Failure to Supervise Resident at Risk for Choking During Meals
Penalty
Fine: $84,160
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Summary
The facility failed to provide required supervision in the dining room for a resident identified as being at risk for choking. Resident #33, who had diagnoses including dysphagia, cognitive communication deficit, and vascular dementia, was assessed as needing one-on-one supervision and assistance with meals and was on a mechanically altered diet. Despite these documented needs, observation showed that Resident #33 and another resident were left unsupervised in the dining room while feeding themselves. This lack of supervision was confirmed by a CNA, who acknowledged that the resident at risk for choking was unsupervised during the meal period. The deficiency had the potential to affect 23 other residents identified as having dysphagia.