Failure to Provide Dignified, Care-Plan-Compliant Mealtime Assistance
Penalty
Summary
The deficiency involves the facility’s failure to ensure a resident was treated with respect, dignity, and appropriate care during mealtimes. The resident had diagnoses including dementia, major depressive disorder, anxiety, and bipolar disorder, with documentation of severely impaired cognition on the MDS and CAA, and daily antipsychotic use. The resident’s care plan and physician orders specified that staff were to provide set-up assistance to supervision with one staff, that someone must sit and assist her with every meal and snacks three times a day due to weight loss, and that she was to be assisted with meal intake at every meal. Despite these documented needs and interventions, observation showed that during breakfast the resident was seated in a Broda chair at the dining room table while a CNA stood next to her attempting to assist with the meal, rather than sitting next to her as required. Subsequent interviews with a CMA and a licensed nurse confirmed that nursing staff should be seated next to residents when assisting with meals, at eye level, and engaging them in conversation. These observations and staff statements demonstrate that the resident was not assisted in the manner specified in her care plan and orders, and that staff did not follow the expected practice for dignified, respectful mealtime assistance.
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