|§483.10(a) Resident Rights.|
The resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility, including those specified in this section.
§483.10(a)(1) A facility must treat each resident with respect and dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement of his or her quality of life, recognizing each resident's individuality. The facility must protect and promote the rights of the resident.
§483.10(a)(2) The facility must provide equal access to quality care regardless of diagnosis, severity of condition, or payment source. A facility must establish and maintain identical policies and practices regarding transfer, discharge, and the provision of services under the State plan for all residents regardless of payment source.
§483.10(b) Exercise of Rights.
The resident has the right to exercise his or her rights as a resident of the facility and as a citizen or resident of the United States.
§483.10(b)(1) The facility must ensure that the resident can exercise his or her rights without interference, coercion, discrimination, or reprisal from the facility.
§483.10(b)(2) The resident has the right to be free of interference, coercion, discrimination, and reprisal from the facility in exercising his or her rights and to be supported by the facility in the exercise of his or her rights as required under this subpart.
Based on review of facility policy, observation and staff interviews it was determined that the facility failed to provide a dignified dining experience for one of three residents (Resident R8).
Review of facility policy "Meal Service in Resident Room" dated 1/3/20, indicated that staff is to assist resident with eating, encourage resident to eat independently, provide supervision, and level of assistance needed by the resident's current level of self-performance.
The Minimum Data Set (MDS - periodic assessment of care needs) dated 11/4/19, indicated that Resident R8 was admitted to the facility on 3/23/15, with current diagnoses that include depression, weakness, anxiety, seizures, respiratory difficulties, high blood pressure, falls, difficulty walking and dementia.
Review of the physician's orders for Resident R8 dated 2/20, indicated that resident is to be fed by staff.
Review of current plan of care for Resident R8 dated 2/20, revealed that staff is to allow adequate time to eat; provide cues; encouragement. Feed resident meals as ordered.
During an observation on 2/11/20, at 11:57 a.m. Resident R8 was sitting at table with food tray infront of her with other residents at the table.
During an observation on 2/11/20, at 2:17 p.m. Resident R8 was sitting at the table with same food tray in front of her, in the same location, no staff in the dining room and resident appeared to be sleeping.
During an interview on 2/11/20, at 2:27 p.m. Registared Nurse Unit Manager confirmed that Resident R8 was not provided a dignified dining experience and was left without assistance.
28 Pa. Code 201.18(a)(b)(e)(1) Management.
28 Pa. Code 201.29(a) Resident rights.
| ||Plan of Correction - To be completed: 03/27/2020|
The Facility submits this Plan of Correction under procedures established by the Department of Health in order to comply with the Department's directive to change conditions which the Department alleges is deficient under State and/or Federal Long Term Care Regulations. This Plan of Correction should not be construed as either a waiver of the facility's right to appeal or challenge the accuracy or severity of the alleged deficiencies or an admission of past or ongoing violation of State or Federal regulatory requirements."
Resident8 feeds self with set-up and cueing from staff and takes a very long time to eat her meal. Unit manager provided new milk and offered new grilled cheese because of length of time resident takes to eat. Resident refused. Unit manager had been checking on resident throughout her meal. Resident 8 will be provided with assistance as ordered for meals. Residents are evaluated for any assistance needed with meals at time of admission, with any noted decline in functioning and through ST and OT assessments. All nursing and dining staff will be educated by the staff development coordinator or designee on elements of a dignified dining experience. Observations of meal time will be conducted weekly for one month by members of the nursing and dining services team to ensure residents with orders to be fed by staff are being provided with that assistance as well as a dignified dining experience. Any issues identified will be addressed. If no issues are identified after weekly observations for one month, these observations will be then be conducted twice per month for three months until substantial compliance is observed and being maintained. Results of these audits will be reported to the QAA committee for review and any further recommendations from the committee will be implemented.