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F0657
E

Failure to Revise Care Plans and Conduct Timely Care Plan Meetings

Wheaton, Maryland 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 revise resident care plans and conduct timely care plan meetings as required, as evidenced by record reviews, staff and resident interviews, and documentation for four residents. One resident reported only attending a single care plan meeting over a two-year stay and did not recall receiving invitations for other meetings. Review of this resident's medical record confirmed that only two care plan meetings were documented in the past year, with attendance sheets and notes missing for other required periods. Staff interviews confirmed that no additional documentation could be found for the missing meetings. Another resident's care plan included anticoagulant therapy, but physician orders showed that the medication had been discontinued several months prior, and the care plan had not been updated to reflect this change. Similarly, a third resident had care plans for pressure ulcers, arterial ulcers, venous ulcers, and antiplatelet medication, despite no current physician orders or active conditions for these issues. Staff acknowledged that these care plans should have been resolved or updated to reflect the residents' current conditions. A fourth resident's family reported difficulty scheduling care plan meetings with the interdisciplinary team. Review of the electronic medical record showed only two documented care plan meetings and one scheduled meeting that the family did not attend, with no further documentation of additional meetings. Staff interviews confirmed that care plan meetings are expected to be held quarterly and documented, but no further records could be located for this resident.

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