Failure to Protect Resident Dignity During Hospice Care Interactions
Penalty
Summary
The deficiency involves the facility’s failure to ensure a resident’s right to be treated with dignity and respect, as required by its Resident Rights policy. The resident involved had diagnoses including traumatic brain injury, morbid obesity, and major depressive disorder, and was moderately cognitively impaired, required maximum assistance with ADLs, and exhibited behavioral symptoms toward others. The resident reported that on one morning a hospice aide called him/her a pig, said she would take him/her to the slaughterhouse to be slaughtered, and told him/her that he/she was a dog who used to live in a cage, which made the resident feel terrible. A CNA was present during this interaction and did not say or do anything in response, despite the resident telling the hospice aide not to call him/her names. Staff interviews corroborated multiple incidents of verbally demeaning behavior by the hospice aide toward the resident. One CNA stated that on two or three occasions, after the resident directed racial slurs and swearing at the hospice aide, the hospice aide responded by calling the resident a “fat pig,” saying they would put the resident in a butcher shop because of having so much meat, and laughing at the resident; the CNA felt uncomfortable but did not intervene or report the behavior at the time. Another CNA reported that around a holiday period, after the resident used a racial slur toward the hospice aide, the aide replied that if she was the slur, then the resident was fat, and asked how the resident liked that; this CNA also did not tell the aide that such name-calling was unacceptable and assumed the assigned CNA would report it. The ADON and DON confirmed that these CNAs later reported witnessing the hospice aide calling the resident a fat pig and fat, and the Administrator acknowledged that no one in this environment should speak to a resident in that manner, underscoring the failure to uphold the resident’s right to dignity and respect.
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