Avoiding F-Tag penalties – A guide for skilled nursing facility administrators
What are F-Tags?
The Department of Health and Human Services is responsible for the comprehensive inspecting and reporting of identified deficiencies within long term care facilities (this is a requirement for Medicare and Medicaid funding). A statement of deficiency document uses a federal tag numbering system that addresses the degree to which a facility meets minimal federal standards.
F-tags correspond to specific stipulations within the Code of Federal Regulations. Facilities that receive F-tags are required to display them in a public location within the facility and reported on federal websites and databases.
VOHRA Wound Physicians has created this F-Tag resource to assist the long-term care community with understanding and preventing costly state survey citations. In many cases, these can be easily preventable if following the proper guidelines and implementing a well-designed wound care program.
F-TAG 710 (formerly F-TAG 385)
TAG 483.30(a)(1)(2) – Physician Services. Resident’s Care Supervised by a
Physician. Adequate physician supervision must be provided for SNF wound.
F-TAG 686 (FORMERLY F-TAG 314) - Pressure Ulcers
TAG F 686 (§483.25 Quality of Care) Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.
Treatment Services To Prevent Heal Pressure Sores
42CFR 483.25 (b)(1) – Quality of Care Pressure Sores (Ulcers)
Based on the comprehensive assessment of a resident, the facility must ensure that; A resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable. A resident who has a pressure ulcer receives care and services to promote healing and prevent additional ulcers.
Refer all wound patients to your Vohra wound physician early for prevention
F-TAG 658 (formerly F-TAG 281)
483.21(b)(3) – Comprehensive Resident-Centered Care Plans
Services Provided Meet Professional Standards. Correct wound dressings must be used on different wound types.
F-TAG 580 (formerly F-Tag 157)
483.10 (g)(14) – Resident Rights
Notify of Changes (Injury/Decline/Room, Etc.). A physician must be notified of any changes to wound healthA physician must be notified of any changes to wound health.
Your Vohra wound care physician is always available to your WCN
F-Tag 315 - Incontinence
1) A resident who enters the facility without an indwelling catheter is not catheterized unless the resident’s clinical condition demonstrates that catheterization was necessary. §483.25(d)
2) A resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections and to restore as much normal bladder function as possible. §483.25(d)
F-Tag 322 Naso Gastric Tubes
Naso-gastric tubes” is considered to include any feeding tube used to provide enteral nutrition to a resident by bypassing oral intake. Since the regulation was promulgated, use of naso-gastric tubes has become extremely rare, and use of other types of enteral feeding tubes (such as those listed in the definitions section) has become prominent. §483.25(g)
F-Tag 325 Nutrition
(1) Maintains acceptable parameters of nutritional status, such as body weight and protein levels, unless the resident’s clinical condition demonstrates that this is not possible.
(2) Receives a therapeutic diet when there is a nutritional problem. §483.25(i)
F-Tag 327 Hydration
The facility must provide each resident with sufficient fluid intake to maintain proper hydration and health. The intent of this regulation is to assure that the resident receives sufficient amount of fluids based on individual needs to prevent dehydration. §483.25(j)