CNA Physically Abuses Cognitively Impaired Resident During Care
Penalty
Summary
A resident with severe cognitive impairment, diagnosed with dementia, anxiety disorder, and major depressive disorder, became combative during incontinence care. During this episode, a Certified Nurse Aide (CNA) responded to the resident's physical aggression and verbal insults, including a racial slur, by threatening retaliation, stating, "If you hit me again, I will hit you back." The CNA then forcefully grabbed the resident's left wrist and slapped the top of the resident's left hand twice, causing the resident to yell out in pain. This incident was directly witnessed by another CNA who was assisting with care and reported that the slaps were hard enough to be audible. The facility's policy prohibits all forms of abuse, including physical abuse such as hitting and slapping, and requires that residents be treated with respect and dignity at all times. The incident was reported through the Health Care Facility Reporting System, and interviews with staff confirmed the sequence of events, including the verbal threat and physical action by the CNA. The resident's severe cognitive impairment was noted, but it was acknowledged that an unimpaired individual would have experienced pain and mental anguish from such treatment.