Failure to Involve Residents and Representatives in Quarterly Care Plan Meetings
Penalty
Summary
The deficiency involves the facility’s failure to ensure residents and/or their responsible parties were allowed to participate in the development and implementation of person-centered plans of care by not scheduling required quarterly care plan meetings. For Resident #1, who was admitted with multiple diagnoses including unspecified atrial fibrillation, right rib fractures, type 2 diabetes mellitus, stroke, hypertension, and age-related osteoporosis, record review showed no documented evidence of any quarterly care plan meetings prior to the resident’s death in the hospital. The Quarterly MDS for this resident showed a BIMS score of 13, indicating no cognitive impairment, yet there was no documentation that the resident had been invited to or participated in quarterly care plan meetings. For Resident #2, admitted with conditions including conversion disorder with seizures or convulsions, severe unspecified dementia with behavioral disturbance, vascular dementia with agitation, malignant neoplasm of the prostate, acute kidney failure, depressive episodes, repeated falls, and other specified mental disorders, the Quarterly MDS showed a BIMS score of 6, indicating severe cognitive impairment. The SSD stated she was responsible for scheduling quarterly care plan meetings but had not scheduled any for this resident, and the last care plan meeting on record was several months earlier. For Resident #3, admitted with Bell’s palsy, chronic pain syndrome, paroxysmal atrial fibrillation, GERD, chronic diastolic heart failure, major depressive disorder, trigeminal neuralgia, generalized anxiety disorder, metabolic encephalopathy, and Parkinson’s disease, the Quarterly MDS showed a BIMS score of 12, indicating moderate cognitive impairment. The SSD similarly confirmed she had not scheduled any quarterly care plan meetings for this resident. In all three cases, the DON confirmed the facility failed to conduct the required care plan meetings.
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