Failure to Honor Resident Snack Preferences and Choice
Penalty
Summary
The facility failed to honor a resident's right to make choices regarding snack preferences. A resident with diagnoses including obesity, chronic pulmonary edema, type 2 diabetes, and hemiplegia, who was cognitively intact and dependent on staff for activities of daily living, was subject to a physician order that restricted snacks to only healthy options and instructed staff to tell the resident that snacks had run out if he requested more. The resident reported feeling frustrated when told that snacks were unavailable, despite his desire for more and enjoyment of snacks such as ice cream. Staff interviews and record reviews revealed that the facility had not actually run out of snacks, and a Licensed Vocational Nurse acknowledged that the physician order was inappropriate and that residents should be provided snacks when requested. Facility policies reviewed indicated that residents have the right to exercise choice and dignity, including decisions about food and daily activities. The practice of misleading the resident about snack availability directly limited his ability to make choices about his food preferences.