Ensure residents have the right to have a choice over activities, their schedules, and health care according to their interests, assessments, and plans of care.
of F242 citations were written at actual harm or above. The mark is the share across all tags, 5.4%.
The harm level
How severely F242 is cited
0.0% of citations found actual harm or worse (level G and above).
Citations by CMS scope and severity. Rows are harm level, columns are how widespread the finding was.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
J—
K—
L—
Actual harm
G—
H—
I—
No harm, potential for more than minimal
D2100.0%
E—
F—
No harm, potential for minimal
A—
B—
C—
Every recorded F242 citation, by the harm level and scope the surveyor assigned.
In the surveyor’s words
What an F242 citation says
One finding from each severity level, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
J · Immediate jeopardy, isolatedOctober 28, 2017
Based on observation, resident interview, staff interview and record review the facility failed to allow a resident the choice to refuse to attend a medical appointment resulting in a staff to resident physical abuse resulting in two bruises on the left wrist and two bruises on the left hip for 1 of 1 sampled residents (Resident #1).
The immediate jeopardy (IJ) began on 10/25/17 when Resident #1 refused to go to an appointment and staff was insistent that she go. Nurse Aide #1 grabbed Resident #1 by both wrists causing her to fall to the floor resulting in bruising to her left wrist and left hip. The IJ was removed on 10/28/17 at 11:00 AM when the facility's acceptable credible allegation was verified. …
Based on observation, record review, and interview the facility did not recognize R4's choice to refuse showering when R4 frequently becomes agitated and yells in anger during the task. The facility has not explored alternative ways to assist him with hygiene and his ADLs (Activities of Daily Living) or discussed his desires and choice with his guardian. This was discovered for 1 of 4 sampled residents.
R4 has limited abilities to express his feelings however staff interpret his tone of voice and non-verbal gestures as his expressions of need and desires. Staff continue to give R4 a shower even when he expresses his dislike of how he is showered. R4's legal guardian was not made aware of the extent of R4's aversion to his 3 times a week showers in order to make the best decisions for R4. …
D · No harm, potential for more than minimal, isolatedNovember 27, 2017
Based on interview and record review, it was determined the facility failed to provide each resident with the right to choose sleeping and waking times that are consistent with his or her interests for 1 of 3 sampled residents (Resident #3).
The findings included:
During interview and review of Resident #3's conducted with the DON (Director of Nursing) on 11/27/17 beginning at approximately 1:30 PM, she was asked about the completion date/time noted on the initial nursing assessment (section entitled Restraints/Adaptive Equipment - Side Rail Assessment) that reflected it was completed on 10/13/2017 at 10:49 PM. The DON stated that is just when the nurse entered the data in the computer and that it was not necessarily when the information was gathered. …
B · No harm, potential for minimal, patternOctober 4, 2017
Based on record review and interviews, the facility failed to ensure that a resident's choice in the area of bathing was being followed for 4 of 6 sampled residents (#2, #3, #5 and #6).
1. On 10/4/17 at 10:00 a.m., during an interview with a surveyor, Resident #2 stated that he/she is scheduled to have a whirlpool on Wednesday and a shower on Saturday. Resident #2 stated that he/she was not able to do whirlpool today because they are short on help, it's been bad. Last week I didn't have whirlpool on Wednesday but did get shower on Saturday. The CNA documentation was reviewed between 9/5/17 thru 10/4/17 which indicated that Resident #2 received a whirlpool on 9/6/17, 9/20/17 and 10/1/17 and a shower on 9/9/17 and 9/23/17.9/23/17. …
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