Failure to Assist Resident Timely and Prohibit Earbud Use During Care
Penalty
Summary
The deficiency involves the facility’s failure to reasonably accommodate a resident’s needs and preferences and to ensure staff were not distracted by personal earbuds while working on the floor. An 86-year-old female resident with morbid obesity, type 2 diabetes with neuropathy, generalized anxiety disorder, monoplegia of an upper limb, gait and mobility abnormalities, and a need for assistance with personal care was care planned as requiring substantial/maximal assistance of one staff member for transfers, including chair-to-bed transfers. On the date in question, this resident was seated at a dining table after lunch and expressed feeling tired and wanting to return to bed. Another resident reported that he repeatedly requested assistance from a CNA for this resident, but the CNA was wearing earbuds and appeared to be talking on her cell phone. According to this resident, the CNA responded that she heard him and would get to the resident when she got to her, then walked off without assisting and did not return. The reporting resident stated they waited approximately 35 minutes to one hour without assistance before he located another CNA, who then helped transfer the resident back to bed. The resident who needed assistance later stated she did not recall asking for help to go to bed but reported having seen a CNA on her hallway wear earbuds and said she did not like it because the CNA could not hear her requests for help and it made her feel ignored and not good. Multiple staff interviews confirmed that personal cell phone use and earbuds were not allowed on the floor because they could interfere with resident care, although the DON and ADM acknowledged there was no direct written policy addressing earbuds specifically. Several staff, including LVNs, CNAs, and a medication aide, stated they had been trained that personal cell phones and earbuds were not permitted while working. In contrast, the CNA identified in the incident stated she had not received training on cell phone or earbud use, admitted to using earbuds on the floor, particularly in the mornings, and acknowledged she might have been in a resident’s room with earbuds in or around her neck. Another CNA reported having seen this CNA wear earbuds “all the time” and not respond to residents’ requests for assistance because she was talking on her cell phone, and stated she had reported this behavior to a nurse. The DON stated she had not been aware of the specific incident but agreed that earbuds could prevent staff from hearing residents’ requests for help.
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