Failure to Update Care Plan for Insulin Refusal in Diabetic Resident
Penalty
Summary
The facility failed to revise a resident's comprehensive care plan to reflect ongoing refusals of prescribed insulin for diabetes management. Despite repeated documentation in the Medication Administration Record (MAR) indicating the resident's refusal of insulin over an extended period, the care plan only included interventions for checking blood sugar and administering insulin as ordered. There was no update to address the resident's consistent refusal of medication or to include education about the risks associated with this refusal. Interviews with the MDS Nurse and the DON confirmed that the care plan should have been updated to reflect the resident's refusal, ongoing monitoring, and the risks of not receiving the prescribed treatment. The resident had a diagnosis of Type 2 Diabetes and was determined to have the capacity to make medical decisions. The facility's policy required the care plan to be person-centered and updated as needed, but this was not followed in this case.