Incomplete POLST Forms and Missing Provider Signatures
Penalty
Summary
The facility failed to ensure that Provider Orders for Life Sustaining Treatment (POLST) forms were fully and properly completed for two residents. For one resident, the POLST form indicated a preference for no CPR with selective treatment and was signed by the resident, but lacked the required signature from a physician or advanced practice practitioner. For another resident, the POLST form indicated a preference for comfort-focused treatment with no CPR, but the patient signature section only contained an 'x' and a check mark, with no printed name or date from the resident or their representative. During staff interviews, it was confirmed that POLST forms should be fully completed, including signatures, printed names, and dates from both the resident or their representative and the provider. The staff member interviewed was unable to explain why the forms were incomplete, though facility policy requires that POLST forms be reviewed and signed by a provider upon admission, with copies placed in the patient's chart and properly documented.