Failure to Honor Resident's Preferences for Getting Out of Bed
Penalty
Summary
The facility failed to honor a resident's preferences for getting out of bed, as evidenced by medical record review, resident interview, and staff interview. The resident, who was cognitively intact and had multiple complex diagnoses including heart failure, COPD, respiratory failure, and major depressive disorder, required substantial assistance for bed mobility and was dependent on staff for transfers. Her care plan documented her right to make decisions regarding her daily lifestyle and directed staff to make every reasonable effort to meet her stated preferences. However, there was no documentation in her progress notes or behavior logs to support that she refused to get out of bed, nor was there evidence that staff consistently offered her the opportunity to get out of bed as per her preferences. During interviews, the resident confirmed she was never offered assistance to get out of bed and often had to request it herself, leading to frustration and at times choosing not to ask. A CNA acknowledged that staff likely did not offer to assist the resident out of bed as often as they should, citing her history of refusals, and also confirmed that refusals were not documented. This lack of consistent offering and documentation resulted in the facility's failure to reasonably accommodate the resident's needs and preferences regarding getting out of bed.