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F0557
D

Failure to Maintain Resident Dignity and Honor Personal Preferences

Ann Arbor, Michigan Survey Completed on 04-23-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to honor the dignity and personal preferences of three residents by not offering them the choice to use their own underwear instead of briefs, and by instructing them to use the bathroom in their briefs due to staff time constraints. One resident, who was cognitively intact and ambulatory with a walker, reported never being offered his own underwear, despite having several pairs in his dresser. He expressed embarrassment and distress at being made to wear briefs, which he did not use prior to admission, and recounted an incident where a CNA told him to have a bowel movement in his brief because staff did not have time to assist him to the toilet. Another resident reported a similar experience, stating that a CNA told her to use the bathroom in her brief due to lack of time. This resident had also filed a grievance about the incident, which was documented as a customer service issue rather than an allegation of abuse. The administrator and DON confirmed awareness of these grievances and acknowledged that staff had told residents to use their briefs when assistance was requested but not provided. A third resident, who was cognitively intact and required assistance for transfers, reported long call light response times and being told to have a bowel movement in his brief while in bed. This resident described the experience as humiliating and degrading, and subsequently began self-transferring to the bathroom to avoid similar incidents. He also filed a grievance regarding the incident but reported no appropriate follow-up or resolution. All three residents experienced emotional distress, including feelings of anger, embarrassment, and being devalued.

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