Failure to Communicate and Honor Resident Preferences for Daily Routines
Penalty
Summary
A deficiency was identified when the facility failed to ensure that a resident's preferences regarding bathing and bedtime routines were communicated and honored. The resident, who had a history of stroke and aphasia but was assessed as cognitively intact, placed high importance on their bathing and bedtime preferences. Despite this, the care plan did not document these preferences, and staff interviews revealed inconsistent awareness and understanding of the resident's desired routines. One CNA reported that some staff were unaware of the resident's preference to sleep in, leading to the resident being awakened earlier than desired, which caused distress. Another CNA noted difficulty in understanding the resident's preferences due to the lack of detailed information in the care plan. Further interviews indicated that while the Activities Director had interviewed the resident about preferences, updates were only made to the care plan for recreational activities, not for daily routines such as bathing or bedtime. The Interim DNS/RNCM acknowledged insufficient oversight in ensuring the resident's preferences were addressed and expected a person-centered care plan to be in place. The lack of clear documentation and communication of the resident's preferences placed the resident at risk for not having their choices honored.