Failure to Timely Report Alleged Abuse to State Agency
Penalty
Summary
The facility failed to report an allegation of abuse to the State Agency in a timely manner for one resident. According to the facility's own policy, any allegation of abuse must be promptly reported to the State Agency and the resident's representative. On the date in question, a resident reported sensitivity and pain in the breastbone area, stating that a CNA had been too rough and had pushed down hard on her sternum during care. Another CNA present during the incident confirmed that the accused CNA held the resident down with her arms crossed over the resident's chest to facilitate care, rather than seeking alternative assistance or de-escalating the situation. The resident expressed feeling that the action was abusive and upsetting. A third CNA reported that the resident had informed her of the alleged abuse shortly after breakfast, and this CNA relayed the information to the facility administrator. However, the administrator initially chose to document the incident as a grievance rather than initiating an abuse investigation or reporting it to the State Agency as required. The administrator only began the abuse investigation and reported the incident to the State Agency the following day, after speaking with the resident's family. The administrator later acknowledged that the allegation should have been reported immediately upon receiving the report from the CNA.