Failure to Timely Report Alleged Abuse to State Agency
Penalty
Summary
The facility failed to ensure that an allegation of potential abuse involving a resident who complained of rough care by a nursing assistant was reported to the State Agency (SA) immediately, but no later than two hours after the suspicion was formed. The incident was initially brought to the facility's attention by local police, who informed the Social Services Director (SSD) that a report had already been filed with the Minnesota Abuse Reporting Center (MAARC) regarding the alleged rough handling of the resident, which resulted in pain to the resident's leg and abdomen. Despite being made aware of the allegation, the facility did not file a separate report with the SA as required by their Abuse Prohibition/Vulnerable Adult policy, which mandates reporting within two hours of suspicion. Interviews with facility staff, including the DON, registered nurse, nursing assistants, and social services designee, revealed inconsistent understanding of the reporting requirements, with some staff believing the timeframe was 24 hours and others unsure of the exact process. The DON confirmed that no report was filed by the facility, relying instead on the fact that another entity had already reported the incident. The facility's policy, however, clearly states that suspected abuse must be reported to the Office of Health Facility Complaints (OHFC) within two hours, a step that was not taken in this case.