Failure to Inform Residents of Right to Formulate Advance Directives
Penalty
Summary
The facility failed to consistently inform and provide written information to residents regarding their right to formulate an advance directive, as required by policy. Record reviews for four residents with various diagnoses, including COPD, chronic pain, high blood pressure, anxiety, and hip fracture, showed no documentation that these individuals had been informed of their right to create an advance directive or had been offered assistance in doing so. Interviews with staff revealed that while advance directives were supposed to be addressed upon admission and during care conferences, there was no evidence that this occurred for the affected residents. Staff interviews indicated confusion and inconsistency regarding the process and responsibility for providing information about advance directives. The Assistant DON believed Social Services were responsible, while the Social Service Director stated the topic was discussed during care conferences and documented in progress notes, but could not provide proof for the residents in question. The Social Service Assistant was unsure of the required timeframe for completing admission packets, and the Director of Business Development acknowledged ongoing difficulties in completing admission paperwork due to staffing vacancies, resulting in incomplete documentation for recent admissions. Further review showed that out of 36 admissions in the past month, only two admission packets containing information on advance directives could be produced. One resident confirmed that staff did not review or discuss advance directives with them upon admission. Staff acknowledged that without timely review of admission paperwork, residents and their representatives would not be fully informed of their rights regarding advance directives, as required by facility policy and state regulations.