Failure to Provide Required Meal Set-Up Assistance for Dependent Resident
Penalty
Summary
The facility failed to provide required meal set-up assistance for one resident who needed help with activities of daily living (ADLs). The resident had diagnoses including cerebral infarction, parkinsonism, hemiplegia, and hemiparesis affecting the left non-dominant side, and a Brief Interview for Mental Status (BIMS) score of 11/15 indicating moderately impaired cognition. The resident’s quarterly MDS documented a need for assistance with meal setup and cleanup. During a dining room observation, the resident was seated alone with his meal plate still covered in plastic wrap; he had only partially torn the wrap and had not fully removed it, and did not respond when asked if assistance was needed. During the same observation, the Dining Services Manager approached and removed the plastic wrap, stating that the serving staff should have removed it when the meal was served. A CNA later acknowledged that she should have removed the plastic wrap from the resident’s meal tray, although she stated the resident no longer required staff to feed him. The DON stated that CNAs serving meals were required to complete meal setup when indicated, and the Nursing Home Administrator stated that staff were expected to meet all ADL needs, including meal setup and cleanup when indicated. Review of the facility’s ADL policy confirmed that, based on the comprehensive assessment and resident needs, the facility must provide necessary care and services to maintain ADL abilities, including assistance with meal setup.
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