Failure to Conduct Timely Care Plan Meetings and Address Smoking in Care Plans
Penalty
Summary
The facility failed to conduct care plan meetings with residents and/or their representatives on a quarterly basis and did not provide residents with the opportunity to participate in the development, review, and revision of their care plans. This deficiency affected six out of seven residents reviewed for care planning. Interviews with social services staff revealed that while care plan meetings are scheduled quarterly and annually, there were lapses in communication and documentation, including not inviting or updating residents and their families about care plan meetings or discharge planning. Medical record reviews showed that several residents did not have documented care plan meetings with their families in the past twelve months, and in some cases, there was no evidence of a discharge care plan or updates provided to families regarding referrals to other facilities. Additionally, the facility failed to develop a comprehensive care plan for a resident identified as a smoker. Despite the resident having a documented smoking assessment and being observed smoking on the patio, the resident was not included on the facility's smoking list, and their care plan did not address smoking. The DON confirmed that smoking should be included in care plans, but this was not done for the resident in question.