Failure to Document and Administer Physician-Ordered Pressure Ulcer Treatments
Penalty
No penalty information released
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 provide physician-ordered wound care treatments for one of five sampled residents with pressure ulcers. Clinical record review showed that a resident with diabetes mellitus and hidradenitis suppurativa had a stage 4 pressure sore on the sacrum. The physician had ordered wound care involving cleansing with wound cleanser, application of a collagen sheet, filling with silver alginate, and covering with an Optifoam gentle dressing every shift. However, the treatment administration record for March 2025 lacked documentation that these treatments were completed on six specific dates. The Director of Nursing confirmed there was no documented evidence that the wound treatments were performed as ordered on those dates.