Failure to Ensure Resident Dignity During Care and Meal Assistance
Penalty
Summary
The facility failed to honor residents' rights to dignity and respect in multiple instances. One resident with severe cognitive impairment and a history of behavioral symptoms was subjected to undignified treatment by a CNA, who was observed forcefully guiding the resident out of another room, telling her to "stay in your damn room," and slamming the door. This incident was witnessed by other staff, and interviews confirmed that the language and manner used were not respectful or dignified, regardless of the resident's cognitive status. Additionally, two residents were not provided with a dignified dining experience during meal assistance. Certified Nursing Assistants were observed standing over these residents while feeding them in bed, rather than sitting at eye level as required by facility policy. The CNAs admitted that standing was for their own convenience and not for the benefit of the residents. They also acknowledged that they had not been trained to sit while feeding and recognized that standing over residents during feeding is a dignity issue. The facility's own policy specifies that staff should be seated next to residents and engage with them during meals to promote dignity. The observations and staff interviews confirmed that this policy was not followed, resulting in a failure to provide a dignified environment for the affected residents.