Failure to Maintain Resident Privacy and Dignity During Personal Care
Penalty
Summary
Staff failed to provide adequate privacy and assistance to two residents who wore incontinent briefs, resulting in their exposure to staff, visitors, and other residents from the hallway. One resident, who had multiple comorbidities including diabetes, morbid obesity, chronic pain, and respiratory failure, was observed on several occasions with her lower body uncovered and her incontinent brief exposed while lying in bed with her leg hanging off the mattress. The resident was dependent on staff for bed mobility, positioning, and use of the call light, which was often not within reach. Staff did not consistently assist with covering the resident or adjusting her bed for meals, leaving her in unsafe positions for eating and drinking, and her privacy was not maintained as required by facility policy. Another resident, with diagnoses including hypertension, stroke, chronic kidney disease, and major depressive disorder, was also observed without adequate privacy. This resident, who required supervision and assistance with mobility and toileting, was seen standing in her room wearing only a blue incontinent brief while staff left the door open, making her visible to those passing in the hallway. The room also had a strong odor of urine, and the resident's clothing was on the floor, indicating a lack of timely assistance with personal hygiene and dressing. Facility policy required staff to promote and protect residents' privacy and dignity, including bodily privacy during personal care. Despite this, staff actions and inactions led to repeated instances where both residents' privacy and dignity were compromised. Administrative staff acknowledged that staff should assist residents to protect their privacy by closing doors and covering them, but these practices were not consistently followed, resulting in the observed deficiencies.