Failure to Provide Medically-Related Social Services and Behavioral Interventions
Penalty
Summary
The facility failed to provide medically-related social services to help residents achieve the highest practicable physical, mental, and psychosocial well-being, as evidenced by the lack of proper assessment, care planning, and intervention for four residents with significant behavioral and psychosocial needs. For two residents with severe cognitive impairment and behavioral disturbances, the facility did not obtain or utilize pertinent information from previous care settings, family, or hospice providers prior to admission. This resulted in the absence of individualized psychosocial interventions and inadequate care plans to address their complex behaviors, including aggression, wandering, and refusal of care. The facility also did not assess or address the trauma backgrounds or social histories of these residents, which were relevant to their care and management. The report details that one resident with Alzheimer's disease, alcohol abuse, and PTSD exhibited aggressive and wandering behaviors upon admission. The facility did not reach out to the resident's previous assisted living facility, hospice, or activated power of attorney to gather essential background information and effective behavioral interventions. As a result, staff were unprepared to manage the resident's behaviors, which included physical and verbal aggression, wandering into other residents' rooms, and rejection of care. Care plans and interventions were either delayed or implemented after the resident was hospitalized following an altercation with another resident. Another resident with psychosis, vascular dementia, and major depressive disorder also demonstrated increasing aggressive behaviors and medication refusals after admission. The facility did not assess these behaviors or develop appropriate psychosocial interventions based on observed patterns. The resident's refusal to take prescribed medications, which were critical for managing dementia and behavioral symptoms, was not adequately addressed in the care plan. The lack of assessment and intervention contributed to repeated altercations between residents, resulting in injury and hospitalization. Additionally, the facility did not assess or address the psychosocial needs of two other residents following multiple altercations, nor did it have a plan for managing residents with parole status or criminal backgrounds.