Ask CCRM: Negotiated Risk Agreement: Resident with Choking History Who Prefers to Eat Alone

A Continuing Care Risk Management (CCRM) member recently asked for guidance on handling a resident with a history of choking who wishes to eat alone in his room. The member’s main concern was honoring the resident’s rights and wishes while still meeting regulatory and liability obligations.

CCRM recommends that, if possible, the facility implement an intense observation schedule for mealtimes during which assigned staff check on the resident every five minutes. Assigning staff to the task rather than simply stating that any available member will check on him more frequently during mealtimes is important to avoid staff from assuming that someone else is checking on the resident. The schedule should be communicated to the resident. In addition, staff members who deliver meals to the resident’s room should ensure that a call bell or staff notification system is located within reach of the resident. All staff members who may bring food to...