Failure to Enact Resident's Advance Directives as Documented in MOLST
Penalty
Summary
The facility failed to ensure that a resident's advance directives were executed according to their documented wishes. Specifically, a resident with severe cognitive impairment was admitted with a valid Medical Orders for Life Sustaining Treatment (MOLST) form, signed by their Health Care Agent prior to admission, indicating Do Not Resuscitate (DNR), Do Not Intubate (DNI), and Transfer to Hospital. However, the facility did not enact the MOLST and instead recorded the resident's code status as Full Code in the electronic medical record. Review of the paper record confirmed the presence of the valid MOLST, but there was no indication in the medical record that the facility had followed these orders. Additionally, the facility did not have a policy for the formulation of advance directives.