Failure to Protect Resident from Verbal and Mental Abuse by CNA
Penalty
Summary
The facility failed to protect a resident from mental and verbal abuse by a Certified Nursing Assistant (CNA), resulting in emotional distress and persistent fear for the resident. The CNA engaged in taunting behavior, including making derogatory remarks about the resident's significant other, sticking her tongue out at the resident, and making threatening gestures such as raising her fists and challenging the resident to a fight. Multiple staff and residents reported that the CNA was confrontational, demeaning, and had a pattern of inappropriate interactions with both residents and staff. The incident occurred in a public area of the facility, and the CNA's behavior was witnessed by other staff members, who described her actions as unprofessional and abusive. Despite the initial suspension of the CNA following the incident, her termination was rescinded due to union involvement, and she was allowed to return to work. This decision left residents and staff fearful, as the CNA continued to work in various areas of the facility, including the dining room and multiple halls. Interviews with several residents revealed that they felt intimidated, bullied, and harassed by the CNA, with some expressing fear of being around her and reluctance to report her behavior due to intimidation. Staff members also reported feeling uncomfortable and scared, with some stating that the CNA's behavior extended to her interactions with employees as well. The facility's own policies affirm the right of residents to be free from abuse and outline expectations for staff conduct, including the prohibition of verbal abuse and mistreatment. However, the facility failed to enforce these policies effectively, as evidenced by the CNA's continued employment and the lack of immediate protective measures for residents. The deficiency resulted in an Immediate Jeopardy situation, as residents experienced emotional harm and ongoing fear due to the CNA's actions and presence in the facility.
Removal Plan
- V3 completed Abuse training and Behavior De-escalation training and was monitored continuously on Second Shift.
- V3 was immediately terminated by V1 (ADM) and V2 (Director of Nursing/DON).
- V1 (ADM), V2 (DON) and V4 (Abuse Coordinator) completed an entire whole house audit to evaluate Facility Residents at risk for potential abuse and no evidence was noted.
- An all-Staff in-service by V1 (ADM) and V4 (Abuse Coordinator) was conducted on Resident Abuse and Reporting. A tracking sheet was expected to be completed.
- A sign was placed by the Facility timeclock to ensure employees complete the Abuse training prior to work on floor and direct care with Residents.
- A checklist was developed to ensure one-hundred percent compliance with the mandatory training for employees/staff that are on vacation and as needed basis (PRN).
- A current employee list was audited and over seen by V1 (ADM), V2 (DON) and V3 (Abuse Coordinator) to evaluate potential staff requiring one-on-one review and said employees to have additional training on Abuse and Mandatory Behavioral De-escalation courses.
- An Abuse training module through the Facility computer program was initiated with trainings on Abuse prevention, sensitivity and respect to be scheduled and implemented for part of the progressive disciplinary process.
- V1 (ADM), V4 (Abuse Coordinator) and Department Heads to monitor for compliance.