How To Avoid Citations & Improve Resident Care

Recently the California Department of Social Services put out a new quarterly Adult and Senior Care update. All of our Advanced Healthcare Studies, LLC update service participants should have already received this update. One topic that was posted in this release was “How to Avoid Citations and Improve Resident Care.”

In this March 2008 update, the Senior Care Program Administration published the following list of suggestions for providers to use to maintain and enhance resident care while also preventing citations.

  1. Listen and respond to resident and family care concerns.
  2. Ensure your Facility Administrator has the ability and staff resources to carry out their responsibilities.
  3. Conduct quality assurance reviews of your facility.
  4. Hire the right staff; do your best to ensure they have patience, and a true interest in working with dependent adults and seniors.
  5. Invest in your staff because your services are only as good as the staff that provides them.
  6. Listen and respond to staff concerns/issues.
  7. Provide initial and ongoing training to your staff on your policies and procedures and the needs of the seniors you serve.
  8. Conduct frequent staff evaluations to provide feedback on performance and to identify training needs.
  9. Ensure you have sufficient numbers of staff to meet your residents’ needs.
  10. Develop a staff retention plan and strategies to reduce turnover.
  11. Have clear written policies and procedures that address resident care in areas such as:
    • Care and supervision;
    • Communication of changes in residents’ needs;
    • Facility medication procedures;
    • Facility disaster and emergency plans;
    • Facility reporting requirements (special incidents and mandated reporting responsibilities);
    • Facility maintenance and resident safety issues; and
    • Eviction procedures.
  12. Only accept or retain residents that your staff are capable of handling (staff abilities and resources can change).
  13. Inform the resident and family that significant changes in the residents’ needs may require relocation to a higher level facility.
  14. Chart each resident’s behavior, activities and medications daily.
  15. Make sure you have clear instructions for reporting changes in your residents’ health and behavior.
  16. Implement fall prevention plans for residents who need this assistance.
  17. Keep toxics away from residents who need protective supervision.
  18. For facilities with shift staff, consider overlaps for sharing resident information.
  19. Know the regulations and share them with staff.
  20. Use the appeal process when you believe a citation was incorrectly issued.
  21. Develop a professional/cooperative relationship with your Licensing Program Analyst.
  22. Join an association; they are your advocates and consultants concerning legislation and licensing policies and regulations that impact your facilities.

Some additional topics in this March 2008 Adult and Senior Care Update include:

  • Chaptered Legislation for 2007
  • CCLD Website Information on Residential Care Facilities
  • Alert: Ombudsman International
  • Scabies Information and Guidelines
  • Pricara TM Recalls 25 mcg/hr DuragesicĀ® Pain Patches
  • Chattem, Inc. Issues Urgent Voluntary Nationwide Recall of Icy HotĀ® Heat Therapy TM Products
  • Automated External Defibrillators

To view this entire five page update, and older quarterly updates, click on the following link to the California Care Licensing Division’s website at

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