[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-163155-105":53,"doc-detail-163155-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","f689-ij-removal-plan-immediate-jeopardy-removal-plan","F689-IJ-Removal-Plan - Immediate Jeopardy Removal Plan","","Immediate jeopardy removal plan for Tag Cited: F-689 addressing the failure to follow the resident’s care plan resulting in a fall with injury. The plan outlines resident identification steps, 1:1 staff education, reassessment using a fall risk assessment tool, addition of safety measures and resident-specific interventions to care plans and Kardex, and instructions for CNAs to review updated information. It includes root cause analysis for falls in the prior 90 days, DON and staff education, daily audit of new admissions, ongoing review and auditing for three months, and QAPI PIP monitoring with reporting to monthly QAA.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/f689-ij-removal-plan-immediate-jeopardy-removal-plan/163155/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/f689-ij-removal-plan-immediate-jeopardy-removal-plan/163155.png","ImageObject",442,249,{"name":88,"@type":89},"Gelato","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/vnd.openxmlformats-officedocument.wordprocessingml.document","2026-09-28","2026-08-31",true,{"@type":98,"interactionType":99,"userInteractionCount":76},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What incident and citation does the F-689 immediate jeopardy plan address?","Question",{"text":108,"@type":109},"The plan addresses the failure to follow the resident’s care plan resulting in a fall with injury, tied to Tag Cited: F-689 under §483.25(d)(1)(2).","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"How does the facility identify residents affected and update their fall prevention interventions?",{"text":113,"@type":109},"Residents are reassessed using the Fall Risk Assessment Tool, and those at risk receive safety measures and resident-specific interventions added to their care plans. Those updates are also reflected on the Kardex so CNAs can access them before their next shift.",{"name":115,"@type":106,"acceptedAnswer":116},"What monitoring and reporting steps ensure the plan remains effective over time?",{"text":117,"@type":109},"A QAPI PIP is initiated to report monitoring and auditing outcomes, with findings presented at monthly QAA meetings. Daily audits of new admissions occur, and the facility reviews falls within one working day for three months, with continued auditing and reporting for at least three months.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},163155,1788138841,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":76,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":79,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":125,"read_time":73},19241457091524,"https://us-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Tag Cited: F-689\n§483.25(d)(1)(2) – Free of Accident Hazards/Supervision/Devices\nIssue Cited: \u000b“Failure to Follow the Resident’s Care Plan Resulting in a Fall with Injury”\nPreparation and/or execution of this plan do not constitute admission or agreement by the provider that immediate jeopardy exists.  This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and immediate jeopardy removal plan.  This immediate jeopardy removal plan is submitted as the facility’s immediate actionable plan to remove the likelihood that serious harm to a resident will occur, or recur.\nIdentification of Residents Affected or Likely to be Affected: \u000bThe facility took the following actions to address the citation and prevent any additional residents from suffering an adverse outcome. (Completion Date: ______________)\nThe Administrator provided 1:1 education to staff whom were directly involved in the resident’s fall.  An emphasis was placed on ensuring residents receive timely care as well as care based on their individually identified needs (or input facility specific citation information here).\nAll residents were reassessed using the Fall Risk Assessment Tool (or insert name of facility specific form/tool here).\nAll residents identified as “at risk” for falls had safety measures, as well as resident specific interventions, added to their care plans.\nThe safety measures and resident specific interventions that were added to the care plans were also reflected on the Kardex so that the CNA’s had access to this information (or insert facility specific procedures and terminology here).\nCNA’s were instructed to review the updated Kardex prior to their next shift.\nActions to Prevent Occurrence/Recurrence: \u000bThe facility took the following actions to prevent an adverse outcome from reoccurring. \u000b(Completion Date: ______________)\nThe Corporate Nurse/Consultant Nurse conducted a Root Cause Analysis (RCA) on all falls from the previous 90 days. Current residents impacted by the findings of the RCA had safety measures and resident specific interventions added to their care plans. Changes to the care plans were also updated on the Kardex.\nThe Corporate Nurse/Consultant Nurse then educated the DON on the facility Fall Prevention Program, all facility fall related policies, how to conduct an RCA, and how to ensure incident investigations are timely and complete.\nThe DON or designee educated all staff on facility Fall Prevention Program guidelines, following care plan/Kardex interventions, as well as all facility fall related policies.\nThe DON or designee will audit new admissions daily to ensure the Fall Risk Assessment Tool has been completed and that risk factors, safety measures, and resident specific interventions are reflected on the care plan as well as updated on the Kardex.\nThe Corporate Nurse/Consultant Nurse will review all falls within one working day for three months to ensure an RCA has been conducted and that resident specific interventions are reflected in the care plan as well as updated on the Kardex.\nThe DON or designee will review all falls at the daily stand up meeting (or insert facility specific meeting here) with the IDT for three months to ensure appropriate fall interventions are implemented, the resident’s care plan has been reviewed and revised, and the Kardex has been updated.\nA QAPI PIP has been initiated to report on the above monitoring and auditing procedures. All findings from the PIP will be presented at the monthly QAA meeting. Monitoring/auditing and reporting will continue for a minimum of three months.\nDate Facility Asserts Likelihood for Serious Harm No Longer Exists: _________________\nAction Plan to Ensure Relevant Recommendations are Followed:\n“Fall Prevention Program and Policies”\nIn-Service Training Guide\nReview the following:\nRegulation: F-689\nThe facility must ensure that –\n§483.25(d)(1) The resident env","cbCaihf6sGkVkGjj","https://ap.wps.com/l/cbCaihf6sGkVkGjj","docx",29668,"English","# Immediate Jeopardy Removal Plan\n## Cited Issue and Legal Basis\n## Identification of Residents Affected\n## Actions to Prevent Occurrence/Recurrence\n## Monitoring, Auditing, and Reporting\n## Facility Policy and Training Records","[{\"question\":\"What incident and citation does the F-689 immediate jeopardy plan address?\",\"answer\":\"The plan addresses the failure to follow the resident’s care plan resulting in a fall with injury, tied to Tag Cited: F-689 under §483.25(d)(1)(2).\"},{\"question\":\"How does the facility identify residents affected and update their fall prevention interventions?\",\"answer\":\"Residents are reassessed using the Fall Risk Assessment Tool, and those at risk receive safety measures and resident-specific interventions added to their care plans. Those updates are also reflected on the Kardex so CNAs can access them before their next shift.\"},{\"question\":\"What monitoring and reporting steps ensure the plan remains effective over time?\",\"answer\":\"A QAPI PIP is initiated to report monitoring and auditing outcomes, with findings presented at monthly QAA meetings. Daily audits of new admissions occur, and the facility reviews falls within one working day for three months, with continued auditing and reporting for at least three months.\"}]","F689-IJ-Removal-Plan - Immediate Jeopardy Removal Plan | DOCX"]