Failure to Honor Resident's Right to Refuse Care
Penalty
Summary
The facility failed to honor a resident's right to make choices regarding personal care, specifically related to bathing preferences. The resident, who had chronic kidney disorder, bipolar disorder, major depressive disorder, generalized muscle weakness, and required assistance with activities of daily living, was assessed as cognitively intact and able to make his own decisions. The care plan indicated that staff should assist with bathing according to the resident's preferences, and a preference evaluation showed the resident preferred sponge baths and valued having his brother involved in care discussions. Despite this, nursing documentation revealed that when the resident refused a shower, staff contacted his Power of Attorney (POA) to obtain permission to proceed with the shower against the resident's wishes, citing concerns about soiled linens and hygiene. The POA ultimately gave permission for the shower, and staff proceeded to bathe the resident. Further review and interviews confirmed that the resident had not been deemed incompetent and did not have a guardianship assigned, meaning his right to make decisions about his care remained intact. The Administrator and DON acknowledged that the POA's authority did not override the resident's choices as long as he was capable of making his own decisions. The incident demonstrates that the facility did not respect the resident's expressed preferences and right to refuse care, as required by regulations, and instead deferred to the POA despite the resident's cognitive ability to make his own choices.