Failure to Develop Resident-Centered Care Plans for Incontinence, Hospice Activities, and Smoking
Penalty
Summary
The facility failed to develop and implement individualized, resident-centered care plans for three residents with specific needs related to incontinence, hospice activities, and independent smoking. For one resident with arthritis and a history of depression and anxiety, the care plan did not include detailed instructions regarding the resident's preferred times for incontinence care, despite staff and resident reports that the resident was particular about care routines and often refused care from unfamiliar staff. The care plan also did not reflect the resident's current status, as the most recent assessments indicated the resident was cognitively intact and did not refuse care, yet staff interactions revealed ongoing issues with care refusals and unmet incontinence needs. Another resident admitted on hospice with cancer had an activity assessment identifying several meaningful activities, such as reading, listening to music, and being outdoors. However, the care plan failed to specify which activities were important to the resident, and staff were unaware that the care plan did not automatically include these preferences. As a result, CNAs did not have access to information about the resident's preferred activities, limiting their ability to provide individualized, meaningful engagement as identified in the assessment. A third resident, approved for independent smoking, did not have a care plan addressing the management and storage of smoking materials. Staff were unclear about whether the resident was allowed to possess smoking materials or where these items were kept, and the facility had not provided a lock box to secure them. The facility's smoking policy did not address individualized care planning for independent smokers, and staff acknowledged that the lack of a care plan prevented them from ensuring the safety of the resident and others regarding access to lighters and smoking materials.