Failure to Provide Person-Centered Activities for Resident with Complex Needs
Penalty
Summary
Facility staff failed to provide an ongoing, person-centered activity program to support the choices, interests, and well-being of a resident with multiple complex diagnoses, including seizures, COPD, hypertension, anxiety, heart failure, a history of suicidal behavior, traumatic brain injury, major depressive disorder, and vascular dementia with psychotic disturbance. The resident was assessed as having moderate cognitive impairment and required maximum assistance for most activities of daily living. The resident expressed strong preferences for activities such as listening to music, being around animals, keeping up with the news, participating in group and religious activities, having snacks, using the phone in private, and involving family in care discussions. Despite these documented preferences, the activity care plan and initial review did not fully incorporate all interests, notably omitting music, which was significant given the resident's background as a musician and possession of a guitar in his room. Review of the activity logs revealed a lack of documentation of the resident's participation in activities beyond the initial assessment date. The Activities Director was unable to recall the resident well and could not provide evidence of ongoing engagement or refusals, indicating a lack of follow-through on the resident's individualized activity plan. There was also no documentation of efforts to involve the resident's family or hospice staff in providing or supporting activities tailored to the resident's interests and needs. During the resident's stay, multiple behavioral incidents were documented, including wandering, aggression toward staff, and attempts to leave the facility. Progress notes indicated escalating behaviors but did not reflect any attempts by staff to use the resident's known activity preferences or interests to redirect or mitigate these behaviors. There was no evidence that the activity program was adapted or implemented in response to the resident's needs, nor that staff leveraged family or hospice involvement to support the resident's psychosocial well-being.