Failure to Honor Resident's Request Regarding Caregiver Assignment
Penalty
Summary
The facility failed to honor a resident's explicit request to not have a specific Certified Nursing Assistant (CNA) provide care or be present in her room upon readmission. The resident, who had diagnoses including a left femur fracture, osteoporosis, rheumatoid arthritis, morbid obesity, and generalized anxiety disorder, had intact cognition and decision-making capacity. Upon readmission, the resident communicated her request to the case manager, who acknowledged it and assured her that the CNA would not be assigned to her care or be present. Despite this, the CNA was initially assigned to the resident's room and, after being informed of the restriction, was reassigned to the roommate but still entered the room and interacted with the resident, including responding to a call light and providing ice water. Interviews with facility staff, including the Assistant Director of Staff Development (ADSD), the case manager, and the Director of Nursing (DON), confirmed that the resident's request was known and that the CNA should not have entered the room or interacted with the resident. The facility's policy on dignity and privacy requires that residents be treated with respect and that their rights and preferences be honored. The DON acknowledged that the CNA's presence in the room had the potential to cause the resident increased anxiety, fear, and discomfort, which was contrary to the facility's stated policy and the resident's expressed wishes.