Failure to Assess and Address Consent in Sexual Behaviors Among Cognitively Impaired Residents
Penalty
Summary
The facility failed to accurately and timely identify and address sexually oriented behaviors involving two cognitively impaired residents, resulting in a deficiency related to ensuring residents' ability to consent to sexual activity and preventing potential incidents of resident-to-resident sexual abuse. Both residents involved had documented cognitive impairments, with one resident having a BIMS score indicating severe impairment and the other moderate impairment. Despite these impairments, both residents were observed engaging in sexual behaviors, including inappropriate touching in common areas and being found partially undressed together in a private room. Medical records and progress notes revealed that while both residents were able to recall and express that their interactions were mutual, there was no documented assessment of their capacity to consent to sexual activity. The psychiatric and behavioral health notes failed to include any evaluation or information regarding the residents' understanding of the nature and consequences of sexual activity or their ability to provide informed consent. Additionally, care plans and educational interventions implemented for both residents did not address or document how the facility determined their ability to consent to sexual activity. The deficiency was further evidenced by the lack of specific documentation in care plans regarding the nature of inappropriate behaviors, the absence of assessments related to consent, and the failure to address these issues in behavioral and psychiatric evaluations. The facility's actions did not ensure that the rights and safety of the cognitively impaired residents were protected in situations involving sexual activity, nor did they provide adequate documentation or assessment to support that the residents were able to consent to such interactions.