Failure to Implement Advanced Directives
Penalty
Summary
The facility failed to accurately obtain and implement advanced directives for a resident upon admission. The resident, admitted from a short-term general hospital, had a verbal order for CPR documented in their Order Summary Report. However, there was no signed document in the electronic health record to confirm the resident's wishes for life-sustaining measures. The Director of Nursing (DON) was unable to locate the resident's Iowa Physician Orders for Scope of Treatment (IPOST) in the binder, which is essential for communicating preferences for treatments such as CPR and artificial nutrition. The DON later stated that the resident's family had communicated a wish for Do Not Resuscitate (DNR) status, and an IPOST was completed and faxed to the physician for signature. However, the Social Services Director (SSD) acknowledged that an attempt to contact the resident's family was made but not documented. The facility's policy on Advanced Directives requires providing residents or their representatives with information and instructions regarding their rights to make such directives upon admission, which was not adequately followed in this case.