TN 25 (07-06)
GN 00605.552 Assessing Environmental Conditions and the Quality of Care in the Institution
Exercise caution when commenting on adverse environmental conditions or the quality of care observed during the course of the onsite reviews because:
The agreement between States and SSA regarding the conduct of the review is primarily confined to financial accounting.
Do not remain silent if gross deficiencies are observed or the lives of the patients may be jeopardized. This does not mean, however, that the objectives of the onsite program are to be modified or that the review team members should attempt to evaluate the quality of care during the review.
If serious deficiencies are observed, the review team must report them to the RO who will determine if this information should be brought to the attention of appropriate institution and/or State officials. For example, when long-term improvements are required, such as projects involving repairs, etc., it would be advisable for the RO to convey this information to the State in a separate letter. However, where more severe health hazards are observed which may be of immediate danger to the beneficiaries, the deficiencies should be reported at the time of the review to the institutional officials.
The RO should notify Central Office staff (OISP/OBDS) when the actions noted above have been taken.