Advance Directive Lacked Required Provider Signature
Penalty
Summary
The facility failed to ensure that a resident's advance directive, specifically a Do Not Resuscitate Comfort Care-Arrest (DNRCC-A) form, contained the required signature of a physician, APRN, or PA. Instead, the form was signed by the Assistant Director of Nursing and a Licensed Practical Nurse, with a note referencing the supervising physician's information but lacking the actual provider's signature. The deficiency was identified during a review of the resident's medical record, which showed an active DNRCC-A order, and was confirmed in an interview with the Administrator, who acknowledged that the nurses signed the form based on the physician's verbal consent rather than obtaining the required provider signature. The resident involved had diagnoses including urinary tract infection, dementia, and prostate cancer.