Failure to Respond to Resident's Calls for Help
Penalty
Summary
The facility failed to provide timely care and services to promote the quality of life for a resident, as evidenced by the resident's continuous calls for help that went unanswered for approximately 30 minutes. During a facility tour, the resident was observed calling for assistance with toileting needs, stating she had 'messed' herself. Despite her cries for help being audible from the hallway, multiple staff members, including an LPN, CNAs, the Maintenance Director, and the Activities Director, walked past the resident's room without responding to her calls. Interviews conducted with the Director of Nursing (DON) and the Clinical Reimbursement Director confirmed that the resident did not use the call bell but would call out for help. The DON stated that staff should enter the room to inquire about the resident's needs when they hear a resident calling for help. The resident expressed a desire to be clean, and the DON acknowledged the importance of timely care, confirming that the resident had experienced a bowel movement during the morning observations. A review of the resident's care plan revealed a focus on providing assistance with toileting and personal hygiene to maintain cleanliness and dignity. The care plan also noted the resident's dependency on staff for toilet use and a behavior problem of continuously calling out for help. The facility did not provide a policy related to this issue, and the deficiency was classified as Class III.
Plan Of Correction
This plan of correction is submitted as required under state and federal laws. The submission of this plan of correction does not constitute an admission on the part of the skilled nursing facility as to the accuracy of the surveyor's findings or the conclusion drawn there from. The plan of correction does not constitute a deficiency or that the scope and severity regarding any of the deficiencies cited are correctly applied. Any changes to facility policy and procedures should be considered remedial measures as that concept is employed in rule 407 of the federal rules of evidence and should be inadmissible in any proceeding on that basis. The facility submits this plan of correction with the intention that it be inadmissible by any third party in any civil or criminal action against the facility or any employee, agent, officer, director, or shareholders of the facility. The facility has not waived any rights to contest any of these allegations or any allegation or action. N-201, Right to Adequate and Appropriate Healthcare Element #1. Resident #2 was provided with care on in response to her requests, and no adverse outcomes were noted. Care Plans for Resident #2 were reviewed and deemed appropriate. Element #2. Director of Nursing (DON) and/or Designee conducted an interview audit with interviewable residents on /205 to determine if their verbalizations/requests were responded to and addressed in a timely manner. No additional residents were identified. Element #3. Staff A (Licensed Practical Nurse/LPN). Staff B (Certified Nursing Assistant/CNA), Maintenance Director, Activities Director, and Staff D (Licensed Practical Nurse/LPN) were individually in-serviced by Director of Nursing (DON) regarding the expectation that staff respond to and address resident verbalizations/requests in a timely manner. Interdisciplinary staff were in-serviced by the Director of Nursing (DON) and/or Nursing Home Administrator (NHA) regarding the expectation that any staff member can/should respond to resident verbalizations/requests to ensure that they are addressed in a timely manner. Element #4. Director of Nursing (DON) and/or Designee will conduct interview audits with interviewable residents three (3) times weekly for four (4) weeks, then two (2) times weekly times eight (8) weeks and/or until substantial compliance is achieved to ensure that resident verbalizations/requests are responded to and addressed in a timely manner. Grievances will be completed on behalf of those residents verbalizing concerns. Completed audits will be brought to the daily stand up meetings and reviewed by the Interdisciplinary Team (IDT). Results of the audits will be brought by the Director of Nursing (DON) and discussed at monthly Quality Assurance Performance Improvement Meetings for review and recommendation. Element #5: Facility's Allegation of Compliance Date is /20525.