Failure to Honor Resident Rights to Dignity and Respect
Penalty
Summary
The facility failed to ensure that residents were treated with respect and dignity, as evidenced by two separate incidents involving two residents. In the first incident, a resident with multiple medical diagnoses, including bradycardia, hypotension, congestive heart failure, and obstructive hypertrophic cardiomyopathy, was administered a bisacodyl suppository by an LPN without being informed or asked for consent. The resident, who also had a care plan addressing paranoia and inappropriate sexual behaviors, expressed distress and stated he did not want the suppository, but the LPN proceeded without explanation or acknowledgment of the resident's refusal. Witness statements and interviews confirmed that the LPN did not communicate with the resident before or after the procedure, and the Director of Nursing acknowledged that the nurse failed to inform the resident as required. In the second incident, a CNA made inappropriate and disrespectful remarks to another resident, who had diagnoses including chronic obstructive pulmonary disease, cardiomegaly, dementia, depression, and hemiplegia following a stroke. The CNA told the resident to stop using the call light and made accusatory statements during lunch, blaming the resident for dropping a plate. On another occasion, the CNA refused to lay the resident down after lunch, stating he was not allowed to use the call light repeatedly, and only complied after being instructed to do so. While providing care, the CNA spoke over the resident and made dismissive comments about fulfilling his request. Facility policies reviewed indicated that staff are required to inform residents in advance of care and treatment, ensure informed consent, and maintain dignity and respect in all interactions. Staff interviews confirmed that the actions taken by the LPN and CNA were inconsistent with these policies, as residents were not included in conversations about their care, were not given choices, and were not treated with the respect and dignity required by facility standards.