Coast to Coast Wound care, PC Long Term Care Facilities
Plastic and Reconstructive Surgeons
Comprehensive wound care service
Coast to Coast Wound Care, PC: Long term care, Wound care surgeons
Your Time, Your Place, Your Way


CMS GUIDELINES 2004 - New OBRA survey standards and guidance to surveyors. The major change in substance is in F314 & 483.25 on pressure ulcers, which has been expanded from three pages in the current Guidance to Surveyors to 37 pages in the new edition. The new revised section for 314 has been rewritten to become a comprehensive in-service on the topic of pressure ulcers, embracing the latest practices. 

There is little that is "new" in the best practices. They are generally consistent with the standards recommended in the Council's Pressure Ulcer protocol in September of 2000 and May of 2001. The difference is that every detailed aspect of the process of prevention, assessment, interventions, and monitoring of pressure sores now become a matter of survey enforcement.

Back-Up Team - As surgeons and only surgeons, we are in the highly advantageous and respectable position to represent the long-term-care-facility in any wound related elements under survey as the "back-up" team. Also, by our expertise, and mere presence, we can help prevent any citations, deficiencies, or state reviews, supported further by our accurate wound-care documentation. 

Our surgeons are highly trained, experienced, and have superb professional evidence of their professional training, skills, background, and professional conduct, supported further by character, and ethical references on request. They are also state licensed, and members in good standing with their distinct and respective professional societies.

Inspections and Surveys - State inspections, surveys, citations, and tags, however, can be time-consuming, questionable, and unexpected. They are usually conducted by: 

  • The National Academy for State Health Policy Surveys Group.
  • Centers for Medicare and Medicaid Services. 
  • State Department of Health (every 10-15 months).
  • Long-Term-Care Ombudsman- complaints by resident-patients-elder abuse;
  • State inspections may include nursing staff training, qualifications, training requirement fulfillments and credentials.
Targets - Furthermore, one-half of all professional liability insurance claims are closely related to wound-care management and problems. Adding to the woes of claims, many plaintiffs' lawyers are now targeting the vulnerable long-term-care facilities. 

New Laws - Inspections can be even more encumbered by newer and more stringent laws. Many States, but particularly Florida, has newly implemented a current State policy-one of the "more stringent" in the U.S.A. - requires nursing homes caring for Medicaid beneficiaries to "hire enough staff to provide an average of 2.5 hours of care."

Infections - "Compulsory reporting of infection statistics" is required by law in hospitals of many States, and may very easily soon "spill over" into long-term-care-nursing-facilities, who may be totally unprepared for such an event, particularly with infectious wound prominence in many facilities.

Protection - Based on the above facts, Coast to Coast Wound Care Surgeons are totally prepared to meet any inspection or survey episode with complete confidence and professionalism. We can intercede in behalf of the long-term-care-facility, and its staff, and protect it from litigation, for our trained surgeons provide early, aggressive care, with trustworthy surgical standards and protocol. Wound care management Medicine is our specialty.

Goal - Our goal is to achieve and maintain an A+, "Superior" rating, by not only caring and treating, but preventing infection and re-injury of wounds.

Certified - In fact, also, we have Board Certified Surgeons among our staff. This allows for expert professional, comprehensive care, integrity, and credibility.

Interaction - Our surgeons interact with the physician, staff, family and friends, thus limiting further, a facilities' undue exposure to unnecessary litigation. Remember, we are your "surgical-consultants," not merely your wound-care specialists. 

"There are no simple solutions, only intelligent decisions." Socrates

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