Failure to Maintain Resident Dignity and Privacy
Penalty
Summary
The facility failed to provide eating assistance in a dignified manner for two residents observed for in-room dining. One resident was left unattended with a food tray for approximately 25 minutes without staff assistance, despite needing supervision and assistance during meals. Another resident was referred to as a "feeder" by staff, which is considered undignified language. Additionally, a resident's privacy was compromised as they were left without a privacy pouch for their drainage bag, contrary to their care plan requirements. The facility also failed to maintain privacy during personal care for several residents. One resident was observed with their room door open and privacy curtain partially drawn while receiving care, exposing them to the hallway. Another resident was found with their bed covers off, exposing their disposable brief and tubing, with the room door open, allowing full view from the hallway. These observations indicate a lack of adherence to the facility's dignity policy, which emphasizes maintaining privacy and respectful communication. Furthermore, a resident experienced a delay in receiving their lunch tray, resulting in them waiting 19 minutes after their roommate had already finished eating. This delay in meal service is inconsistent with the facility's policy of treating residents with dignity and ensuring timely assistance. The report highlights multiple instances where the facility's actions or inactions failed to uphold the residents' right to be treated with dignity and respect, as required by the facility's policies and procedures.
Plan Of Correction
N203 RIGHT TO BE TREATED WITH DIGNITY 1. What corrective action(s) will be accomplished for those residents found to have been affected by the practice: 1) In the allegation of Resident #82, being referred to as a "feeder". Staff will be in-serviced regarding dignity, not calling residents "feeders" but as someone who needs assistance with feeding. 2) In the allegation of Resident #103, waiting a long time to be fed. Staff will be in-serviced not to leave trays in the room, but to feed residents in a timely manner as to not cause dignity issues. 3) In the allegation of Resident #103, not having a privacy pouch for bags. Nursing staff will be in-serviced to ensure residents with bags have privacy covers for them. 4) In the allegation of Resident #175, privacy during care. Nursing staff will be in-serviced to provide privacy for residents while they are receiving care. 5) In the allegation of Resident #275, delay in feeding, residents in the same room should be brought their trays at the same time. Staff will be in-serviced to bring food trays to all residents in the same room at the same time not to cause dignity issues. 6) In the allegation of Resident #475, door open no covers (linens) covering resident, resident exposed in only a brief and a shirt. Nursing staff will be in-serviced to ensure residents are dressed or covered for privacy and dignity. 2. How you will identify other residents having potential to be affected by the same practice and what corrective action will be taken: All residents in the facility have the potential to be affected by these practices. 3. What measures will be put into place or what systematic changes you will make to ensure that the practice does not recur: The measures put into place/systemic changes made to ensure the standards are met: - In-service staff about dignity, not calling residents "feeders" but as someone who needs assistance with feeding. - In-service staff not to leave trays in room, to feed residents in a timely manner as to not cause a dignity issue. - In-service Nursing staff to ensure residents with bags have privacy covers for them. - In-service nursing staff to provide privacy for residents while they are receiving care. - In-service staff to bring food trays to all residents in the same room at the same time not to cause a dignity issue. - In-service nursing staff to ensure residents are dressed or covered for privacy and dignity. Random QA audits will be conducted by the Director of Nursing or a qualified Designee, weekly for one month, then biweekly for another one month and then monthly for one month or until substantial compliance has been determined. 4. How the corrective action(s) will be monitored to ensure the practice will not recur, i.e., what quality assurance program will be put into place: Random QA audit will be conducted by the Director of Nursing or a qualified Designee, weekly for one month, then biweekly for another one month and then monthly for one month or until substantial compliance has been determined. Findings of the QA audits will be reported in the Monthly QAPI meeting by the Director of Nursing or a qualified Designee for a period of three months and until substantial compliance is met. Corrective action completion date: