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F0657
D

Failure to Conduct and Document Care Plan Meetings After MDS Assessments

Durham, North Carolina Survey Completed on 04-10-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to conduct and document care plan meetings following the completion of quarterly and significant change Minimum Data Set (MDS) assessments for one resident. The resident was admitted to the facility and had multiple MDS assessments completed over the course of a year, including quarterly and significant change assessments. Despite these assessments, the last documented care plan meeting in the resident's medical record was over a year prior to the most recent assessment. The resident was cognitively intact and listed as their own responsible party, yet did not recall receiving invitations or participating in care plan meetings with the interdisciplinary team. Interviews with the resident's emergency contact confirmed that no invitations or notifications for care plan meetings had been received since an initial meeting over a year ago. Staff interviews revealed that the process for scheduling care plan meetings after MDS assessments was not followed, with responsibility for these meetings shifting between multiple social workers and, more recently, the administrator. There was no documentation of care plan meetings for the resident after the initial meeting, and the administrator acknowledged that meetings had not been conducted as required.

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