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F0550
D

Failure to Maintain Resident Dignity During Mealtime Assistance

South Pasadena, California Survey Completed on 07-24-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

A deficiency was identified when a certified nurse assistant (CNA) was observed standing above a resident's eye level while assisting with mealtime, rather than sitting or positioning themselves at eye level with the resident. This occurred during breakfast in the resident's room, with a registered nurse (RN) present who did not intervene or instruct the CNA to adjust their position. The facility's policy requires staff to provide care in a manner that respects and enhances each resident's dignity, including maintaining eye-level interaction during assistance. The resident involved had diagnoses of dementia, Parkinson's disease, and quadriplegia, and required varying levels of assistance with activities of daily living, including eating. Interviews with staff confirmed that proper practice is to be at eye level with residents during feeding to show respect and maintain dignity. The failure to follow this practice was acknowledged by multiple staff members, and the facility's policy supports the expectation of maintaining resident dignity during care.

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