Failure to Update Care Plan for NPO Resident Receiving Enteral Nutrition
Penalty
Summary
The facility failed to develop and implement a comprehensive, person-centered care plan that accurately reflected a resident's current medical needs. Specifically, a male resident with diagnoses including cerebral infarction, dysphagia, and gastrostomy status was admitted and assessed as requiring enteral nutrition via a G-tube and was designated as NPO (nothing by mouth) due to swallowing difficulties. Despite this, the resident's care plan included interventions for encouraging oral intake, such as offering alternate meals or supplements if less than 50% of food was consumed and encouraging or assisting with oral fluid intake. These interventions were not appropriate for a resident with NPO status and were not updated following a recent hospitalization and change in condition. Observations confirmed the resident was receiving enteral nutrition via a feeding pump, and interviews with facility staff, including the MDS Nurse and DON, revealed that the care plan had not been revised to remove oral intake interventions after the resident was made NPO. The staff acknowledged the oversight and the importance of ensuring care plans reflect current orders and resident needs. Review of facility policy did not provide specific guidance on ensuring the accuracy of care plan content.