Failure to Honor Resident Dignity and Timely Care
Penalty
Summary
The facility failed to honor residents' rights to dignity and respect in several instances involving three residents. For one resident with multiple sclerosis and neuromuscular bladder dysfunction, observations revealed that the urinary catheter drainage bag was repeatedly covered with a transparent trashcan liner and hung on inappropriate objects such as a trash bin, making it visible upon room entry. The resident reported that previously used cloth privacy bags were no longer provided, and staff interviews confirmed that trashcan liners were not an acceptable substitute and posed infection control concerns. Facility policy required the use of privacy bags to maintain dignity, which was not followed. Another resident with hemiplegia, atrial fibrillation, and dementia was observed being turned in bed by a CNA without the use of a lifting sheet, contrary to the resident's care plan. The CNA forcefully rotated the resident, causing a facial grimace, despite the care plan specifying the need for gentle handling and the use of a lifting sheet to prevent pain and skin shearing. The care plan also emphasized the importance of asking the resident about pain and ensuring comfort during care. A third resident with a history of stroke and hemiplegia experienced a significant delay in incontinence care. After requesting assistance via the call light, the resident waited over three and a half hours before care was provided, despite staff being notified of the need. The resident expressed feeling unwelcome due to staff comments about frequent call light use. Facility policy required timely assistance with activities of daily living, including toileting, but this was not adhered to in this instance.