Failure to Update Care Plans to Reflect Residents' Current Status
Penalty
Summary
The facility failed to revise and update care plans to accurately reflect the current status of two residents reviewed for falls. For one resident, the care plan included interventions to ensure personal items, including a mirror, were within reach, but repeated observations showed that no personal items or mirror were present in the resident's room. Staff interviews confirmed that the resident no longer had or used these items, and had not done so for a significant period. For another resident, the care plan included an intervention to educate staff to assist with dentures, but both the resident and staff confirmed that the resident had natural teeth and did not have dentures. Nursing and nutritional assessments also documented that the resident had natural teeth and no dentures, indicating the care plan was not updated to reflect this change.