Failure to Complete Required MDS Assessments for Two Residents
Penalty
Summary
The facility failed to complete required Minimum Data Set (MDS) assessments for two residents. For one resident, the quarterly MDS assessment due in July remained incomplete and was still listed as 'in progress' in the electronic health record as of late August. The MDS Coordinator acknowledged that MDS assessments had not been completed in a timely manner, citing insufficient time to complete the required work. The Director of Nursing confirmed that MDS assessments should be completed within the appropriate time frames. Another resident, who had diagnoses of chronic obstructive pulmonary disease and diabetes and was cognitively intact, experienced a hospitalization in July. The clinical record review showed that the required MDS discharge assessment with anticipated return and the reentry MDS assessment were not completed following the resident's transfer to and return from the hospital. Progress notes documented the resident's transfer to the hospital, admission, and subsequent return to the facility, but the necessary MDS assessments were missing. The Director of Nursing confirmed that these assessments should have been completed.