Foundational Investigative Skills

Question 1

What are the three Foundational Investigative Skills (FIS)?

Answer 1

• Observation
• Interviews
• Record Reviews

Question 2

What are the four components of an effective investigation?

Answer 2

1. Gather evidence
2. Determine facts
3. Draw conclusions
4. State your conclusions in writing

Question 3

What is evidence?

Answer 3

An observation, interview, or document that permits us to determine facts.

Question 4

What is the importance of well-detailed evidence?

Answer 4

It will hold up better in court.

Question 5

What are some consequences of an inadequate investigation?

Answer 5

• Recipients of care would have to continue to live with the risks and dangers of a deficient practice.
• The citation might not hold up in court due to it not being strong enough.
• The facility might win a challenge in court and not be required to fix deficiencies.

Question 6

Identify the six best practices when investigating a facility.

Answer 6

• Pay attention to the facility, not the regulations.
• Pay attention to smell, touch, taste.
• Document observations, not opinions.
• Details matter.
• Follow up allows you to support observations or provides additional context.
• Observe more than one shift.

Question 7

How should interviews be conducted?

Answer 7

In a courteous and professional manner.

Question 8

How does using open-ended questions benefit you as the interviewer?

Answer 8

They are broad and exploratory. Can lead you to additional information.

Question 9

True or False:

Surveyors should discuss regulatory violations with staff.

Answer 9

False

Question 10

Testimony before an Administrative Law Judge (ALJ) might rely on what from your investigation?

Answer 10

• Observations
• Statement of Deficiencies
• Evidence

Question 11

What are the roles of a Surveyor?

Answer 11

• Investigator
• Medical Professional
• Legal Analyst
• Writer

Question 12

What are the three ways a facility can appeal a citation?

Answer 12

1. Informal Dispute Resolution (IDR)
2. Independent Informal Dispute Resolution (IIDR)
3. Formal Appeal (Held in front of an Administrative Law Judge)

Question 13

What is the most important form of evidence?

Answer 13

Detailed, well-documented observations.

Question 14

During a formal hearing, whom does the burden of proof lie on? The Facility or CMS (you)?

Answer 14

CMS

Question 15

What is the definition of Sexual Abuse?

Answer 15

SOM, Appendix PP, Section 483.5 defines sexual abuse as “nonconsensual sexual contact of any type with a resident” and includes:
* Unwanted intimate touching of any kind
* All types of sexual assault or battery
* Forced observation of masturbation or pornography
* Taking sexually explicit photographs or audio or video recordings of resident and maintaining or distributing them.

Question 16

What is the burden of proof when investigating abuse?

Answer 16

You’re not required to gather evidence that the deficiency exists. You just need to gather enough evidence to prove abue allegation is likely to be true.

Question 17

How can you corroborate allegations of abuse without evidence?

Answer 17

• Did the individual report the allegation to anyone?
• Interview family as they might see changes in personality/behavior that is common in victims of abuse
• Pay attention to details in witness statements. Use your judgement.

Question 18

Where can complaint procedures be found?

Answer 18

SOM, Chapter 5

Question 19

What legal statute obligates a facility to report abuse of a recipient of care to law enforcement?

Question 20

What are appropriate ways to gather evidence?

Answer 20

• Observations
• Interviews
• Record Reviews