Failure to Provide Written Notice Before Room Changes
Penalty
Summary
The facility failed to provide written notice to two residents prior to changing their rooms, as required by policy and resident rights regulations. One resident, who had diagnoses including depression, anxiety disorder, abnormalities of gait and mobility, and schizophrenia, was assessed as mildly impaired in cognitive skills and required varying levels of assistance with daily activities. This resident reported not receiving any written notice before being moved to a different room and expressed not wanting the room change. Similarly, another resident with diagnoses of gait and mobility abnormalities, depression, anxiety disorder, hypertension, and schizophrenia, and who was also mildly cognitively impaired, stated that no written notice was given prior to their room change and did not consent to the move. Interviews with facility staff, including the Assistant Director of Nursing and the Social Service Director, confirmed that written Notices of Room Change (NORC) were not provided to the residents before the room changes occurred, nor were signatures obtained to verify receipt or consent. The facility's policy requires that residents receive written notice, including the reason for the change, before any room or roommate change is made. The lack of written notice and consent was acknowledged by both the nursing and social services staff during the investigation.