Survey Results Not Readily Accessible to Residents
Penalty
Summary
The facility failed to ensure that the results of the most recent survey were posted in a location that was readily accessible to residents without requiring staff assistance. During interviews and observations, it was found that the survey binder containing the survey results was kept on the opposite side of a locked gate near the Administrator's Office. Residents, including the Resident Council President, confirmed that they knew where the binder was kept but could not access it independently. The binder was not present in the designated holder during observation, and staff confirmed that residents would need to ask for assistance to view the survey results. A review of facility policy indicated that survey reports and plans of correction should be readily accessible to residents, family members, and the public, and that a copy should be kept in the residents' day room. However, the current practice did not align with this policy, as the binder was not accessible to residents without staff intervention. The deficiency was identified during a review of a resident with a history of depression, anxiety disorder, and schizophrenia, who was cognitively intact according to the most recent assessment.