Failure to Honor Resident Representative's Refusal of Specific Caregiver
Penalty
Summary
The facility failed to ensure that a legal surrogate, designated as the resident's representative (RP), could exercise the resident's rights as provided by state law. Specifically, the RP instructed LVN F not to provide care to a resident after a verbal request was made through a camera in the resident's room. Despite this request, LVN F continued to provide care to the resident on the same day and was also assigned to the resident's hall the following day. The RP's request was not communicated to the appropriate facility staff in a timely manner, resulting in the continued assignment of LVN F to the resident. The resident involved was a 37-year-old male with diagnoses including unspecified convulsions, schizophrenia, weakness, and a history of traumatic brain injury. He was dependent on staff for all forms of mobility and required significant assistance with activities of daily living. The RP's request for LVN F to be removed from the resident's care was made verbally via the room camera, citing concerns related to social media. However, the facility's staff, including the ADON and administrative personnel, were not promptly informed of the restriction, and the staff assignment sheets continued to list LVN F as responsible for the resident's care. Interviews with facility staff revealed a lack of awareness regarding the restriction, and the list of staff not permitted to care for the resident was not available to all relevant personnel prior to the second day. The facility's policy states that the decisions of a resident representative must be treated as the decisions of the resident, but this was not followed in practice. As a result, the resident's right to have their care decisions made by their legal surrogate was not honored.