Failure to Treat a Resident With Dignity During Blood Pressure Assessment
Penalty
Summary
The deficiency involves a failure to maintain a resident’s dignity and respect during routine care. A male resident with hemiplegia and hemiparesis following a cerebral infarction, Bell’s palsy, and Type 2 diabetes was cognitively intact per a recent MDS, with a BIMS score of 15 and minimal hearing difficulty. His care plan documented hemiplegia/hemiparesis related to a stroke and noted impaired cognitive function/dementia or impaired thought processes and problems communicating. Despite these conditions, he was usually able to understand and be understood by others. During an episode in which a nurse was attempting to obtain the resident’s blood pressure, the resident was moving, wiggling, and reaching for what appeared to be a TV remote, and the nurse repeatedly asked him to be still. While attempting to complete this task, the LVN told the resident he was “acting like a 2-year-old” or “acting like a child,” as confirmed by the LVN herself and by video reviewed by the administrator. After making the comment, the LVN removed the blood pressure cuff and left the room. The resident later reported that a staff member had been rude to him, agreed that she had said something close to calling him a child or 2-year-old, and stated that at the time he felt “about that tall,” indicating a small size with his fingers. Multiple staff members, including the administrator, RCN, RN, CNA, ADON, and social worker, characterized the comment as demeaning, condescending, or a dignity issue, with some staff describing such a statement as verbal abuse that must be reported. The facility’s resident rights policy states that each resident has the right to a dignified existence and must be treated with respect and dignity in a manner and environment that promotes or enhances quality of life and recognizes individuality. The LVN acknowledged making the statement and justified it by describing the resident’s behavior during care, but also stated it might have been wrong to say. This conduct constituted the failure to treat the resident with dignity and respect as required by facility policy and resident rights.
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