Failure to Support Resident's Right to Refuse Care Without Coercion
Penalty
Summary
Staff failed to promote and facilitate a resident's right to self-determination and choice, specifically regarding the right to refuse care. The resident, an adult male with diagnoses including hypertension, chronic kidney disease, and coronary artery disease, and with intact cognition as evidenced by a BIMS score of 15, was subjected to staff telling him that his family member would be called if he refused to change his clothes. This approach was used as a means to gain compliance with care, as confirmed by both the DON and a CNA, and was described as a threat by the resident himself. The care plan included a directive to call the family member upon refusal of care, per the family member's request. The resident reported feeling sad and infantilized by this practice, expressing concern that his family member would be angry and stop visiting if called. The DON acknowledged that staff had become accustomed to using the threat of calling the family member to compel the resident to comply with care, and recognized this as a violation of the resident's rights. The administrator also confirmed that such actions were not permitted, even if requested by the family, as they infringed upon the resident's right to refuse care and could cause psychosocial harm.