3. Nursing facilities must develop a care plan for each resident within seven days after the completion of the comprehensive assessment. These plans must include objectives and timeframes to meet residents' physical, mental, and psychosocial needs. These plans are supposed to be completed by an interdisciplinary team with participation, to the extent practicable, of the resident's family or legal representative.
Nearly all, or 98.9%, of records failed to meet this requirement.
4. Implementation of the care plan requires, for example, that the nursing home attempt gradual dose reductions of antipsychotic drugs at least once per quarter, monitor resident for side effects of these drugs, and document that the implementation actually occurred.
About 17.9% of the reviewed records failed to meet this requirement.
The report also says that a psychiatrist, geriatrician, or psychologist should be involved in developing care plans. "However, only two (out of the 375) care plans involved such practitioners," the report says. And 20% of the records indicated that an RN, a social worker, or a licensed practical nurse was solely responsible for developing the plan.