Failure to Provide Person-Centered In-Room Activity Program for a Cognitively Intact Resident
Penalty
Summary
The deficiency involves the facility’s failure to provide an ongoing, person-centered activity program for a cognitively intact resident who prefers to remain in her room. The resident’s MDS documented moderate hearing difficulty, impaired vision, dementia, and bilateral hearing loss, with activity preferences that included a strong interest in pets and some interest in reading and music, while group activities, going outside, religious services, and keeping up with the news were of low importance. The activity care plan listed numerous self-directed activities and friendly visits, including pets, arts and crafts, music, outdoor activities, and puzzles, with a goal that the resident would report satisfaction with these activities. However, the only listed interventions were to facilitate video calls with family and to provide friendly visits as needed. An activity assessment later documented that the resident wished to participate in activities in the center, wanted 1:1 staff time, and liked self-directed activities. Record review showed that monthly documentation of 1:1 and friendly visits was limited and lacked detail, with only 13 documented visits in each of two full months and 10 visits in the first 22 days of the following month, and no indication of time spent or which staff provided the visits. During observations, the resident was seen in bed with no TV, no music, no pictures on the walls, a newspaper in the trash, and stuffed animals placed out of reach. On a morning when the activity calendar listed a daily meet & greet, morning snack, and an outdoor activity with an activity aide, the aide was observed briefly giving the resident cookies and promising to return, but not engaging in extended interaction or taking the resident outdoors, despite documentation that the resident had been invited and attended certain activities that day. The Director of Recreation confirmed that pet visits, which the resident enjoys, were not on the activity calendar and were not documented, and that weekly family calls for the resident were also not captured in the activity log or care plan. The care plan was acknowledged as not person-centered with measurable objectives and timeframes.
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