Failure to Accommodate Resident Needs and Maintain Dignity
Penalty
Summary
The facility failed to accommodate the needs and maintain the dignity of two residents by not ensuring their access to call bells and by not providing timely assistance with activities of daily living (ADLs). One resident, who had a history of stroke with hemiplegia, aphasia, dysphagia, and depression, required maximum assistance with self-care, including dressing and toileting. Despite care plan interventions for staff to anticipate and meet her needs, observations revealed that she was left in bed wearing only a hospital gown that was not properly fastened, with her hair uncombed and no evidence of hygiene care. Her call bell was tangled and out of reach, and she was unaware of its location, preventing her from calling for assistance. When later observed dressed and groomed, she indicated improved well-being. Another resident, diagnosed with diabetes, fibromyalgia, and major depressive disorder, also had an ADL self-care deficit and was to be encouraged to use the call bell for assistance. However, she was observed calling out for help to use the bathroom, unable to locate her call bell, which was found draped over the nightstand and out of her reach. These findings demonstrate that the facility did not reasonably accommodate the needs and preferences of these residents, nor did it maintain their dignity as required.