Failure to Provide Mental Health Services After Traumatic Event
Penalty
Summary
A deficiency occurred when a resident who witnessed a traumatic medical emergency involving his roommate did not receive appropriate mental health services. The resident, who had a history of heart failure and bilateral hearing loss, was present in the room when his roommate was found unconscious from a suspected drug overdose and subsequently received CPR from staff. Both the registered nurse and physician assistant confirmed that the resident was visibly distressed, crying, and scared during the incident. Despite this, there was no documentation in the resident's medical record indicating that he was seen by a medical professional on the day of the incident or afterwards, nor was there any record of a referral for psychiatric evaluation or talk therapy. Interviews with facility staff, including the RN, PA, social services, and the administrator, revealed that although staff recognized the traumatic nature of the event and the need for mental health support, no action was taken to provide such services. The social services staff admitted to not speaking with the resident or making a referral, and the administrator confirmed that no psychiatric services were ordered or documented for the resident following the incident.