Failure to Honor Resident Dignity in Toileting and Food Preferences
Penalty
Summary
The facility failed to honor the dignity and preferences of two residents by not responding appropriately to their expressed needs for toileting assistance and food temperature preferences. One resident, with diagnoses including severe intellectual disability and a BIMS score indicating severely impaired cognition, was observed to request assistance to the bathroom but was told by a CNA that it was not time yet and was not assisted. Staff interviews confirmed that the resident was on a two-hour toileting schedule, and there were instances when staff did not assist the resident outside of this schedule, despite her requests. The resident's care plan directed staff to anticipate her needs and respond to her calls for assistance with incontinence episodes. Another resident, diagnosed with Alzheimer's disease and severe cognitive impairment, required substantial assistance for toileting. During a meal, the resident expressed the need to use the bathroom, but staff did not immediately assist her and continued feeding her instead. Additionally, this resident communicated that her oatmeal was too hot, but the LPN dismissed her concern and attempted to feed her another bite. The facility did not have a policy related to dignity, as confirmed by the Assistant Director of Nursing.