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F0609
D

Failure to Timely Report Abuse Allegation to State Agency

Racine, Wisconsin Survey Completed on 05-30-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to provide evidence that an initial report of an abuse allegation was submitted to the State Survey Agency (SA) within the required two-hour timeframe for one of two residents reviewed for abuse. According to the facility's policy, all alleged violations involving abuse or serious bodily harm must be reported immediately, but not later than two hours after discovery. In this case, a resident alleged that a Certified Nurse Aide (CNA) refused to assist her to bed and was mean to her. The facility's documentation included a printed Misconduct Incident Report with the incident details, but the report was marked as a draft, and critical sections such as "Report Submitted BY" and "Report Submitted Date" were left blank. There was no documentation to confirm the actual date and time the report was submitted to the SA. During interviews, the Administrator referenced the Incident ID on the report as evidence of submission, but the absence of a submission date and time meant there was no verifiable proof that the abuse allegation was reported within the required two-hour window. The lack of proper documentation and timely reporting had the potential to delay corrective measures and appropriate responses to the abuse allegation, as required by facility policy and regulatory standards.

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