Failure to Maintain Resident Dignity and Privacy During Room Interaction
Penalty
Summary
The facility failed to maintain a resident’s dignity and respect for privacy when a Social Services Designee (SSD) entered the room of Resident F without proper identification or permission and exposed her to another resident. Resident F had diagnoses including depression and anxiety, and her quarterly MDS dated 12/23/25 indicated intact cognition. According to an incident report dated 1/28/26, Resident F reported that the SSD entered her room with her new roommate, Resident G, and hastily pulled open Resident F’s privacy curtain. The SSD then stated to Resident G, “see, she is a woman,” and told Resident F that she needed to shave her face. Resident F stated she did not know the SSD had entered until the curtain was flung open and that other staff typically knock and identify themselves before entering. In an interview, Resident F reported that after Resident G moved into the room, she had introduced herself to Resident G earlier. Later, the SSD came in with Resident G, abruptly opened the privacy curtain, and told Resident G that Resident F was not a man, then told Resident F in front of Resident G that she needed to shave. Resident F reported feeling humiliated, horrible, and that she cried after the incident. A written interview from the SSD indicated that it had been reported to her that Resident G refused to sleep in a room with a man, and that the SSD went into the room with Resident G, pulled the privacy curtain, introduced the residents to each other, and told Resident G that Resident F was a woman, adding that Resident G may have thought Resident F was a man due to facial hair. The SSD stated she told Resident F she could get someone to help her shave, but her written account did not document that she identified herself to Resident F upon entering or that she asked permission before pulling back the privacy curtain. The facility’s resident rights document provided by the Regional Nurse Consultant included the right to be treated with dignity and respect.
