Resident Threatened and Emotionally Harmed During Incontinence Care
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) threatened a resident during incontinence care, resulting in emotional and psychosocial harm. The resident, a female with multiple complex diagnoses including Moyamoya disease, dysphagia, altered mental status, conversion disorder with seizures, and cerebral aneurysm, was being changed after a bowel movement. During the care, the CNA rolled the resident onto her left side, causing pain, which the resident communicated by kicking and swinging her arms. The CNA responded by telling the resident, "No, no, you better stop, or I am going to leave you here like this," while the resident was naked and soiled. This statement was perceived as a threat to leave the resident in a vulnerable and undignified state. The incident was witnessed by another resident and a family member, both of whom observed the resident become hysterical and emotionally distressed. A video recording of the incident confirmed the CNA's threatening statement and the resident's distress. The family member reported the incident to the facility administrator, who viewed the video but did not indicate any follow-up action. The administrator was unable to confirm whether staff received training on managing residents with behavioral challenges. The facility's abuse policy prohibits mental abuse, including threats and humiliation, but the actions of the CNA were inconsistent with this policy, resulting in documented emotional harm to the resident.