Failure to Investigate and Address Missing Resident Property
Penalty
Summary
The facility failed to investigate and take prompt corrective action regarding a resident's missing property, specifically a prosthetic glass eye. According to the facility's policy, all grievances and complaints, including missing items, are to be investigated and resolved. The resident in question had a history of cancer in the right eye, resulting in removal of the eye and use of a prosthetic, which she frequently removed. The care plan documented that the resident lost her glass eye and that the physician recommended leaving it out due to complications. Despite documentation in the care plan about the missing glass eye, there was no evidence that the facility investigated the loss or took action to locate or replace the item. The Social Services Director (SSD) and the Director of Nursing (DON) were unable to provide any documentation of an investigation or follow-up regarding the missing property. The SSD reported hearing that the resident may have left the prosthetic on a meal tray, which was subsequently removed, but no formal investigation or documentation was found.