Failure to Suspend Alleged Perpetrator During Abuse Investigation
Penalty
Summary
The facility failed to follow and implement its abuse and neglect policies and procedures during the investigation of an abuse allegation involving a cognitively intact resident. According to the facility's policies, any employee accused of abuse, mistreatment, neglect, or exploitation must be immediately suspended pending the outcome of the investigation. However, when a resident reported feeling threatened and fearful after an interaction with a staff member described as the head of nurses, the staff member fitting that description (the Director of Nursing) was not suspended or ruled out as a possible alleged perpetrator at the outset of the investigation. The investigation report showed that the resident initially described the alleged perpetrator as a tall nurse and the head of nurses, which matched the Director of Nursing. Despite this, the Director of Nursing conducted a follow-up interview with the resident, during which the resident provided a different description. The Director of Nursing then ruled themselves out as the alleged perpetrator based on this new description and their claim of not being present during the alleged incident. There was no documentation that the Director of Nursing was suspended or excluded from the investigation process, as required by policy. Interviews with other staff confirmed their understanding that any staff member accused of making a resident feel threatened or afraid should be suspended pending investigation. Staff also identified the Director of Nursing as the head of nurses, matching the resident's initial description. The Executive Administrator stated that staff are expected to follow the facility's abuse and neglect policies, but the investigation did not reflect adherence to these procedures in this case.