Failure to Facilitate Resident Preferences for Bathing and Meals
Penalty
Summary
A cognitively intact resident with multiple medical diagnoses, including multiple sclerosis, malnutrition, and recent laparoscopic surgery, was admitted to the facility and required assistance with activities of daily living (ADLs) such as dressing, grooming, bathing, mobility, and incontinence care. The resident's care plan emphasized the importance of honoring her preferences for bathing methods and meal choices, and directed staff to provide assistance accordingly. Despite these documented preferences and needs, the facility failed to facilitate the resident's choices regarding bathing and meals. The resident reported not receiving a bath or shower since admission, despite expressing a desire for a shower, particularly before medical appointments. Staff attempted to provide a sponge bath, which the resident declined in favor of a shower to wash her hair, but was told she would have to wait for the next scheduled shower day. There was confusion among staff regarding whether the resident was restricted from showering due to her surgical incisions, but no provider order or policy was found to support such a restriction. The resident eventually received a shower and hair wash, but only after a significant delay and after her concerns were raised during a care conference. Regarding meals, the resident was unaware of her meal selections, did not receive a menu in her room, and was unsure how to order alternatives or what options were available. She also did not consistently receive requested items such as sugar, cream, and straws with her meals, despite these preferences being noted on her tray slip. The dietary staff and registered dietitian were unclear about the process for providing updated menus to residents who dined in their rooms, and there was a lack of clarity about how resident preferences were communicated and honored. The facility's policies stated an intent to provide person-centered care and honor resident choices, but these were not consistently implemented in practice for this resident.