Failure to Provide Appropriate Bed Size for Resident with Morbid Obesity
Penalty
Summary
Facility staff failed to provide reasonable accommodation for a resident with morbid obesity, whose BMI was 47.8 and weight was 334 pounds. The resident, admitted with multiple complex diagnoses including acute and chronic respiratory failure, hypertensive heart and chronic kidney disease, diabetes, chronic pulmonary edema, sleep apnea, and a mood disorder, reported that the bed provided was too small. The resident expressed difficulty moving in the bed, a fear of falling, and a need for bed rails for support. Observations confirmed that there was less than three inches of space on either side of the mattress, and the resident was seen struggling to adjust his position. Despite staff being present in the room on multiple occasions, no action was taken to address the resident's concerns about the bed size until after the survey observations. Interviews with staff, including an LPN and the DON, acknowledged that bed size should be tailored to the resident's needs and that safety assessments for bed rails are required. However, the clinical record and staff actions showed that the resident's size and comfort needs were not initially accommodated, resulting in the resident remaining in an inappropriately sized bed until the issue was later addressed.