Failure to Develop Timely Baseline Care Plans for New Admissions
Penalty
Summary
The facility failed to develop baseline care plans within 48 hours of admission for two residents. For one resident admitted after hospitalization for left lower extremity cellulitis and a venous stasis ulcer, the clinical record showed that his medication regimen included daily Warfarin, and he was later started on insulin for prediabetes. However, the baseline care plan did not address the use or complications of anticoagulant therapy, nor did it include the use of insulin for elevated blood sugars. The care plan for anticoagulant therapy was not initiated until one week after admission, and there was no evidence that insulin use was included in the care plan during the initial period after admission. Another resident was admitted with a Stage 4 sacral pressure ulcer and a PICC line for intravenous antibiotics due to sacral osteomyelitis. The baseline care plan did not address interventions for the resident's skin integrity impairment or the care and potential complications of the PICC line. A care plan for the pressure ulcer was not initiated until more than two weeks after admission, and no care plan was developed for the PICC line. These omissions were confirmed by staff interviews and clinical record review.