Failure to Ensure Resident Dignity and Respect During Care and Communication
Penalty
Summary
The facility failed to ensure that residents were treated with dignity and respect, as evidenced by two separate incidents involving inappropriate staff behavior toward residents. In the first incident, a certified nursing assistant (CNA) was observed leaning a resident forward in her wheelchair and checking the back of her brief in a hallway where other residents were present, rather than providing privacy for this personal care. The CNA acknowledged that this action did not respect the resident's dignity and that care should be provided in private. The resident involved had a severe cognitive impairment, as indicated by a Brief Interview for Mental Status (BIMS) score of 6, and had diagnoses including congestive heart failure, type 2 diabetes mellitus, and encephalopathy. In the second incident, another CNA used inappropriate and profane language when addressing a resident near the nurses' station, in the presence of the resident's family and other staff and residents. The CNA told the resident to "Back your a** up" and later, "get your a** back out of here," claiming it was meant as a joke. The resident, who was cognitively intact and had diagnoses including end stage renal disease and type 2 diabetes mellitus, reported feeling disrespected and embarrassed, especially as the language was used in front of her children. The CNA admitted to using the language and acknowledged it was disrespectful. Both CNAs had received prior training on resident rights, dignity, and respect, as documented in their training records. The facility's policy on resident rights clearly states that residents have the right to a dignified existence and to be treated with respect. The administrator confirmed that the expectation is for all resident care to be provided in privacy and for staff to use respectful language, acknowledging that these incidents did not meet those standards.