Failure to Update Care Plan for Hospice Status Change
Penalty
Summary
The facility failed to ensure that care plans were updated in a timely manner for a resident who was receiving hospice care. The resident, who had been admitted to the facility with diagnoses including congestive heart failure, ventricular tachycardia, and the presence of a pacemaker, had a physician order on October 10, 2023, to have the pacemaker turned off due to hospice status. The care plan was updated on the same day to reflect this change. However, a subsequent physician order dated December 2, 2024, discontinued hospice care, but the care plan was not updated to reflect this change as of January 10, 2025. Interviews with the Nursing Home Administrator and the Director of Nursing confirmed that the facility's expectations were for care plans to be reviewed and updated promptly with every major change, such as signing on to or discontinuing hospice care. It was acknowledged that the care plan for this resident had not been updated as required, leading to a deficiency in meeting the regulatory requirements for care plan timing and revision.
Plan Of Correction
The Care plan is revised as appropriate for R31. DON or designee will conduct in-service education on the importance of updated and accurate care plans. Unit managers or designees will update all residents' care plans who have pacemakers, to ensure that they reflect the resident's current pacemaker status. Care plans will be audited by unit managers or designee monthly x 3 months then quarterly thereafter. Results will be reported in monthly QAPI.