Failure to Invite Resident to Care Plan Meetings
Penalty
Summary
The facility failed to ensure that a resident was invited to participate in their care planning meetings, as required by policy and regulation. Specifically, a resident with chronic kidney disease, heart failure, and major depressive disorder, who was cognitively intact as indicated by a BIMS score of 15, was not invited to any care plan meetings during their stay. The resident reported never having attended or been informed about care plan meetings. Review of the medical record confirmed there was no documentation of the resident or their representative being invited or participating in care plan meetings, including those following significant change and quarterly MDS assessments. Interviews with facility staff revealed that the process for inviting residents or their representatives to care plan meetings was not consistently followed. MDS staff stated that invitations were only extended for quarterly and annual assessments, not for significant change assessments, and there was no documentation of invitations or attendance for the resident in question. The Social Service Director also confirmed not having been instructed to invite residents to care plan meetings and had not done so for this resident. This practice was inconsistent with the facility's own policy, which requires resident and/or representative participation or documentation if participation is not practicable.