Failure to Prevent Resident Neglect in Nutrition and Bathing Assistance
Penalty
Summary
The facility failed to protect two residents from neglect as required by policy and regulation. For one resident with diagnoses including high blood pressure, dementia, and diabetes, who was receiving nutrition through an enteral feeding tube and was designated NPO, an activity employee provided a cookie to the resident without proper authorization. The activity employee stated she had asked the speech therapist for permission, but the speech therapist denied giving approval, noting that the resident had returned from the hospital and required a full evaluation before any oral intake could be recommended. Documentation confirmed the resident was to remain NPO until assessed by the speech therapist. In a separate incident, another resident with high blood pressure, weakness, and wheelchair dependence, who required two-person assistance for bathing, was given a shower by a single nurse aide. The aide proceeded without a second staff member, contrary to physician orders and facility policy. The incident was observed and reported by a registered nurse, who reiterated the requirement for two-person assistance and educated the aide on proper procedure. Both the nursing home administrator and director of nursing confirmed that these actions constituted neglect of the residents involved.