Failure to Notify Residents and Representatives of Care Conferences
Penalty
Summary
The deficiency involves the facility’s failure to notify residents or their representatives and invite them to participate in care conferences, as required for development and review of the comprehensive care plan. For one resident with COPD, anxiety, hemiplegia, abnormal posture, and bilateral osteoarthritis, the quarterly MDS showed intact cognition and a need for assistance with ADLs, and the care plan identified the resident as full code with interventions including education of the resident and responsible party and review of advance directives. The face sheet listed the resident as responsible party and identified an emergency contact with power of attorney, yet the care conference signature sheet did not include the resident or representative, and progress notes over several months contained no documentation that the family was notified of the quarterly care conference. The resident reported that only once had the facility called the daughter to talk by phone and otherwise had not invited them to care conferences, and the daughter confirmed she had not received information regarding care conferences. The DON acknowledged awareness that the family wanted notification and that they had reported not being notified of recent care conferences, and the Administrator confirmed there was no documentation of notifications or invitations. For a second resident with type 2 diabetes mellitus, morbid obesity, depressive disorder, panic disorder, and anxiety, the admission MDS showed intact cognition and a need for set-up assistance with eating, toileting, bed mobility, and transfers. Progress notes over several weeks were silent regarding any notification to the resident or representative about participation in care conferences. The DON and Administrator both verified there was no documentation of notification or invitation for this resident, and the resident stated he was not notified of or invited to participate in a care conference. For a third resident with hypertension, COPD, and stroke, the quarterly MDS showed impaired cognition and a need for assistance with eating, bed mobility, transfers, and toileting; the care plan noted impaired cognitive functioning and included interventions to communicate with the resident and family regarding capabilities and needs. The face sheet listed the resident as responsible party with three emergency contacts, but progress notes over several months contained no documentation that the resident or representative was notified of the quarterly care conference. The resident stated the facility would let his family know if something was going on with his health but could not recall receiving notification of care conferences or invitations to participate. The DON and Administrator again verified there was no documentation of notification or invitations for this resident.
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