Failure to Timely Revise Care Plans for Hospice, Enteral Feeding, and IV Devices
Penalty
Summary
The facility failed to ensure that care plans were revised in a timely manner for residents with significant changes in condition or new interventions, specifically related to hospice services, enteral feeding, and intravenous devices. For one resident with hypertensive heart disease, aphasia, and failure to thrive, hospice services were initiated, but there was no care plan developed to address goals or interventions for hospice care. Another resident with dysphagia, dementia, diabetes, and a gastrostomy had a physician order for tube feeding, but the care plan did not include current goals or interventions for enteral feeding after the previous plan was cancelled. A third resident with severe intellectual disability, borderline personality disorder, and anxiety disorder experienced multiple incidents of intravenous device dislodgement due to behavioral issues and lack of understanding of the necessity of the IV. Despite repeated incidents and documentation of the resident's non-compliance and mental status, there was no evidence of care plan goals or interventions addressing these issues. These findings were based on clinical record reviews, staff interviews, and incident reports, and were not in accordance with the facility's policy requiring timely care plan updates following significant changes in condition.