Use of Timer During Care Undermining Resident Dignity and Self-Determination
Penalty
Summary
The facility failed to honor a resident’s right to dignity and respect when staff placed a visible timer on the resident’s overbed table to indicate the duration of feeding and repositioning care. The resident, who had quadriplegia and was completely dependent on staff for meals, had a BIMS score of 12, indicating moderate cognitive impairment. During observation, a small white rectangular timer with visible red markings was seen on the resident’s overbed table. The resident reported that the DON had put the timer there about two months earlier, that no one had asked for his permission or consent before placing it in front of him, and that staff last used the timer about a month prior. The resident stated that the timer made him feel rushed and worried that eating too fast could cause choking. In interviews, CNA 1 confirmed awareness of the timer in the resident’s room. The DON stated that the resident required two CNAs for one to two hours or longer to provide care and had complained that CNAs did not spend enough time with him. The DON reported that, after discussion with the IDT, the team decided to place a timer in the resident’s room to make the resident aware of the amount of time CNAs were spending with him. The Unit Manager stated he placed the timer in the room after speaking with the resident and obtaining verbal permission, but he was unable to locate any documentation of the resident’s agreement or consent. The facility’s Resident Rights policy stated that employees shall treat all residents with kindness, respect, and dignity, and that residents have rights to a dignified existence, to be treated with respect, kindness, and dignity, and to self-determination.
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