Failure to Provide Ordered Pressure Ulcer Care and Prevention
Penalty
No penalty information released
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Summary
The facility failed to provide physician-ordered treatments and services necessary for the healing of a pressure ulcer for one resident. The resident had a physician order for daily cleansing and dressing changes to a left heel pressure ulcer, as well as an order to float the heels on a pillow at all times. On observation, the dressing on the resident's left heel was found to be dated two days prior, and there was no pillow present to float the heels. Review of the Treatment Administration Record showed that the dressing change was not completed or documented on multiple dates, and the order to float the heels was not followed. The Director of Nursing confirmed that these orders were current and should have been carried out and documented.