Failure to Update Care Plans for Residents Needing Feeding Assistance
Penalty
Summary
The facility failed to develop and implement comprehensive, person-centered care plans for two residents with significant cognitive and physical impairments. Both residents had documented needs for assistance with eating, as evidenced by their medical diagnoses, MDS assessments indicating severely impaired cognition, and therapy evaluations showing the need for supervision or physical help during meals. Despite this, their care plans inaccurately stated that they were able to feed themselves without physical assistance, only noting that they might need help preparing their trays or drinks. These care plans were not updated to reflect the residents' actual needs for feeding assistance, as confirmed by multiple staff interviews and therapy documentation. Staff interviews revealed that both residents regularly required help with eating, with some days necessitating full assistance throughout the meal. Nursing and therapy staff acknowledged the importance of providing this support for safety and nutritional reasons. The facility's process for updating care plans was described as challenging, with oversight sometimes resulting in missed updates. The care plans serve as the basis for the Kardex, which guides CNAs in resident care, and the lack of accurate, updated information in these documents led to the deficiency cited by surveyors.