Failure to Provide Individualized Activities for Residents with Cognitive Impairment
Penalty
Summary
The facility failed to provide activities designed to meet the physical and mental needs and interests of two residents, as required by facility policy and resident rights. Observations revealed that both residents spent extended periods in the dayroom without any structured or care-planned activities. One resident, who is nonverbal and has a history of traumatic brain injury with a BIMS score of 0, was observed sitting in a Geri-chair, not participating in activities such as music or bingo, which staff acknowledged were not appropriate for her. The other resident, diagnosed with dementia and psychosis and also with a BIMS score of 0, was repeatedly observed sitting alone with her back to the television and no engagement in any activities. Interviews with staff, including a CNA, the Activities Director, the DON, and the Administrator, confirmed the lack of individualized activities and engagement for these residents. Staff admitted to oversights in including the residents in suitable activities and acknowledged that the activities provided, such as bingo, were not appropriate for their cognitive abilities. The DON specifically recognized the need for more stimulating activities for one resident and cited a lack of staff follow-through. Facility policy requires support of resident choice and activities consistent with assessments and care plans, which was not observed in these cases.