F0679

E

Failure to Provide and Document Resident-Preferred Activities and Community Outings

Pleasantville, Ohio Survey Completed on 03-05-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to provide activities that met individual residents’ assessed needs and preferences, and to make those preferences accessible to staff. For one resident admitted with COPD, bipolar disorder, alcohol dependence, and hypertension, the admission activity assessment documented that he did not respond to questions and there was no evidence that family was contacted to obtain preferences. His care conference indicated activity staff were to offer group activities and review the monthly calendar, yet activity documentation from admission through the first week showed only a single one-on-one “chatting” interaction by a nurse aide and no evidence he had been invited to group activities. Multiple observations over several days showed this resident either in bed or in a wheelchair in the hallway with no entertainment, even when craft activities were occurring in common areas. Activity staff later stated they were unable to document any activities for him and had no evidence he had participated in or been invited to activities since admission.

Another resident, cognitively intact and with multiple chronic conditions including chronic respiratory failure, morbid obesity, COPD, sleep apnea, and several psychiatric diagnoses, was assessed as preferring room visits three times per week and not wanting to participate in activities outside her room. However, the assessment did not document that she was asked about interest in community activities. Activity logs over a three‑month period showed no activities outside her room and no community activities. Observations on several dates showed her lying in bed with no staff approaching to ask about activity participation. In interview, she confirmed that no community activities were offered and stated she would love to go out to eat or go shopping but that this was never offered. Activity staff confirmed they did not have access to residents’ activity assessments, were unsure of individual preferences unless residents told them directly, and that no community activities were scheduled; review of facility activity calendars over three months showed no community activities.

A third resident with vascular dementia, anxiety disorder, and muscle weakness had an activity assessment and care plan indicating she did not wish to participate in group activities but preferred independent activities such as listening to music, doing word searches, attending church services, and receiving music, word search books, and crafting supplies. Observations over two days at multiple times showed her sitting in her room without any of her preferred independent activity items provided. Activity staff interviews revealed that one‑on‑one documentation was kept on paper in a book held by the activity coordinator, that individual preferences were obtained from the Activity Director or by learning from staff and residents, and that no activities had been provided for this resident during the week.

A fourth resident with major depressive disorder, generalized anxiety disorder, schizoaffective disorder (including bipolar type), dementia, and restlessness/agitation had a care plan directing staff to encourage attendance at activities of interest and to provide preferred activities such as bingo, dancing, singing, writing and solving math problems, and going outside, while noting that the resident did not like coloring or drawing. Observations over two days showed this resident in their room with the door shut and not participating in activities while other residents in the common room engaged in coloring and drawing. Review of the resident’s activity task documentation over 30 days showed that activities offered were predominantly coloring, crafts, “chit chat,” or art, with participation often passive or refused. A 90‑day review of one‑on‑one activity documentation showed activities were not consistently offered and often recorded generic entries such as the resident being out of the room or “morning news,” with no entries for bingo, music, dancing, or outdoor activities. Activity staff reported that if residents did not want group activities they would offer one‑on‑one interactions such as talking or hand massages, that this resident struggled with group activities and was given one‑on‑ones, and that they identified music and talking as interests. Staff also confirmed they lacked access to residents’ activity evaluations, used paper tracking for some one‑on‑ones, and that community activities were not being conducted. The facility’s Activity Programs policy stated that programs are to be geared to individual needs and reflect residents’ schedules, choices, rights, interests, hobbies, and personal preferences, which was not supported by the documented practices and observations.

The Administrator confirmed that the facility did not have consistent activity logs to verify when activities occurred and which residents participated. Activity staff further confirmed that they did not have access to residents’ activity evaluations to identify preferences and that some one‑on‑one activities were tracked only on paper for certain residents. Across the four residents reviewed, surveyors found a pattern of missing or incomplete assessment follow‑through, lack of documented invitations to activities, absence of preferred or community activities, and reliance on limited or generic activities such as coloring and crafts that did not align with documented or expressed preferences. These findings demonstrated that the facility failed to ensure activity preferences were available to aides and failed to complete activities according to resident preferences, contrary to its own Activity Programs policy.