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*TJCsvyrRN_Rahe_Sandra A. Rahe RN


Sandra A. Rahe, RN

 

Surveyor Program(s): Behavioral Health Care and Health Accreditation Programs

Surveyor Tenure: x 20??

Lives: Ohio

TJC Bio:

  • Recently retired from Ohio Dept of MH where served in various administrative roles including CEO of an acute care hospital and was instrumental in the development of the first community support network programs in Northern Ohio.  Experience includes employment in leadership roles in private and public sector organizations serving children through he geriatric populations, including forensic.
  • Mrs. Rahe was formerly Director of Psychiatric Rehabilitation and SAMI Services at Northcoast Behavioral Healthcare, Ohio Department of Mental Health
  • Mrs. Rahe is licensed in Ohio as an R.N. She has an MBA in Healthcare Administration and maintains certifications as NEA-BC from the American Nurses Association, Certified Public Manager, and Certified Chemical Dependency Counselor Assistant.  She has completed training as an EMDR therapist.  She has completed FEMA training and serves on her community’s CERT (Community Emergency Response Team)
  • Mrs. Rahe is a certified Yellow Belt, Six Sigma and is interested in utilization of data to improve both short-term and long-term patient quality care and safety.
  • Special projects and personal interests have included:  Recovery, Supported Employment, Consumer Advocacy, Cognitive Enhancement Therapy, Pet Therapy, and Integrated Dual Diagnosis Treatment

Other Background:

  • xxxxx xxxxx xx

Comments & Recommendations

2014

  • xxxxx xxxxx xxxxx xxxx xx xxx xxxx xxx xx x x xx xx xx xxx x xx
  • xxxxx xxxxx xxxxx xxxx xx xxx xxxx xxx xx x x xx xx xx xxx x xx x.
2007

  • xxxxx xxxxx xxxxx xxxx xx xxx xxxx xx
  • xxxxx xxxxx xxxxx xxxx xx xxx xxxx xxx

Relevant Survey History:

• Madison State Hospital 07/12/07  • Richmond State Hospital 06/29/07 
•Eastern Louisiana Mental Health System  1407 • Central Regional Hospital

102


** Sample Survey Citations (Premier Level)**

[private Membership premier]

[/private]


Sample Citations:

2014

  • HR.01.06.01/EP 6/ 
    • Review of seclusion and restraint tracer records reveled that registered nurses were conducting the one hour evaluation.  There was lack of documented competencies to conduct the evaluation in RN files reviewed in the sample from the Forensic Units. It was further noted that the medical staff by- laws did not authorize nurses to conduct the evaluation in lieu of the psychiatrist, nor were qualifications and competencies defined. Nursing leadership confirmed that complacencies were not available.
    • There was lack of documented competencies for nursing and social workers conducting the restoration of competency groups in the forensic units in the sample files reviewed.
    • In the file of a LCSW providing sex offenders treatment, there was lack of documented competencies, based on professional based criteria, for providing this specialized services.

  • IC.01.05.01/EP 1/ Observed in Infection ControlTracer: Those responsible for infection control activities acknowledged that they were not using CDC or other recognized
    guidelines for defining and reporting HAIs. /Direct
  • LD.03.06.01/EP 3/ Observed in Individual Tracer: The organization lacked sufficient staffing to provide consistent and individualized care to the population
    served, based on discussion with nursing leadership, review of staffing sheets and tracer observations. According to the nurse executive, minimum staffing on the CMS civil Units is based on CMS requirements for one RN per unit per shift. RN, LPN, Psych Aides and Correctional staff ratios were established for each civil and forensic unit. Shifts were “flagged” for additional Psych Aides or Correctional staff as needed for 1:1 observations and use of seclusion and restraint. The organization has 17 RNs and 35 Psych Aides assigned to five civil units to staff twelve hour shift, seven days a week. Based on established ratios, this does not appear to provide sufficient staff without overtime. The organization reported that for twelve months 22% of staff hours was attributed to overtime for CGT (Correctional staff), 15% for clinical nurses and 17% Psych Aides. A review of daily staffing sheets on the Forensic Units from April 17 – 23, there were between 9 and 15 of 32 shifts each day that were flagged and covered with mandatory call back or the flex pool for coverage. Staffing sheets were reviewed daily. However, it was noted that there was lack of analysis of staffing data to
    evaluate staffing needs over time There was lack of evidence that acuity and/or treatment needs (for example) were considered in setting staffing levels or variances except as noted above. There was lack of evidence that the organization used data about patient incidents in establishing staffing schedules or that variances between required and actual staff were tracked over time.

  • NR.02.01.01/EP 5/ Observed in Record Review: Rules and regulations of the medical staff specify that following restraint “a physician must conduct a face to face
    assessment of the patient within one (1) hour . . . .” Hospital policy on seclusion and restraint states: “The RN shall monitor to assure completion of a face to face evaluation of the patient within one hour of the initiation of Seclusion and/or
    Restraints.” During survey on different units, at least three instances were observed where the physician face to face evaluation did not occur.

2007

  • XX.00.00.00/EP 0/ Observed in Tracer Activities: xxxxx xxxxx xxxxx xxx xx x x xx xx xx xxx x xx xxxxxxx. /Indirect/
  • XX.00.00.00/EP 0/

 

 

 

 

 

 

 

 

You may provide surveyor feedback by clicking on the ‘Comments’ link above (2nd line, top left) and/or via the New Post Survey Questionnaire (PSQ).


One response to “*TJCsvyrRN_Rahe_Sandra A. Rahe RN”

  1. Sandra Rahe was at  our last two surveys and was team leader in 2014.  Sandra was very knowledgeable and nice but with a “no nonsense” approach.  She didn’t fall for all our excuses and distraction tricks.  Of course the Psychiatrists resented her surveying their medical staff stuff…. 

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