Failure to Provide Written Notification and Choice for Room Changes
Penalty
Summary
The facility failed to protect the rights of two residents by not providing written notification of room changes to them or their family members, as required by facility policy. Both residents had care plans indicating the right to be fully informed in advance of any room or roommate changes and to participate in decision-making, especially given their diagnoses of anxiety, depression, and other medical conditions. Despite this, one resident experienced six room changes in six weeks without written notice or the opportunity to decline, resulting in emotional distress. The resident's family member, who was the responsible party, also reported not being notified or consulted about at least five of these moves. Another resident was moved to a different room without consent, despite expressing a desire not to move and not wanting a new roommate. The move was executed while the resident was at lunch, and belongings were relocated without the resident's participation. The Social Services Director confirmed that written notifications were not provided, and there was no established policy or process for room change notifications. Notification practices were inconsistent, sometimes occurring only a few hours before the move, and records of written notices were not maintained.