Failure to Educate and Notify Regarding Dialysis Refusals
Penalty
Summary
The facility failed to provide appropriate dialysis care and services for two residents requiring such care. For one resident with end stage renal disease and moderately impaired cognition, the care plan was not individualized and lacked specific details such as the dialysis location, contact information, and schedule. When this resident refused dialysis due to agitation and discomfort, there was no documentation that the resident was educated on the risks and benefits of refusing treatment. Interviews with staff confirmed that education should have been provided and that the care plan was not resident-specific. For another resident with end stage renal disease, cognitive communication deficit, and a history of noncompliance with hemodialysis, the care plan included instructions to remind the resident of the consequences of refusing treatment and to document such refusals. However, when this resident refused dialysis, there was no evidence that the family was notified as required. Staff interviews confirmed that both resident education and family notification should occur in the event of a dialysis refusal.