Failure to Involve Residents and Contacts in Care Planning
Penalty
Summary
The facility failed to ensure that residents and their emergency contacts were properly informed and involved in care plan meetings, as required by 42 CFR Part 483.10(c)(2)(3). Specifically, the facility did not provide advanced notice of care plan meetings to residents and their emergency contacts, nor did they hold these meetings in a timely manner. This deficiency was identified for three residents, all of whom were not given the opportunity to participate in the planning of their care. Resident R1, who had impaired thought processes due to dementia, was not provided with the opportunity for his emergency contact to participate in care plan meetings. Despite the emergency contact's requests for updates and meetings with the medical director, there was no evidence that she was invited to the care plan meeting held on November 24, 2024. The social worker admitted to only contacting responsible parties if the resident was not alert or oriented, and often did so with insufficient notice. For Resident R2, the facility failed to conduct the required care plan meetings prior to the one held on January 7, 2025. Similarly, Resident R3 had not had a care plan meeting since May 2, 2024, and reported not remembering the last time a meeting was held. The social worker acknowledged that some care plan meetings were late or not held at all, and the Regional Nurse confirmed the lack of evidence for timely meetings. This lack of compliance with care planning requirements was corroborated by interviews with facility staff, including the Nursing Home Administrator and Director of Nursing.
Plan Of Correction
Res R1, R2 and R3 careplan meetings have been conducted. Current residents scheduled for careplan meetings and their emergency contact are being notified by the Social Worker or designee in advance of upcoming careplan meetings and documented. The Social Worker and Nursing management team have been re-inserviced on the careplanning process with the focus on advance notifications to the resident, emergency contact, and timely completion of care plan meetings. The Social Worker or designee will schedule and notify the resident and emergency contacts and review upcoming care plan meetings during the morning meetings. Scheduled careplan meetings are being reviewed during morning meeting with the management team. The Social Worker or designee will conduct weekly x4 weeks, then monthly x2 audits of upcoming care plan meetings to verify advance notification of the resident and emergency contact have been completed and documented, and the careplan meeting has been conducted. Results of the audits will be reported at the monthly Quality Assurance Improvement Meetings for review and recommendations.