cms_GA: 56
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 56 | BELL MINOR HOME, THE | 115020 | 2200 OLD HAMILTON PLACE NE | GAINESVILLE | GA | 30507 | 2017-12-14 | 550 | D | 0 | 1 | 4OSS11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations record review, review of the facility policy titled Social Service- Dignity Policy, resident and staff interviews, the facility failed to promote care in a manner that maintained or enhanced each resident's dignity and respect. Specifically, three of 29 sampled residents (R B, R A and R C) stated that they are undressed and naked in the shower room while other residents are present. (Refer F583) Findings include: Review of the facility policy titled Social Service- Dignity Policy revised (MONTH) (YEAR) documented: According to federal regulations, the facility must promote care for residents in a manner, and in an environment, that maintains or enhances each resident's dignity and respect in full recognition of his or her individuality. Dignity means that their interactions with the resident, staff carries out activities which assist the resident to maintain or enhance his/her self-esteem and self-worth. 1. Record review for R B revealed an Annual Minimum Data Set (MDS) assessment dated [DATE] which documented a Brief Interview for Mental Status (BIMS) summary score of 14, indicating no cognitive impairment. The resident required extensive assistance with bathing and personal hygiene. Interview on 12/11/17 at 2:39 p.m. with R B revealed that staff undress and re-dress her in front of other resident's in the shower room. Resident B further stated that when she is finished with her shower, the staff transport her from the shower stall to the area where they dress everyone with only a small towel covering her. Resident B stated that this has been going on for so long that she has had to just turn it into a funny thing so that it's not an embarrassing thing and will tell herself Well, here comes (name!). R B further stated That's just the way it is! Interview on 12/14/17 at 10:29 a.m. with Certified Nursing Assistant (CNA A) who was actively providing care in the shower room revealed that they always have two residents in the shower room but not more than that unless one is leaving out and one is coming in. CNA A stated that the residents are in the tub area together being undressed and stated we try to have them back to back. CNA A further stated that once undressed, the resident is taken into the shower stall uncovered and naked. CNA A stated when they are finished with the resident's shower they put a towel over them and they are taken back to the tub area to be dried off and re-dressed. When CNA A was asked why the residents are not undressed and re-dressed separately or privately, she stated because they do two at a time with two CNAs and they usually finish their showers at the same time so they are dressed in the dressing area at the same time. She further stated there is only one curtain for that area CNA A stated that no residents have ever told her that they are embarrassed or humiliated. Interview on 12/14/17 at 11:19 a.m. with the Administrator revealed she was not aware that the staff were undressing and re-dressing residents in front of each other in the shower rooms. The Administrator stated she expects staff to maintain a resident's privacy and dignity at all times. The Administrator stated that the staff should not be dressing and undressing resident's in the open area where the bathtub is located. She stated that the two shower stalls in each shower room (Unit A and Unit B) are very large with privacy curtains. The staff should undress, shower and re-dress the residents in the shower stalls. 2. Review of the policy titled Resident Rights Policy, last revised 8/22/17, the resident has a right to a dignified existence and the right to personal privacy. Review of the Annual Minimum Data Set (MDS) Assessment for Resident (R) A dated 10/13/17 revealed the resident has a Brief Interview for Mental Status (BIMS) score of 13 indicating the resident is cognitively intact. The resident was also assessed on the annual assessment as needing the support of one person with bathing and dressing. During interviews conducted on 12/11/17 at 3:26 p.m. and on 12/14/17 at 1:50 p.m., Resident A said she received showers on Mondays and Thursdays, and the staff takes as many as five or six residents in at a time into the shower area. Only two residents at a time can be showered in the two curtained shower stalls. However, the other residents wait right outside the curtained areas, sometimes wearing simply a towel. Afterwards, the two residents receiving a shower at any one time are taken into another curtained drying area to be toweled off and dressed in clean garments. She feels embarrassed at such times - while waiting outside the shower stall and while being dressed. She complained to the facility, at least once before, about having to sit undressed among several other residents. The facility addressed her concern, and the situation got better for a while, but it has deteriorated again to where staff are taking five or more residents in to the shower room at the same time. Observation of the vacant shower room on the resident's hall on 12/12/17 at 8:15 a.m. revealed the shower room consisted of two curtained shower stalls and an open area just in front of these stalls. To the right, when facing the shower stall, was a large area, also curtained with an old spa tub containing several discarded items. One wall of this tub area also had a curtain, and behind it was a toilet and sink. Review of facility care records revealed RA and several other residents are scheduled for showers on Mondays and Thursdays; other residents in the facility are scheduled for showers on Tuesdays and Fridays. Interview on 12/14/17 at 12:34 p.m. with Certified Nursing Assistant (CNA) AA revealed she sometimes provides showers for the residents if the shower team is not available. CNA AA said when she provides showers to residents, she usually does so on an individual basis. However, if another CNA is using the shower room at the same time to bathe another resident, they may take the two residents into the drying area at the same time. She takes care to protect the privacy of the residents and there are never more than two residents in for a shower when she assists residents with taking a shower. However, she has seen the shower teams take several residents into the shower area at the same time because of the volume of showers the team is required to complete on shower days. Interview on 12/14/17 at 2:00 p.m. with D, a family member of the roommate for Resident A revealed she has received complaints from Resident A and the roommate that several residents are taken into the shower area at the same time and must wait along with several other residents for their showers while sometimes dressed in only a towel. Family member D also said she reported to the state ombudsman, her concerns that several residents were being left in the hallway while awaiting their showers. This practice (residents waiting in the hallway outside the shower room prior to receiving a shower) occurred on a regular basis, but improved after it was addressed by the ombudsman earlier this year. 3. On 12/13/17 at 10:30 a.m. interview with Resident C revealed that, while crying, she states that she does not feel like she is treated with respect and dignity when she is taken to the shower and has to take her clothes off in front of other people who are also in the shower room waiting to take a shower. Review of R C Care Plan, dated 11/30/17, reveals planning for: a behavior problem related to (r/t) dietary preferences and inability to be satisfied with meals served even if an alternative meal choice is requested. Resident may manipulate family and staff at times. Resident C has negative feelings regarding staff and facility characterized by; anxiety, mistrust, conflict/anger, ineffective coping related to: unrealistic expectations regarding meals, ADL's, and activities after discharging from Hospice care. Family is aware of resident's inability to cope and persistent complaints. Interventions for the above behaviors include: Monitor behavior episodes and attempt to determine underlying cause. Consider location, time of day, persons involved, and situations. Document behavior and potential causes. Other interventions include: Discuss feelings about placement with resident, offer activities of which resident has shown interest, talk with resident about setting realistic self-expectations and goals. | 2020-09-01 |