F0656

D

Failure to Complete Comprehensive Care Plan After Admission Assessment

Alva, Oklahoma Survey Completed on 01-15-2026

Penalty

3 days payment denial

Summary

The facility failed to develop and implement a comprehensive, person-centered care plan with measurable objectives and timeframes for a resident within the required timeframe following admission. The resident, who had documented issues including delirium, cognitive loss/dementia, communication problems, urinary incontinence with an indwelling catheter, falls, nutritional status concerns, dental care needs, pressure ulcer risk, and psychotropic drug use, was admitted on 12/12/25. Observation showed the resident was unable to hear what was being said, with hearing aids observed on their table. Record review revealed that although these care areas were identified in the admission assessment, there was no corresponding comprehensive care plan developed within seven days of completion of the admission assessment in the clinical record. During interview, the MDS coordinator acknowledged that the comprehensive care plan for this resident had been missed.