Q: Our facility was recently cited under F-656, Comprehensive Care Plans, for the third year in a row. How can we ensure compliance?
A:F-656 is one of the top 10 most-cited deficiencies. The regulation’s goal is to ensure facilities have developed and implemented a comprehensive, person-centered care plan to address care needs.
When care plans lack specificity regarding each resident, the facility risks a citation. Using care plan templates for all residents with a particular risk factor creates such a situation. For example, if all residents on a diuretic have the same care plan interventions, regardless of a specific diuretic in use, the care plans are not tailored to individual care needs.
Additionally, surveyors cite facilities for not involving staff, the resident or resident representative in creating or updating the care plan. Unless care plans reflect the resident’s preferences, goals and outcomes, they are not personalized.
To ensure compliance, audit care plans periodically. For facilities that have already received F-656 citations, surveyors will scrutinize care plans with every survey. Such situations may necessitate more frequent audits. Self-audit to ensure they include person-centered interventions and residents’ measurable goals.
Also review the care area assessments to confirm the record documents the reason to proceed to the care plan. Remember that the MDS does not include all needs; therefore, additional care plans may be necessary.
Care plans are not solely the responsibility of the nurse assessment coordinator. Everyone providing care must review care plans regularly. Staff members must collaborate to care for residents and inform care plan development.
Please send your nursing-related questions to Amy Stewart at [email protected].
From the September 2024 Issue of McKnight's Long-Term Care News
