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F0550
D

Failure to Maintain Resident Dignity During Mealtime Assistance

Montrose, California Survey Completed on 07-03-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

A deficiency occurred when a certified nurse assistant (CNA) provided feeding assistance to a resident while standing over the resident, rather than sitting at eye level as required by facility policy. The resident, who had contractures in both hands, dysphagia, unspecified dementia, and was on a mechanically altered, pureed, nectar thick diet, was observed lying in bed with the head of the bed elevated during the feeding. The CNA stated that a chair was not used because one could not be found, resulting in the CNA feeding the resident while standing. The CNA acknowledged that staff are expected to sit at eye level with residents during feeding to avoid making them feel rushed and to maintain dignity. Interviews with the CNA and a registered nurse confirmed that the standard practice is for staff to be seated and at eye level with residents during meals to promote communication, ensure comfort, and uphold the resident's dignity. Facility policy also requires staff to interact with residents in a manner that accommodates their physical limitations and maintains their dignity. The failure to follow these procedures during mealtime assistance for this resident constituted a lack of respect and dignity, as required by resident rights regulations.

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