Failure to Provide Person-Centered Activities to Meet a Resident’s Psychosocial Needs
Penalty
Summary
The deficiency involves the facility’s failure to provide person-centered activities that met a cognitively intact resident’s interests and supported his physical, mental, and psychosocial well-being. The resident had diagnoses including ADHD, depression, and Huntington’s disease, and his MDS mood assessment showed he had little interest or pleasure in doing things nearly every day. His care plan identified a potential for altered activity pattern related to preferences, with goals for him to attend group activities of interest such as sports-related groups, science lab, and table activities, and interventions including explaining the importance of social interaction and inviting him to activities that promote intake of food and fluids. Despite this, the resident’s activity participation declined steadily since November 2025, and he was noted to now participate only in church and singing activities. Staff interviews and observations showed that the facility did not effectively implement individualized, person-centered activities for this resident. A CNA reported that the resident had become obsessed with attention, bored easily, cried frequently, and became upset when family did not answer his calls, and that there were no person-centered activities that kept him engaged. An activities staff member stated they had not figured out how to get him more involved, that his scheduled smoke break conflicted with the first daily activity, and that he would get mad, say he was bored, and walk away if he did not like the activity. On observation, during a scheduled “Whole Brain” activity, the resident was present in the dining room but was only eating and not involved in the activity, and he was not present in the sunroom during later scheduled activities. A nurse’s note documented behavioral issues including unsteady gait, refusal to sit, yelling, attempting to hit staff, and demanding staff call his family. These findings contrasted with the facility’s policy requiring identification and involvement of each resident in an ongoing program of activities designed to appeal to their interests and needs, including specialized or extended programs.
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