From Difficulties to Deficiency-Free

A New Community-Based Nurse’s Journey to Achieving her First Deficiency-Free Survey  

Just before starting her job as a nurse in an assisted living community in Pendleton, Oregon, Amanda’s team had gone through a pretty rough State survey.  

Their community was in a period of transition, but she and her new team were on a mission to turn things back around.  

After spending most of her career working in the hospital setting, Amanda was new to community-based care (CBC) nursing. By the time the survey team came to inspect their community, Amanda had been working there part-time for about three years.  
 
“This was the first CBC survey I had ever gone through in my career,” she said. “I primarily work at the hospital in Day Surgery, which is a whole different ballgame in terms of regulations, so it was a little nerve-racking going into my first survey.” 

Leading up to it, Amanda’s Assistant Administrator was on edge. She had been there through the facility’s previous survey, which did not go as they had hoped. “There was a lot that needed fixing,” Amanda said, “and over the last three years, our main shared goal was to put procedures and plans in place and appropriately train our staff so that we did not have those problems again.” 

“We put in a lot of work over those three years,” Amanda exhaled, letting her shoulders release. “But it paid off,” she added with a proud smile.  

And indeed, their work did pay off. Amanda’s team had a huge win this time around, earning themselves a completely deficiency-free survey.  

That’s right. Zero deficiencies in the facility. 

“It was a huge relief and weight off our shoulders,” she remembered. “We had been anticipating survey to come for over a year, and the September prior we got endorsed for a locked memory care. So, we had been working really hard to have all our ducks in a row.” 

Well, consider their ducks thoroughly lined up because in the end, their team accomplished an incredible feat.  

“The surveyors even complimented me on my attention to detail in my resident notes,” she added. “They said they could tell I was putting into practice what I was learning in the NurseLearn Enhanced Program, and they could see the progression in my notes from before I started the program until now.” 

Amanda started the NurseLearn Enhanced Program in March of 2024 as part of our first learning cohort of nurses. The free six-month education program is designed for nurses practicing in, or interested in, community-based care settings such as assisted living, memory care, residential care facilities, adult foster homes, and in homes. The NurseLearn Enhanced Program offers nurses a range of CBC-specialized online modules, mentorship, and other learning and community resources.  

“Going through this program, it is reassuring to know now with certainty that I have been doing my job correctly, but that there are areas where I could be better and more detail oriented,” Amanda said. “I’m also learning there are so many areas where I could be doing something more efficiently, which saves me a bunch of time. All these little lightbulb moments make my life easier.” 

Amanda was at home sick when she got the call that her community was one-hundred percent deficiency-free. “I was like, ‘What?! They had so many questions! Are you sure?’,” she recalled, laughing as she played out the scene.  

“This was a huge morale booster in our community,” she grinned. “And it was very reassuring to see that I had done my job correctly.” 

“I have also seen a huge difference in my care team as well,” she said, referring to the progress and success she has had since starting the program. “As I do the NurseLearn modules, I bring my knowledge back to the staff meetings to identify where we are already doing a great job and what we can do to be even better.” 

“My care team and I have built strong communication about what I, as the nurse, need to know and be notified about. And, in turn, there is an education component on my end, teaching them what they need to know to take care of a resident,” she said.  

It was exactly this kind of team communication and training that got Amanda’s community where they wanted to be. “I will say, even our owner commented after the survey that she did not realize everything I had to do in my job as a nurse––every little detail I have to do,” Amanda said. “She has even more of an appreciation for the NurseLearn program and everything I do in the building to help it run smoothly.” 

Kala, Amanda’s NurseLearn mentor, was equally proud and impressed with Amanda’s work in getting to the point of zero deficiencies. “Amanda has diligently applied the best practice concepts as she learned them in the program, which has clearly paid off for her and her community. She is always engaged in our monthly mentoring sessions and has shown tremendous growth over the course of the program, something she should feel very proud of!” she stated, fondly. Her success in the program has had unintended impacts outside of her community as well. “I actually take what I learn at NurseLearn back to my job at the hospital,” she said. “We have patients come in all the time from community-based and skilled nursing facilities, so I can help my hospital team understand what needs to be done when they encounter a patient coming from a community setting. What I learn in the program is helping me bridge the gap between both settings and provide consistent quality care to my residents,” she concluded.  

The survey results speak for themselves; without a doubt, Amanda and her team have put in great work.  

“Right now, we are still riding the high of being deficiency-free,” she said. “But still, we are putting in energy to maintain that level of progress. As I continue through the rest of the program, I will continue to implement what I learn to adapt and evolve our processes and keep honing our skills,” she added. 

Amanda is a passionate nurse, dedicated to the people around her. “In the community setting, I really enjoy that I play a big role in how people are cared for. I help make a lot of the policies and procedures in my community, and I educate staff on best care practices,” she affirms. “As a nurse in this setting, I like the fact that I get to have a direct impact on how these residents are cared for and make sure they are cared for the way they should be.” 

“With the typical training classes CBC nurses have access to, you learn the very basics of your role. But they are not able to go in depth like this six-month NurseLearn program does,” she says, thinking back to her start in community-based care. “Additionally, what I have learned in this program has made me a better nurse both in my community and in the hospital.” 

Amanda made the most of her time in the six-month NurseLearn Enhanced Program and has seen it pay off in her community and in her professional journey. If you are interested in joining our free Enhanced Program, visit nurselearn.com to learn more and apply.