Failure to Conduct Timely Quarterly Care Plan Review
Penalty
Summary
Facility staff failed to ensure that a comprehensive care plan review and care plan meeting were conducted at least quarterly for one resident with multiple diagnoses, including schizophrenia, hypertension, and major depressive disorder. The resident, who has a legal guardian and is coded as DNR, was admitted to the facility and had a documented severe cognitive impairment based on a BIMS score of 00. The last documented care plan meeting for this resident occurred over 90 days prior to the review, and there was no evidence that the interdisciplinary team (IDT) reviewed or revised the care plan within seven days of the most recent quarterly MDS assessment. Record review and staff interviews confirmed the absence of required quarterly care plan meetings and timely IDT review for the resident. The Social Services Director acknowledged that the last care plan meeting was held more than 90 days ago and could not provide a reason for the delay. Documentation did not show that the care plan was reviewed or updated as required by regulation, resulting in a deficiency related to care plan management for this resident.