Failure to Support Resident Choice in Dressing
Penalty
Summary
The facility failed to promote and facilitate a resident's right to self-determination by not supporting her choice of clothing. The resident, who had a history of transient ischemic attack, cerebral infarction, protein-calorie malnutrition, major depressive disorder, chronic obstructive pulmonary disease, cognitive communication deficit, and chronic knee instability, was observed multiple times over two days dressed only in a hospital gown. Despite having a moderate cognitive impairment and requiring one-person assistance with dressing, the resident expressed a clear preference to be dressed in her own clothes. Staff interviews and medical record reviews revealed that scheduled dressing tasks were frequently marked as not applicable or not attempted, with no documentation of resident refusals. The resident's own statements and observations confirmed that her preference to wear her own clothes was not being honored consistently. Staff interviews indicated a lack of awareness or follow-through regarding the resident's clothing preferences. One CNA stated she did not recall seeing the resident in regular clothes, while a physical therapy assistant confirmed the resident had clothes available and a known preference for a particular dress. The DON was unaware of the resident's preference and stated that being in a wheelchair should not prevent dressing assistance. On one occasion, a CNA acknowledged the resident's request to get dressed but delayed assistance, citing the need to complete charting. The facility's policy required involving residents in ADL decisions and providing assistance according to assessed needs, but this was not consistently implemented for this resident.