Opinion ID: 612907
Heading Depth: 4
Heading Rank: 3

Heading: Comprehensive Care Plan

Text: Within 14 days of a patient's admission, Facilities must develop a comprehensive assessment. 42 C.F.R. § 483.20(b)(2)(i). Within seven days after this assessment is completed, the facility must develop a care plan for the resident. 42 C.F.R. § 483.20(k)(1) (the care plan must include[] measurable objectives and timetables to meet a resident's medical, nursing, mental and psychosocial needs that are identified in the comprehensive assessment). Under part (i) of this provision, the care plan must describe, [t]he services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being as required under § 483.25. § 483.20(k)(1)(i). Moreover, the Facility must ensure that services arranged by the facility meet professional standards of quality. § 483.20(k)(3)(i). Both care plans developed by Golden were not specific to R1's needs. The December 7, 2007 initial plan stated the intervention to address R1's risk for dehydration was detection and intervention through next review. The subsequent care plan aimed to encourage fluids as tolerated but did not specify how much fluid to provide. Id. at 1582. Moreover, the December 28 care plan did not address R1's extremely high potassium levels. Because the care plans did not address a number of R1's specific needs nor provide measurable objectives, there is substantial evidence in the record to support a finding of violation of the requirement to provide a comprehensive care plan for each resident. Golden's initial brief does not address the issue of professional standards of quality for the care plan. Therefore the issue is waived. See Marks v. Newcourt Credit Grp., Inc., 342 F.3d 444, 462 (6th Cir. 2003). [4]