Stay Ahead of Compliance with Monthly Citation Updates


In your State Survey window and need a snapshot of your risks?

Survey Preparedness Report

One Time Fee
$79
  • Last 12 months of citation data in one tailored report
  • Pinpoint the tags driving penalties in facilities like yours
  • Jump to regulations and pathways used by surveyors
  • Access to your report within 2 hours of purchase
  • Easily share it with your team - no registration needed
Get Your Report Now →

Monthly citation updates straight to your inbox for ongoing preparation?

Monthly Citation Reports

$18.90 per month
  • Latest citation updates delivered monthly to your email
  • Citations organized by compliance areas
  • Shared automatically with your team, by area
  • Customizable for your state(s) of interest
  • Direct links to CMS documentation relevant parts
Learn more →

Save Hours of Work with AI-Powered Plan of Correction Writer


One-Time Fee

$49 per Plan of Correction
Volume discounts available – save up to 20%
  • Quickly search for approved POC from other facilities
  • Instant access
  • Intuitive interface
  • No recurring fees
  • Save hours of work
F0657
D

Failure to Update Care Plan After Multiple Falls

Hawarden, Iowa Survey Completed on 10-08-2025

Penalty

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to update care plan interventions for a resident after multiple falls, as required by policy and regulatory standards. Record review showed that a resident with diagnoses of Alzheimer's disease, dementia, and malnutrition, and a BIMS score indicating severe cognitive impairment, experienced several falls over a period of time. Despite these incidents, the care plan did not reflect updated or new interventions to address the resident's fall risk. Incident reports documented each fall, but the care plan remained unchanged regarding fall prevention strategies. Interviews with staff, including an LPN and the DON, confirmed that nurses are responsible for entering interventions into the care plan after a fall. However, it was revealed that while interventions were sometimes documented in progress notes and discussed by the interdisciplinary team, they were not consistently incorporated into the resident's care plan. The DON acknowledged that the process for updating care plans was not always followed, particularly due to reliance on the MDS nurse to finalize interventions, and noted that a new MDS nurse was in training at the time.

An unhandled error has occurred. Reload 🗙