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F0689
D

Failure to Complete Required Neuro Checks and Update Care Plan After Resident Fall

Shawano, Wisconsin Survey Completed on 11-10-2025

Penalty

No penalty information released
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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

A resident with severe cognitive impairment and multiple medical diagnoses, including acute metabolic encephalopathy, myxedema coma, hypothyroidism, and UTI, experienced a fall from bed that resulted in injury. The fall was unwitnessed, and the resident was found on the floor entangled in bedding, with a dark bruise observed on the right temporal region. Facility policy required a specific schedule of neurological checks following such an event, but only 5 out of the 15 required checks were completed, as confirmed by record review and staff interview. Additionally, the Interdisciplinary Team (IDT) identified the need for a bolster mattress as an intervention to help prevent future falls. However, this intervention was not added to the resident's care plan. The Director of Nursing verified that both the neurological checks and the care plan update were not completed in accordance with facility policy and IDT recommendations.

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