F0679

E

Failure to Provide Individualized Activities and Scheduled 1:1 Programming

Saint Louis, Missouri Survey Completed on 03-13-2026

Penalty

No penalty information released

Summary

Surveyors identified a deficiency in the facility’s failure to assess residents’ activity preferences and to provide an ongoing activity program consistent with those preferences, as well as a failure to provide scheduled 1:1 activities to certain residents. The facility’s Activities Program policy, dated 6/2020, stated that the facility would provide an activity program designed to meet residents’ needs, interests, and preferences, with assessments completed within seven days of admission and individualized care plans developed and implemented. Observations on multiple days showed Mardi Gras decorations and an outdated February activity calendar posted, but no activities were observed being provided to residents at various times on several dates. The Activity Director reported that her first day was during the survey period, that the March activity calendar had not yet been created, and that she expected activities to be scheduled and calendars distributed and posted.

Multiple residents who were cognitively intact and had various diagnoses reported that there were not enough activities and that they were bored. One resident with anxiety, depression, bipolar disorder, schizophrenia, and PTSD stated there were no activities taking place, that the previous Activities Director had left about two weeks earlier, and that the resident paid for a car ride to a store just to get out of the facility. Another resident with stroke, dementia, diabetes, kidney failure, and depression reported doing nothing all day except going to dialysis, expressed interest in puzzles, and recalled that the facility previously had a small bus for outings. Additional residents with diagnoses including diabetes, hearing loss, schizophrenia, multiple sclerosis, insomnia, hypertension, anemia, dementia, and bipolar disorder similarly stated that there were not enough activities, that there were not enough activity staff, and that they were bored most of the time. For several of these residents, record review showed no activity assessments and no care plan documentation related to activity participation or preferences, despite the facility’s policy and the Administrator and DON’s expectation that care plans reflect activity preferences.

The survey also found that residents identified by the facility as needing 1:1 activities were not receiving them. A facility 1:1 Activity List showed three residents scheduled for 1:1 activities on specific days of the week, but their medical records contained no documentation of activities offered or provided. These residents had significant cognitive and neurological conditions, including dementia, bipolar disorder, hypertension, malnutrition, Alzheimer’s disease, stroke, hemiplegia, seizure disorder, anxiety disorder, aphasia, mild cognitive impairment, malnutrition, and Rett’s syndrome. Observations of these residents throughout the survey period showed them not engaged in any 1:1 activities. The Activity Director acknowledged that she had not started conducting 1:1 activities for residents on the 1:1 list, and the Administrator and DON stated they expected 1:1 activities to be provided to residents determined to benefit from them.