Failure to Maintain Resident Dignity and Privacy During Personal Care
Penalty
Summary
A deficiency occurred when a resident’s right to dignity and privacy during personal care was not maintained. The facility’s Resident Rights policy, last reviewed on 10/01/2025, stated that each resident has the right to be treated with dignity and respect, and that all staff interactions must focus on maintaining and enhancing the resident’s self-esteem, self-worth, and individuality. Resident #5 had diagnoses including Chronic Obstructive Pulmonary Disease, General Anxiety Disorder, and Muscle Wasting and Atrophy, and was cognitively intact with no behaviors noted. The resident used a wheelchair for locomotion and required moderate assistance for eating and total dependence for bathing, toileting, bed mobility, and transfers. A psychosocial wellbeing care plan identified the resident as at risk related to anxiety and major depressive disorder and included interventions to encourage the resident’s participation in decision-making and care. During surveyor rounds on 12/05/2025 at 11:13 AM, the door to Resident #5’s room was observed open while Certified Nurse Aide (CNA) #2 was providing morning personal care. The resident was lying in bed undressed, covered only from the waist down with a sheet, with the chest fully exposed and visible from the hallway. After the surveyor notified the unit manager, CNA #2 pulled the curtain around the bed but left the room door open while continuing care. CNA #2 stated they kept the door open because they could not breathe in the room due to the heater and later reported that, for the past couple of weeks, residents had been coughing and not covering their mouths, so they sometimes left doors ajar when providing care. CNA #2 acknowledged knowing that both the curtain and the door should be closed when providing personal care. Registered Nurse #2 stated that residents should always be provided privacy when personal care is given and that the door should be closed during such care.
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