Failure to Notify Resident Council of Grievance Resolutions
Penalty
Summary
The facility failed to consider and act upon the views, grievances, and recommendations of the Resident Council regarding issues of resident care and life in the facility. Specifically, for multiple months, the Resident Council submitted grievances related to nursing, dietary, and housekeeping services, but there was no evidence that the facility provided a verbal or written response to the Council addressing these concerns. Documentation showed that the Social Worker (SW) often marked grievances as resolved through 'one-to-one' discussions, but there was no record of these discussions occurring with the Council or its members, and residents reported not being informed of resolutions. Interviews with residents and staff revealed that the process for addressing Resident Council grievances was inconsistent and lacked follow-up. Residents stated that they rarely received feedback about their grievances, and issues they raised remained unresolved. Staff interviews confirmed that while grievances were documented and distributed to department heads, there was no established process to ensure that resolutions were communicated back to the Resident Council. The SW and Assistant Director (AD) acknowledged that resolutions were not routinely shared with the Council, and there was confusion about who was responsible for this communication. The facility's own grievance policy required that grievances be investigated, documented, and that findings and resolutions be communicated to the person or group who raised the concern. However, the policy was not followed, as there was no documentation of follow-up with the Resident Council, and residents consistently reported a lack of feedback. This failure was observed for all nine Resident Council members reviewed, and included grievances about nursing, dietary, and housekeeping services, as well as issues such as assistance with smoke breaks.