Failure to Involve Correct Resident Representative in Care Planning
Penalty
Summary
The facility failed to ensure that the correct resident representative was invited to participate in care planning conferences for a resident with severe cognitive impairment. Record review showed that the resident had a durable power of attorney (DPOA) for financial matters only, appointing one individual (P6), while a family member (F3) was involved in medical care decisions. Despite this, the facility repeatedly listed the DPOA-financial (P6) as the resident representative and sent care conference invitations to this individual, who did not attend or respond. Documentation of care conferences consistently indicated that the DPOA-financial was invited, but there was no RSVP, and the agreement with the plan of care was marked as 'YES' without the appropriate representative's input. Interviews confirmed that the resident's profile incorrectly listed the DPOA-financial as the first point of contact, resulting in the family member responsible for medical decisions not being invited to participate in care planning. This error persisted over multiple care conferences, preventing the correct representative from exercising the resident's rights regarding medical care and treatment decisions.