Failure to Provide Behavioral Health Services
Penalty
Summary
The facility failed to ensure the highest practicable mental and psychosocial well-being for a resident diagnosed with anxiety and depression. The resident, admitted on November 7, 2024, had a care plan that included monitoring and reporting any acute episodes of mood changes to a physician and obtaining behavioral health consults as needed. However, a review of the clinical record revealed that no behavioral health consults were conducted for the resident, despite the care plan's requirements. During an interview, the Social Service Director confirmed that the facility had not sent any referrals for behavioral health services for the resident. This lack of action resulted in the facility's failure to maintain the resident's mental and psychosocial well-being, as required by the facility's policy and regulatory standards.
Plan Of Correction
Resident R94 remains at the facility pending discharge home on 2/10/25. Resident R94 declined behavioral health consult when offered. No negative outcome has been identified as a result of the lack of an as needed behavioral consult. All residents with an "as needed" behavioral consult care plan will be reviewed for behaviors or willingness to receive behavioral care consults. The NHA will educate all social services employees on the social services policy. The Social Services Director or designee will audit any residents requesting behavioral health referrals to ensure the referrals are generated in a timely manner from date of request. Audits will be completed weekly x 8 weeks. All results to be reviewed through QAPI for further recommendation.