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F0657
D

Failure to Update Care Plan for Resident Receiving Diuretic and Opioid

Hillsboro, North Dakota Survey Completed on 06-26-2025

Penalty

No penalty information released
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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

The facility failed to review and revise the care plan to reflect the current status for one resident who was receiving unnecessary medications. Record review showed that the resident had physician's orders for Lasix, a diuretic, and Tramadol, an opioid pain medication, both administered twice daily. However, the resident's care plan did not identify problems or interventions related to the use of these medications. This omission was confirmed by an administrative staff member, who acknowledged that the care plan had not been updated as required by facility policy, which states that the plan of care should be modified to reflect the care currently required or provided for the resident.

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