Failure to Provide Timely ADL Assistance After Meal
Penalty
Summary
A deficiency occurred when a resident with osteoarthritis, muscle atrophy, and dementia, who required substantial assistance with activities of daily living (ADLs), was not provided appropriate care following a meal. The resident was observed seated in the dining room with dried red sauce on her shirt and pants, and a large ravioli on her thighs, approximately 1.5 hours after lunch had been served. Staff interviews revealed that the resident required maximal assistance with eating and dressing, and her care plan specified assistance with ADL tasks as needed due to impaired cognition and limited mobility. Despite these documented needs, the resident remained unattended, soiled, and in need of repositioning and clothing change for an extended period after the meal. Certified Nursing Assistants (CNAs) assigned to the dining room and to the resident did not provide the necessary assistance or ensure the resident's hygiene and comfort were maintained. Staff acknowledged the resident's need for maximal assistance and confirmed that her appearance and condition had not been addressed. Facility policies required the use of clothing protection during meals and individualized dressing/grooming assistance, but these procedures were not followed, resulting in the resident remaining soiled and improperly cared for after eating.