Failure to Develop Care Plans for Scabies Exposure
Penalty
Summary
The facility failed to develop comprehensive care plans addressing potential exposure to scabies for three residents. Each resident had documented physician orders for prophylactic treatment with Elimite 5% cream following probable exposure to scabies, and the treatment was administered and recorded in the Treatment Administration Record. However, there was no evidence that individualized care plans were created to address the exposure, treatment, or monitoring for scabies for these residents. Resident 1 was admitted with multiple diagnoses, including diabetes mellitus, chronic pain syndrome, and COPD. The resident's cognitive status was reported as intact on the Minimum Data Set, and the resident required supervision for activities of daily living. Resident 2 had metabolic encephalopathy, generalized muscle weakness, and unspecified dementia, with severely impaired cognitive skills and total dependence on staff for daily activities. Resident 3 had atherosclerosis heart disease, unspecified chest pain, and cardiomegaly, with moderately impaired cognitive skills and a need for moderate assistance with some activities. All three residents received the prescribed prophylactic treatment for scabies exposure, as documented in their records. During an interview and record review with the Director of Nursing, it was confirmed that no care plans were developed for the residents' possible exposure to scabies. The facility's policy required the development of individualized nursing care plans to promote continuity of care, but this was not followed in these cases. The lack of care plans for scabies exposure and treatment was acknowledged by the Director of Nursing, who stated that this omission could result in nurses not following the appropriate plan of care for scabies treatment and prevention.