Failure to Honor Resident Choice for Wheelchair Seatbelt and OT Provider
Penalty
Summary
The deficiency involves the facility’s failure to honor resident self-determination and support resident choice for two residents regarding adaptive equipment and therapy provider preferences. One resident reported that they previously used a wheelchair seatbelt at an outpatient day program, which provided a sense of security and safety. After discontinuing the day program and receiving a different wheelchair in the facility, the resident repeatedly requested a seatbelt but stated the facility refused to equip the new wheelchair with one. The resident reported being physically able to unbuckle the seatbelt independently and said staff told them they could not have a seatbelt because “the State doesn’t allow it,” which the resident believed was untrue. Surveyors interviewed the Rehab Director, who initially denied knowledge of the resident’s request for a seatbelt and indicated they would look into the request and perform an assessment. The Administrator was later informed that the resident had been told the State did not allow a seatbelt and acknowledged that this was an inappropriate response. The report notes that the facility’s own policy on Accommodation of Needs requires evaluation and reasonable accommodation of residents’ individual needs and preferences, including adaptive devices, upon admission and on an ongoing basis. The second resident expressed ongoing complaints about rehabilitation services, specifically regarding OT. This resident stated that after frequent hospital transfers, PT would assess them upon return, but they refused OT assessments because they did not want PT services and preferred OT services from someone other than the current COTA. The resident reported disliking the assigned COTA and refusing treatment from that individual, while being willing to work with another therapist. Documentation showed the resident had previously filed a concern form requesting a different OT, and progress notes recorded repeated refusals of OT evaluations, with the resident stating they would wait until a new therapist was hired. The Rehab Director confirmed the refusals were due to the resident’s dislike of the COTA and stated they did not think the contract company would send another COTA for one resident. The Administrator later stated they were not aware of the resident’s ongoing concerns but acknowledged they should have been informed and that something should have been done to accommodate the resident’s preferences.
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