Failure to Notify Residents/Responsible Parties of Physician-Ordered Treatment Changes
Penalty
Summary
The facility failed to notify residents or their responsible parties of physician-ordered changes in treatment for two of five sampled residents, as required. For one resident with diagnoses including congestive heart failure and dementia, the clinical record showed that on February 1, 2026, the resident complained of sacral pain and the physician ordered application of triad paste, and on February 4, 2026, the physician ordered application of calcium alginate to a right heel wound; there was no documented evidence that the resident or responsible party was notified of these new treatment orders. For another resident with dementia, the clinical record showed that on February 6, 2026, the physician ordered Mucinex for five days for a productive cough and hydrocortisone cream twice daily for a rash, with no documented evidence that the resident or responsible party was notified of these medication and treatment changes. In an interview on February 24, 2026, at 1:04 p.m., the Administrator confirmed there was no documented evidence that the residents or their responsible parties were notified of these physician-ordered changes, constituting a failure to immediately inform the resident, physician, and family of changes affecting the resident, in violation of 28 Pa. Code 211.12(d)(1)(5) Nursing services.
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