Failure to Inform and Obtain Consent for Medication and Wanderguard Placement
Penalty
Summary
The facility failed to ensure that two residents or their representatives were fully informed and able to participate in decisions regarding their care and treatment. For one resident with severe vascular dementia and significant cognitive impairment, the facility initiated an antidepressant medication (Escitalopram) without notifying or obtaining consent from the resident's representative prior to starting the medication. Record review and interviews confirmed that no documentation of consent or notification was found before the medication was administered. In another case, a resident who had recently eloped from the facility was fitted with a wanderguard device upon return. Documentation showed that the wanderguard was placed before obtaining informed consent from the resident or her guardian. The consent form and related progress note were completed two days after the device was applied, and staff interviews confirmed that consent should have been obtained prior to placement. These actions demonstrate a failure to inform and involve residents or their representatives in advance of significant care interventions.