Failure to Provide Accessible and Anonymous Grievance Forms
Penalty
Summary
The facility failed to ensure that grievance forms were available and that residents could file anonymous grievances on both the West Wing and East Wing units. A review of the facility's posted Concern Resolution and Grievance Procedure indicated that residents have the right to file grievances orally, in writing, and anonymously, with instructions to use forms located near the front desk and submit them in a suggestion box. However, during an observation, no Concern/Grievance forms were found in the Front Lobby or at the Front Desk, and the facility's Grievance Log showed no grievances filed during July and August 2025. During an interview, the Nursing Home Administrator (NHA) stated that residents could request a grievance form from staff or use a blank piece of paper, but acknowledged this did not facilitate anonymous reporting. The only available form at the suggestion box was an "Impact" card intended for staff recognition, which did not include information about filing grievances. The NHA confirmed that grievance forms were not readily available and that the current process did not allow residents to file anonymous grievances as required by facility policy.