Failure to Promote Dignity During Mealtime Assistance
Penalty
Summary
The facility failed to promote dignity during mealtime assistance for two residents who required support with eating. One resident with diagnoses including dysphagia, vascular dementia, and severe cognitive impairment was totally dependent on staff for all activities of daily living, including eating. Another resident with Parkinson's disease and dysphagia had fluctuating needs for eating assistance, but his care plan did not specify his mealtime support requirements. Observations revealed that staff provided mealtime assistance while standing rather than sitting at eye level, despite available chairs, and staff interviews confirmed this practice. The Central Supply Coordinator, who was also a CNA, acknowledged that staff should be seated at eye level for dignity and proper support. Additionally, multiple CNAs referred to residents requiring feeding assistance as "feeders" rather than using respectful terminology such as "assisted diners." The DON confirmed that this language was a dignity concern and that staff should use more respectful terms. The facility did not have a formal policy, procedure, or competency regarding CNA mealtime assistance, and the DON stated that such training should be included in CNA education. The facility's Resident Rights policy emphasized the importance of maintaining or enhancing resident dignity and respect, but staff practices and language did not align with these expectations.