Failure to Include All Interdisciplinary Team Members in Care Plan Review
Penalty
Summary
The facility failed to ensure that a quarterly comprehensive care plan was reviewed and revised by all required interdisciplinary team members for one resident. Review of the medical record showed that a quarterly care plan meeting and review was documented as completed by the interdisciplinary team; however, the attending physician and a nurse aide responsible for the resident did not participate in the review or revision of the care plan. This was confirmed by the Director of Social Services during an interview, who acknowledged that these team members were not involved in the care plan process for the resident on the specified date. The deficiency was identified during the facility's recertification survey, with findings discussed during the exit conference with the Administrator and Director of Nursing.