Inaccurate MDS Assessments for Multiple Residents
Penalty
Summary
The facility failed to ensure the accuracy of Minimum Data Set (MDS) assessments for three residents. For one resident, the progress notes indicated an emergent transfer to the hospital, but the MDS discharge status was incorrectly coded as a discharge to home/community. This discrepancy was confirmed by both the MDS RN and the Director of Nursing during interviews. Another resident had a physician's order for daily Sertraline for depression, but the quarterly MDS did not reflect the use of antidepressant medication. Additionally, a third resident had an active physician's order for Atenolol to manage hypertension, yet the quarterly MDS did not indicate hypertension as an active diagnosis. In each case, staff interviews confirmed the inaccuracies in the respective MDS sections.