Failure to Ensure Resident Dignity, Privacy, and Respect
Penalty
Summary
Multiple deficiencies were identified regarding the failure to honor residents' rights to dignity, respect, privacy, and self-determination. Two residents with Foley catheters were observed on several occasions to have their catheter bags fully visible from the hallway and common areas, without any cover bags in place. There were no documented interventions in their care plans to ensure privacy for these medical devices, and staff interviews confirmed that Foley catheters should have been covered but were not. Additionally, a urine odor was noted in one resident's room during these observations. Another resident reported that staff spoke to them in a demeaning manner and ignored their requests to have the privacy curtain open when their roommate was not present. This resident also experienced significant delays in response to their call bell, with staff failing to return as promised to provide needed care. The resident stated they had been waiting to be changed for several hours, and these observations were corroborated by the surveyor's direct observations and interviews. Further, a resident with severe dementia was observed repeatedly requesting to be toileted, but staff did not respond promptly. The LPN on duty acknowledged the request but deferred action, and the resident was only assisted after nearly an hour when another CNA from a different unit intervened. Another resident reported that some staff provided care in a rough manner and that staff sometimes smelled of marijuana and cigarettes, which the resident found offensive. The administrator confirmed receiving reports of rude or inappropriate staff interactions and acknowledged previous issues with staff conduct.