Legal & EthicalQuestion 175 of 200

A competent resident with capacity refuses her prescribed evening medications. The CNA should:

a.Hide the medications in her food without telling her
b.Honor the refusal, document the resident's words, and notify the licensed nurse so the physician can be informed and the care plan adjusted
c.Physically force her to take the pills
d.Tell the resident she must take medications or be discharged

Explanation

42 CFR §483.10(c)(6) protects a resident's right to refuse treatment. A competent resident may refuse care; staff must honor the refusal, ensure the resident understands consequences (educated via the nurse/physician), document the refusal verbatim, and notify the nurse. Covert medication (a) is battery, fraud, and abuse — and often illegal absent specific physician orders and an established surrogate process. Force (c) is battery (PC §242). Threatening discharge (d) is coercion and may violate transfer/discharge protections under 42 CFR §483.15. CNAs do not administer medications regardless.

Law Reference: 42 CFR §483.10(c)(6)

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