED & OPERATIONAL-
IZED policies and procedures designed
to protect residents from the following:
- Abuse
- Neglect
- Involuntary seclusion
- Misappropriation of their property
ABUSE PROHIBITION REVIEW: De- This includes policies and procedures
scription for:
- Hiring practices
- Training
- Ongoing supervision for employees and
volunteers who provide services
- Reporting and investigation of allega-
tions and occurrences that may indicate
abuse
ABUSE PROHIBITION REVIEW: Gener-
al Procedures
, SMQT- Fraud & Abuse
General Procedures:
The review includes components of the
facility's policies and procedures as con-
tained in the Guidance to Surveyors.
These include policies and procedures
for:
- Screening of potential hirees (or em-
ployees)
- Training of employees (both for new
employees and ongoing training for all
employees)
- Prevention policies and procedures
- Identification of possible incidents or
allegations that need (or require) inves-
tigation
- Investigation of incidents and allega-
tions
- Protection of residents during investiga-
tions
- Reporting of incidents, investigations,
and facility response to their investiga-
tions
- The general procedure for the Abuse
Prohibition Review is to use/follow the
Abuse Prohibition Investigative Protocol
to complete the task.
ANSWER:
The general objective of the Abuse Pro-
hibition Review is to determine if the fa-
cility has BOTH developed & operational-
, SMQT- Fraud & Abuse
ized policies & procedures that PROHIB-
IT
QUIZ QUESTION: 1) abuse
What is the general objective of the 2) neglect
Abuse Prohibition Review? 3) involuntary seclusion
4) misappropriation of property for all
residents.
The investigative protocol for abuse pro-
hibition is to be used in EVERY long term
care standard survey.
This protocol requires your team to per-
form certain procedures. They are as fol-
lows:
- Obtain and review policies and proce-
dures
Investigative Protocol for Abuse Prohibi- - Interview the responsible individual(s)
tion
- Request written evidence
- Interview several residents and families
- Interview at least FIVE direct care staff
persons
- Interview at least THREE front line su-
pervisors
- Obtain a list of recently hired employees
Investigative Protocol for Abuse Prohibi-
tion
1) Obtain & Review Policies & Proce-
dures
