Failure to Implement Timely Skin Impairment Treatment and Monitoring Orders
Penalty
Summary
The facility failed to implement treatment and monitoring orders for skin impairments for two residents upon admission. For one resident, who was admitted with a right lower leg laceration that had been sutured in the hospital, the facility did not initiate any treatment or monitoring orders for the wound until 11 days after admission, despite hospital discharge instructions to follow current wound care recommendations. The resident's initial assessment documented the presence of a significant laceration with 15 stitches, but this was not followed by timely care orders. Another resident was admitted with multiple medical diagnoses and was noted during the nursing admission evaluation to have a large bruise on the right upper shoulder and bruises on both arms. However, no treatment or monitoring orders for these bruises were implemented until 14 days after admission. The Director of Nursing Services confirmed that the expectation was for a full-body skin assessment upon admission and prompt communication with a medical provider for any skin impairments, which did not occur in these cases.