Livewell Connecticut

Penalty

No penalty information released

The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The deficiency involves the facility’s failure to ensure staff provided care in accordance with the resident’s care plan and to re-approach the resident when care was resisted. Resident #1 had dementia with behaviors, delusions, and major depression, with a BIMS score of 0/15 indicating severe cognitive impairment, was dependent with ADLs, and independent with transfers and ambulation. The resident’s care plan identified cognitive loss due to dementia, altered communication, and altered ADL function, with interventions including assisting the resident to make needs known, using the resident’s personal life story to make connections, asking yes/no questions, assessing communication ability with each interaction, assisting with ADLs, and, if the resident was not interested in care, leaving and coming back later to try again. On the date of the incident, a facility reportable event documented that NA #1 observed NA #2 enter a room where Resident #1 and Resident #2 were lying on a bed that belonged to another resident whose roommate was asleep in the second bed. According to NA #1’s written and verbal statements, NA #2 stated, “I’m not doing this s-t tonight,” then immediately approached Resident #1, grabbed the resident by the ponytail close to the scalp with a clenched fist, and pulled the resident from a lying to a seated position on the bed. When Resident #1 attempted to lie back down, NA #2 again pulled the ponytail, causing the resident to move into a low squatting position next to the bed while yelling, mumbling, and moving arms. NA #1 reported that NA #2 told Resident #1 to “get the f-k up,” after which the resident stood and left the room independently. NA #1 did not intervene or call for help at the time, stating she was in shock and it was her first time witnessing abuse. In interviews, NA #2 acknowledged that both residents with dementia were found sleeping in another resident’s bed and that she attempted to get Resident #1 up despite the resident saying, “leave me alone, don’t touch me, I want to sleep.” NA #2 stated she was pulling the resident up by the back to get the resident into a sitting position and admitted she did not consider re-approaching later, explaining that it was time for the bed’s assigned resident to go to bed and that NA #1 was busy with the other resident. NA #2 denied grabbing the resident’s hair or making the alleged profane statements, and stated she only touched the resident’s hair when holding the neck area. Facility policies, including the Resident’s Bill of Rights, CNA job description, and Compliance and Ethics – Code of Conduct, directed that residents be treated with dignity and respect, be free from verbal and physical abuse, have their right to refuse care respected with staff leaving and returning later, and that staff use an empathic approach to dementia care. The facility’s failure centered on staff actions that did not follow the care-planned interventions for refusal of care and did not reflect the required respectful, empathic approach.