Unqualified Private Sitter Provided Care Outside Resident's Plan
Penalty
Summary
The facility failed to ensure that care was provided by qualified staff in accordance with a resident's written plan of care. A private sitter, hired by the resident's family to be present daily, was not provided with any training by the facility and was not permitted to perform care tasks such as feeding, bathing, transferring, or assisting with incontinence. Despite this, the private sitter was observed by staff feeding the resident and holding the resident's hand during care provided by certified nursing assistants. The Director of Nursing acknowledged that the private sitter had been counseled multiple times for providing care, but there was no documentation of these conversations, and the facility had no policy in place regarding the training or oversight of private sitters or companions. The resident involved had severe cognitive impairment, as indicated by a BIMS score of 0 out of 15, and required increased assistance with activities of daily living, transfers, and safety awareness. The resident's care plan specified one staff assistance and the use of appropriate equipment but did not mention the involvement of a private sitter. Facility policy stated that companions may help with social or basic care needs but cannot perform nursing or aide duties. Interviews with staff and administration revealed a lack of clarity and oversight regarding the role and training of the private sitter, resulting in care being provided by an unqualified individual outside the resident's plan of care.