Failure to Update Care Plans for Changes in Bowel Patterns
Penalty
Summary
The facility failed to ensure that the care plans for two residents were reviewed and revised by the interdisciplinary team to reflect ongoing changes in their bowel patterns, specifically the presence of watery bowel movements. For both residents, Certified Nursing Assistant Accountability Records documented multiple instances of watery bowel movements over several days. Despite this, their comprehensive care plans, which addressed constipation and included interventions such as medication administration and monitoring, were not updated to reflect the new bowel patterns. The facility's policy requires care plans to be updated whenever there is a change in the resident's condition or other factors affecting care, but this was not followed in these cases. Resident #1 had diagnoses including cerebral palsy, peripheral vascular disease, seizure disorder, chronic lung disease, and asthma, with severely impaired cognition. Resident #2 had coronary artery disease and a cerebrovascular accident, with moderately impaired cognition. Both residents had care plans focused on constipation, but neither plan was revised to address the documented watery bowel movements. Interviews with nursing staff and the DON confirmed that care plans are typically updated quarterly or as needed, but in these instances, the updates did not occur as required, with staff citing reasons such as the absence of active unit managers and the resident's transfer to the hospital.