Failure to Provide Appropriately Sized and Configured Bed for Resident
Penalty
Summary
The facility failed to reasonably accommodate a resident's needs and preferences by not providing an appropriately sized and configured bed. Surveyors observed the resident, who is 74 inches tall and weighs 240.6 lbs, lying in a 76-inch bed with his feet pressed against the footboard and the right side of his face and body pressed against the wall. The bed was positioned perpendicular to his roommate's bed, with one side flush against the wall and his feet facing his roommate. An overhead trapeze was hanging approximately three inches above his head, and the resident reported being unable to turn or sit up comfortably because of the limited space and the trapeze striking his face when upright. The resident stated he had requested a larger (longer and wider) bed, repositioning of the bed to be parallel to his roommate's bed so they could talk and he could watch television without turning his neck, removal of the trapeze, and installation of side rails or enablers to assist with bed mobility. Review of the resident's care plan showed directives for person-centered care to afford him as much initiative, control, and self-determination as possible, including elevating the head of the bed to 90 degrees to prevent shortness of breath related to asthma, encouraging correct positioning for comfort and to prevent muscle and joint strain, and offloading his heels to prevent pressure injury. At the time of the survey, the EMR did not document any behaviors or refusal of interventions. The DON stated the facility had no specific policy or criteria for providing bariatric beds and that such beds were assigned on a case-by-case basis without defined height or weight parameters. The DON reported that, based on her recent assessment, the resident's current bed was appropriate for his height and weight and that he did not require a different type of bed, but she and the ADON were unable to provide the bed's measurements or manufacturer guidelines, despite the bed label indicating a total length of 76 inches, leaving only approximately two inches of clearance for the resident's height.
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