F0679

E

Failure to Provide Adequate, Individualized Activities and Sufficient Activity Staffing

Hopedale, Ohio Survey Completed on 02-11-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to provide activities that met all residents’ needs and to maintain adequate activity staffing. Resident Council minutes documented residents reporting that activities were being cut short due to insufficient staff and that live musical entertainers were no longer provided. The Administrator responded that activities were not being shortened because of staffing and explained that entertainers were now required to have a tax identification number to be issued a 1099, and that no entertainers were willing to comply. Review of activity calendars for several months showed only one facility-wide calendar with no separate programming for residents with cognitive impairments, limited variety in scheduled activities, and very few one-on-one or independent activities/room visits. Activities were largely repetitive, consisting of daily coffee and discussion with distribution of the Daily Chronicle, weekly Bible study and church services, and bingo three times per week.

Interviews and observations showed that activity staff were being used for non-activity tasks and that residents with higher needs were discouraged from attending group activities. An activities staff member reported that the facility previously had pastors come in for Sunday services but now relied on televised services, and a resident expressed a desire for more religious services, particularly Catholic, stating that television services were not interactive. Observations showed an activities assistant hurriedly delivering the Daily Chronicle with minimal interaction and later spending nearly two hours going room to room obtaining menu selections for the next day’s meals. Multiple residents and staff reported that the activities department lacked sufficient staff, that one activity aide was routinely diverted to pass snacks and obtain menus, and that staff had been told by the Administrator not to bring residents to group activities if they needed help, as it was considered unfair to other residents. Anonymous employees stated that residents who were not cognitively intact or were significantly disabled were not to attend activities like bingo if they could not participate independently, and that in-person religious services had not occurred for approximately two months.

Specific residents’ records and observations further demonstrated unmet activity needs. One resident with severe dementia, anxiety, depression, insomnia, and impaired mobility had a care plan calling for daily one-on-one room visits by activity staff to promote socialization and reduce boredom, but electronic records for three consecutive months showed no documentation that these visits occurred. Another resident with moderate dementia, anxiety, difficulty walking, and anorexia had a similar care plan for daily one-on-one room visits, also without any documented completion over the same three-month period. During a bingo activity observed with about 20 participants, two activity assistants were present, but one resident sat with eyes closed and no active participation despite having a bingo card and chips, and two cognitively impaired residents were seated without adequate assistance; one was not given a bingo card or chips and continuously chewed on a blanket, and another could not follow the game despite having a card and chips. An employee reported that there was room for improvement in activities, that there were not enough activities, residents were bored, and residents felt their activity suggestions were not being considered. These findings contrasted with the facility’s written activities policy, which stated that activities would reflect residents’ cultural and religious interests and be person-appropriate, with accommodations in schedules, supplies, and timing to optimize participation.