Failure to Develop Dementia Care Plan for Resident
Penalty
Summary
The facility failed to provide a personalized care plan addressing dementia for a resident diagnosed with moderate vascular dementia and senile degeneration of the brain. The resident's medical record indicated severe cognitive impairment, moderate hearing difficulty, and the use of hearing aids. Despite these diagnoses and needs, the care plan did not include any specific problems, interventions, or goals related to dementia care. Observations showed the resident spent time both in bed and in a wheelchair, was able to feed themselves, and was seen removing wet clothing and a brief independently. Interviews with the DON and Administrator confirmed that the care plan should have addressed the resident's dementia diagnosis and needs, but this was not done. The facility also did not provide a policy regarding dementia care.