Failure to Provide Meaningful Activities for Cognitively Impaired Residents
Penalty
Summary
The facility failed to provide a meaningful activity program for cognitively impaired residents on the locked unit, as well as for two sampled residents. Observations revealed that, at multiple times, residents were left unengaged in common areas, with only one activity assistant present and no other staff facilitating activities. Activity calendars were not posted in the hallways, common areas, or resident rooms, and where a calendar was present, it was left blank. Scheduled activities were not carried out as planned, and there was no system in place to indicate which activities had been completed or canceled. Staff interviews confirmed that activities were often not happening, particularly on the locked unit, and that staffing shortages contributed to the lack of engagement for residents. Two residents were specifically identified as being affected by the lack of meaningful activities. One resident, with a history of bipolar disorder, frontotemporal neurocognitive disorder, and other mental health diagnoses, was noted to have behaviors such as talking to themselves, agitation, and a history of physical aggression. The care plan for this resident included interventions to analyze triggers and de-escalate behaviors, but there was no evidence that meaningful activities were provided to address these needs. Another resident, with unspecified dementia and behavioral disturbances, was described as physically active, social, and in need of frequent one-on-one attention. This resident exhibited wandering, exit-seeking, and intrusive behaviors, and staff struggled to find activities to keep him occupied. Attempts to redirect him with simple tasks were only briefly effective, and documentation of interventions and outcomes was incomplete. Staff interviews further highlighted the deficiency, with multiple CNAs and LPNs reporting that there were no planned activities on the unit and that they struggled to keep residents engaged. Staff described increased resident agitation and behavioral incidents, including a physical altercation between two residents, which occurred in the absence of meaningful activities. The facility's own policy required ongoing activity programs tailored to residents' needs and preferences, including special considerations for those with dementia, but these requirements were not met as evidenced by the observations, interviews, and record reviews.