Failure to Provide Individualized Activities for Resident
Penalty
Summary
The facility failed to provide meaningful, individualized, and engaging activities to a resident, identified as R7, who was cognitively intact and had a history of hypertension, heart failure, kidney failure, depression, and anxiety disorder. Despite having a care plan that included 1:1 visits from staff and volunteers, and a preference for activities such as keeping up with the news, watching TV, coloring, word searches, and reading, there was no evidence of 1:1 activity visits being conducted. Observations revealed that R7 was often found in bed, yelling for help, and no staff were observed entering the room to engage with the resident. The resident's care plan also indicated a risk for altered activity patterns due to anxiety and disinterest, yet the facility did not adhere to the plan. Interviews with Certified Nurse Aides (CNAs) revealed that R7 did not get out of bed and staff were not observed conducting activities with the resident. The CNAs reported that residents on the same hall often complained about yelling, which caused frustration and sleep disruption. The facility's documentation showed that R7 was only offered 1:1 activities on five occasions over a 60-day period, and there was no documentation of R7 being invited to or refusing group activities or outdoor programs. The facility's administrator acknowledged the lack of documentation in the medical record and the failure to follow the resident's care plan.
Plan Of Correction
Element 1: Resident 7 no longer resides in facility. Element 2: Residents in facility were reviewed to ensure their care plans were updated appropriately to reflect interests and preferences. If missing, interests and preferences were added to care plans. Element 3: Education was provided to Activity Director and staff to ensure likes/dislikes are followed, care plans are updated, and a meaningful and diverse calendar was offered. Activities staff will ensure residents get equal opportunity to participate in activities each week. Element 4: Act dir/designee will audit 10 random residents weekly to ensure activity likes and dislikes are in place and care planned. Audit findings will be presented to the facility QAPI Committee and will only be discontinued with substantial compliance and with approval of the facility QAPI Committee. Any instances of noncompliance that are identified will be addressed per company policy concerning education and disciplinary action when necessary. The Administrator is responsible for achieving and sustaining compliance.