Failure to Provide and Document Individualized Activities for Residents
Penalty
Summary
The facility failed to ensure that individualized activities were provided and documented for two residents with cognitive impairments and specific activity preferences. For one resident with severe cognitive impairment, a history of loneliness, and interests in activities such as church, music, socialization, and gardening, there was little to no documentation of participation in activities over several months. Observations and interviews revealed that this resident was often found alone, either sleeping, sitting by the nursing station, or watching television, and expressed a desire to be kept busy. Family members reported a lack of available activities and noted that the resident would likely participate if activities were offered. Staff interviews confirmed that activities were not consistently offered or documented for this resident, and the responsible staff member acknowledged the failure to implement the resident's assessed preferences. Another resident with cognitive impairment, Parkinson's disease, and a preference for books, pets, news, religious activities, and outdoor activities also did not have documented participation in activities. The care plan indicated a need for encouragement to attend group programs and support for independent leisure activities, but both paper and electronic records lacked evidence of activity attendance. Family members and a privately paid companion reported that the resident was not invited to activities and that participation only occurred when facilitated by family. Staff interviews confirmed that the resident was not consistently invited to activities, and all recent participation had been with family members rather than facility staff. The facility's policy required comprehensive documentation of residents' interests and involvement in therapeutic recreation programs, including daily attendance records and regular care plan reviews. However, documentation and interviews revealed that these requirements were not met for the two residents reviewed. The lack of consistent offering, encouragement, and documentation of individualized activities led to the deficiency identified during the survey.