Failure to Update Care Plans and Hold Timely Care Conferences
Penalty
Summary
The facility failed to update care plans and conduct timely care conferences for two residents. For one resident with a history of brain injury, brain bleeding, and right-side paralysis, the care plan was not updated to reflect a new diagnosis of COVID-19, despite the resident testing positive and this being verified by the DON and IP. Staff confirmed that the care plan should have been updated to include the respiratory infection but was not. Another resident with diagnoses including duodenal cancer and heart failure reported not recalling any care plan conference meetings. Record review showed that care conferences were only documented twice within a 16-month period, with no conferences held for over seven months. The DON acknowledged that additional care conferences should have occurred and could not provide documentation for the missing meetings.