Memory care residents did not receive activities as scheduled, and the unit’s calendar was not implemented consistently. Observations showed missed morning activities, residents sitting with movies or TV on instead of planned programming, and limited participation in activities such as nail care, devotion, puzzles, and sticker work. The AD stated not all residents were asked about nail care, and an LPN confirmed the regular activity aide was in CNA training and residents were not offered the scheduled activities that week.
Failure to Offer Resident-Centered Activities: A cognitively intact resident with a history of cerebral infarction and depression had documented interests in books, music, group activities, news, religious services, and favorite activities, with a preference for in-room activities. Although the care plan included music, one-on-one visits, activity materials, and room visits, there were no documented activity offers or provided activities, and the Activity Director confirmed there was no evidence of one-on-one or group activity logs.
Failure to provide individualized activities for two residents. One resident with significant hearing and vision loss had a care plan for 1:1 visits, but records showed no evidence of those visits and she reported being bored, relying mainly on audio books, and not being offered outdoor time. Another cognitively intact resident had documented interests in news, favorite activities, outdoor time, and crossword puzzles, but the record showed no 1:1 activity visits and he reported the facility had not provided magazines or crossword puzzles despite his preferences.
Failure to honor activity preferences for two residents was identified. One resident with acute respiratory failure, necrotizing fasciitis, and DM2 wanted to use his TV and personal devices, but multiple TV channels were not working and maintenance work orders were closed as completed despite the issue remaining unresolved. Another resident with quadriplegia and a C4 SCI had a stated preference for going outside for fresh air, but staff said he could not go outside without supervision after a prior smoking policy issue; records showed little to no patio or deck participation and the resident reported he was not being taken outside.
A resident with dementia, severe cognitive impairment, depression, visual and hearing impairments, and other comorbidities had documented preferences on the MDS for reading materials, music, and being around animals, but the activity assessment was completed only with the resident, not family, and concluded the resident could not identify preferred activities. The care plan inconsistently described the resident as sociable with interests in arts and crafts, bingo, and music, yet noted no current activities of interest, and a later activity participation review was left incomplete. Activity records listed daily relaxation and media-based activities and one-on-one reading, but staff later clarified that relaxation meant the resident was simply resting in bed and that recorded one-on-one sessions did not actually occur because the resident was asleep. Surveyors repeatedly observed the resident awake in a dark room with no television, music, reading materials, or other entertainment, and staff were unable to state the resident’s specific activity preferences, demonstrating a failure to adequately assess and implement individualized activity services.
A resident with multiple chronic conditions and frontotemporal neurocognitive disorder, who was dependent on staff to meet emotional, intellectual, physical, and social needs, did not receive individualized activities consistent with documented preferences. The activity assessment showed the resident was Catholic, valued pets and sports, and was interested in various group and leisure activities, yet observations found the resident repeatedly in a dark room with only television for stimulation. Activity staff reported the resident often refused activities but admitted they did not document what was offered or refused, had limited activity documentation, could not access the activity assessment and care plan, and were unaware of the resident’s religious affiliation and specific entertainment preferences.
A resident with stroke-related hemiplegia, aphasia, dysphagia, and a feeding tube was not provided an ongoing activity program based on his preferences. Although his record listed interests such as music, TV, and 1:1 activities, staff interviews and observations showed he remained in bed, could not independently use the TV remote, and had not participated in activities. His daughter/POA said the facility did not ask about his routines or preferences and that he was always in bed unless she requested otherwise.
A resident with severe cognitive impairment and multiple diagnoses was care planned for one-to-one activity visits, but activity logs showed none were provided during the look-back period. The AD confirmed the visits were scheduled after activity staff had already left, and an AA stated she did not complete any one-to-one visits. In addition, residents on the memory care unit were repeatedly observed without structured therapeutic activities, while staff reported that dedicated activities were rare or absent and that the unit lacked a separate activity calendar.
Surveyors found that the facility failed to provide an ongoing, individualized activity program consistent with residents’ assessed preferences and the facility’s own policy. Two residents with multiple comorbidities had detailed activity assessments and care plans listing interests such as one-on-one visits, bingo, music, religious practices, social events, and other pursuits, yet their records showed only a few brief one-on-one contacts and long gaps with no documented activities. Activity calendars lacked scheduled one-on-one sessions for certain months, offered limited variety, and posted calendars were not always within residents’ view, resulting in residents spending extended time in their rooms without engagement despite documented goals and interventions for activity participation.
Surveyors found that the facility failed to provide adequate, individualized activities for all residents on the memory care unit. The activity calendar showed only repetitive offerings such as juice, news, and table talk daily, with a single weekly morning stretch. Observations revealed multiple residents sitting in the dining room or in recliners with only television music and no structured or spontaneous activities, and an activity aide distributed word searches only to residents at the table, not to those in recliners. A CNA reported that residents were not offered mental stimulation between scheduled activities. The activity aide stated that a blind resident was not offered adapted activities, and that two other residents who wandered or became easily agitated were also not offered activities, despite facility policy requiring diverse, adapted programming.
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