Failure to Appoint Guardian for Resident with Severe Cognitive Impairment
Penalty
Summary
The facility failed to appoint a guardian in a timely manner for a resident with severe cognitive impairment. The resident, who was admitted from another nursing facility, had a Brief Interview for Mental Status (BIMS) score of 2, indicating severe cognitive impairment. The resident's family had not been involved for years, and the only listed representative, a cousin, had requested to be removed from the contact list. Despite the resident's need for a legal representative, the facility had not successfully appointed a guardian. Interviews with the Social Service Director (SSD) and the Administrator revealed that the facility had been attempting to address the guardianship issue since early 2024, but progress was hindered by difficulties in finding an attorney. The SSD admitted that the facility had been working on the issue longer than initially thought, but no paperwork was found to support this. The Administrator was unaware of the resident's need for guardianship until the day of the interview and stated that the facility lacked a policy on guardianship. The process of obtaining guardianship typically takes 6 to 9 months, depending on the court system.
Plan Of Correction
Boca Circle Rehabilitation Center failed to appoint a guardian in a timely manner for 1 of 1 resident sampled for guardianship. Actions Taken: 1) Resident #56 continues to reside at the facility. On Center SSD obtained a proxy for resident #56. SSD was re-educated by Ellie Schutt, LNHA on to ensure of a guardian is done timely. Others Identified: 2) On a residents records were audited to ensure that residents with a less than 12 had a designated representative or legal surrogate. Any concerns identified were immediately addressed. Measures Taken: 3) Social Services staff and members if the Interdisciplinary team were re-educated on obtaining guardianship or a proxy timely on residents who are unable to direct their care by Ellie Schutt, LNHA. Newly hired Social Service staff and nursing management will receive this education during general orientation. Ongoing Monitoring: 4) Social Services or designee will audit residents with a of less than 12 to ensure that residents identified have a guardian or a proxy in place to ensure that residents have the right to designate a representative upon admission, weekly x 4 weeks, and then every 2 weeks x 2 months. Audit results will be reviewed in Center QAPI meeting monthly to ensure compliance has been met.