Failure to Provide and Document Treatment for Non-Pressure Skin Conditions
Penalty
Summary
The facility failed to provide necessary treatment and services for two residents with non-pressure related skin conditions. For one resident with a history of schizophrenia, Alzheimer's, dementia, anxiety, and bipolar disorder, surveyors observed persistent reddened, raised areas on her chin and nose over several days. Although there was a physician's order for clotrimazole-betamethasone cream to be applied to dry patches on the face as needed, the medication administration record showed the cream had not been applied since earlier in the month, despite visible symptoms. Nursing staff were unaware of the recurrence of the skin condition and had not applied the prescribed treatment. Another resident, diagnosed with vascular dementia, atrial fibrillation, and hypertension, was observed with a nickel-sized purple discoloration on her right wrist. She was on antiplatelet therapy, and her care plan included monitoring for signs of bleeding such as bruising. However, weekly skin assessments lacked documentation of the discoloration, and the DON was not aware of the issue until informed by surveyors. The facility's policy required documentation of skin color and presence of bruises, but this was not completed as required.