Failure to Provide Baseline Care Plan Summary Within 48 Hours of Admission
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
Nursing staff failed to provide a resident and/or their representative with a written summary of the baseline care plan within 48 hours of admission. The resident, who was admitted with interstitial pulmonary disease, chronic respiratory failure with hypoxia and hypercapnia, and neurocognitive disorder with Lewy Bodies, did not receive documentation outlining initial goals, current medications, dietary instructions, or the services and treatments to be administered. Medical record review confirmed the absence of this summary, and interviews with the resident, a nurse, and the administrator verified that the baseline care plan was not developed or shared within the required timeframe.