Failure to Provide Resident-Centered Activities Program
Penalty
Summary
The facility failed to implement an ongoing, resident-centered activities program that incorporated the interests and needs of a sampled resident with severe cognitive impairment. Observations over several days revealed that the resident, who was diagnosed with unspecified dementia and had a severely impaired BIMS score, spent most of her time alone in her room, with minimal staff interaction and no participation in organized activities. Despite the facility's policy requiring daily, individualized activities and encouragement for participation, the resident was repeatedly observed sitting in her room, often facing the window, and not engaged in any meaningful activities. Multiple activity schedules were posted throughout the unit, but staff interviews indicated that these were not consistently followed or updated. CNAs reported that there was no set activity schedule on the hall, and activities were often improvised rather than planned. Staff also noted that the resident rarely participated in group activities unless accompanied by family, who visited infrequently. The posted schedules listed various activities, but there was a lack of evidence that these were implemented or tailored to the resident's documented preferences, such as reading, listening to music, or going outside for fresh air. Interviews with staff, including CNAs, the DON, and the Administrator, confirmed that there was no consistent routine for activities, especially for residents with dementia who require structure and engagement. The DON acknowledged being unaware of the lack of activity interaction for the resident and stated that staff were expected to encourage participation. The resident's care plan identified important preferences for activities, but these were not observed to be addressed during the survey period, resulting in a failure to meet the resident's individual needs as required by facility policy.