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F0607
G

Failure to Protect Resident During Abuse Investigation

St. Clair Shores, Michigan Survey Completed on 02-26-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to protect a resident during an abuse investigation, resulting in fear of retaliation and feeling scared. The incident involved a staff member, Staff A, who was alleged to have misappropriated funds from a resident's bank account. The resident, R901, had opened a bank account with Staff A as a secondary account holder. Over time, R901 noticed unauthorized withdrawals and gambling transactions linked to the account, leading to a total unauthorized withdrawal of $18,364.14. Despite the resident's attempts to address the issue, Staff A continued to have access to the account until it was closed. The situation escalated when the police were involved, and Staff A was instructed not to have contact with the resident. However, the following day, Staff A entered the resident's room, confronting them aggressively and causing the resident to feel threatened and scared. The resident was unable to call for help as their phone was out of reach. Staff A's actions included leaving multiple voicemails and text messages, further intimidating the resident. The facility's failure to protect the resident during the investigation is evident in the lack of immediate removal of Staff A from the premises and the inability to prevent further contact with the resident. The facility's policy on abuse prevention was not effectively implemented, as Staff A was able to confront the resident despite being suspended. This oversight led to the resident experiencing significant emotional distress and fear for their safety.

Plan Of Correction

Element 1: Cited Residents R901 no longer resides in the facility. The facility failed to protect one resident during an abuse investigation resulting in fear of retaliation and feeling scared. Element 2: Like Residents Residents who reside in the facility have the potential to be impacted by the identified practice. The facility completed an initial baseline audit to ensure that residents feel protected in the facility. Element 3: Education Staff will be educated on the facility abuse policy and process to ensure that residents are protected and free from abuse. Element 4: Audits Administrator or designee will complete 10 random audits x4 weeks to ensure that residents feel safe in this facility has no fear of retaliation. Element 5: Compliance The facility Administrator will be responsible for assuring substantial compliance is attained through this plan of correction by 3/21/2025 and for sustained compliance thereafter.

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