Failure to Develop Comprehensive Care Plans for Bowel and Skin Issues
Penalty
Summary
The facility failed to develop comprehensive care plans for two residents with specific clinical needs. For one resident with diagnoses including Parkinson's disease and chronic kidney disease, the record showed moderate cognitive impairment and occasional bowel incontinence. Despite physician orders for three different medications to manage constipation, there was no care plan addressing the resident's bowel issues or the use of these medications. This was confirmed by the Assistant Director of Nursing during an interview. Another resident, who had a G-tube and diagnoses such as cerebral infarction, rhabdomyolysis, dysphagia, and chronic kidney disease, developed blisters on the abdomen attributed to friction from the G-tube tubing. Observations and nurse documentation indicated the presence of new and previous blisters, but there was no care plan in place to address skin issues related to the G-tube. The Director of Nursing confirmed that a care plan should have been created for G-tube care after admission, and there was no facility policy for creating care plans, relying instead on general nursing standards.