Failure to Honor Resident Self-Determination and Preferences
Penalty
Summary
The facility failed to respect and promote resident self-determination for two residents reviewed for the ability to choose important aspects of their lives. One resident, who was cognitively intact and used a wheelchair due to paraplegia and other conditions, repeatedly requested to be informed in advance about the schedule of ancillary services such as optometry, podiatry, and dental visits. Despite his requests to the social worker to have this information posted in his room, the social worker refused, stating the information was posted elsewhere. However, observation revealed that the only posted schedules were outdated and located in a secured memory care unit, with no current schedules posted elsewhere in the facility. Another resident, also cognitively intact and dependent on staff for activities and personal care, was scheduled to receive showers during the night shift without being consulted about her preferences. The resident reported that she was never asked when she preferred to have her showers and was simply told they would occur during the 11:00 P.M. to 7:00 A.M. shift. When staff attempted to provide showers during these hours, the resident declined due to the late timing, but this was recorded as a refusal rather than a lack of preference accommodation. Review of the resident's care plan and admission documentation confirmed that her preferences for shower times were not assessed or documented. The facility's policy states that residents have the right to exercise autonomy regarding important facets of their lives, including scheduling healthcare and daily routines such as bathing. However, the facility did not follow its own policy in these cases, as residents' requests and preferences regarding ancillary service schedules and shower times were not honored or accommodated.