Care Plan Not Updated with Correct Diagnosis
Penalty
No penalty information released
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Summary
The facility failed to revise the care plan for Resident #118 to reflect the correct diagnosis following a comprehensive assessment. During record review, it was found that the care plan listed Parkinson's disease as a diagnosis under the focus area for alterations in comfort related to chronic pain, neuropathy, left knee pain, bilateral calf pain, bladder spasms, fibromyalgia, ganglion right wrist, spondylosis, and osteoarthritis. However, the resident did not have a diagnosis of Parkinson's disease but did have a diagnosis of restless leg syndrome, which was not included in the care plan. This discrepancy was confirmed by the facility administrator during staff interview, who acknowledged the care plan contained the incorrect diagnosis.