Failure to Honor Resident's Right to Refuse Care
Penalty
Summary
The facility failed to respect a resident's right to refuse care, resulting in a deficiency related to the provision of necessary care and services. The resident, who had diagnoses including Parkinsonism, muscle wasting and atrophy, quadriplegia, and depression, was assessed as having the capacity to make decisions and communicate her preferences. On the day of the incident, the resident expressed that she did not want a particular CNA to provide her care and requested to wait for the next shift for assistance with personal care. Despite these requests, the CNA and an RN proceeded to provide care against the resident's wishes. Multiple interviews and record reviews confirmed that the resident repeatedly asked for the care to be delayed and for the staff to leave her alone, but her requests were not honored. The staff transferred the resident from her wheelchair to her bed and changed her, during which the resident became upset and physically resisted, resulting in minor injuries to the staff. The resident later described the experience as traumatizing and characterized the staff's actions as physical abuse, emphasizing that her right to refuse care was not respected. Facility policy requires that residents' rights to refuse treatment be honored, with staff expected to document refusals and attempt to address concerns. However, in this case, the staff did not follow these procedures, and the resident's preferences and rights were disregarded. The administrator acknowledged that failing to respect a resident's right to refuse care can lead to a lower quality of care and a violation of resident rights.