Physical Abuse of Cognitively Impaired Resident by CNA
Penalty
Summary
A deficiency occurred when a certified nurse assistant (CNA) physically abused a resident by forcefully and aggressively pushing the resident's face back into a wheelchair. This incident was directly witnessed by two student nurses, who observed the CNA using his whole hand to push the resident's face, resulting in a whiplash motion. The CNA appeared frustrated while repositioning the resident, who repeatedly leaned forward in the wheelchair. The student nurses were disturbed by the event and later reported it to facility leadership. The resident involved had a history of dementia and post-traumatic stress disorder (PTSD), was totally dependent on staff for activities of daily living, and was severely cognitively impaired, as indicated by a Brief Interview of Mental Status (BIMS) score of 0 out of 15. The resident was unable to verbalize needs and exhibited tremors. Staff interviews confirmed that the resident required two-person assistance for safe repositioning and that the CNA's method of handling was inappropriate and could have caused harm. Interviews with facility leadership, including the administrator and director of nursing, confirmed that the CNA's actions were considered abusive and demeaning. The administrator noted that the CNA had previously been investigated for suspected physical abuse, though it was unsubstantiated at that time. The facility's policy emphasized the right of residents to be free from abuse and the importance of maintaining a culture of compassion, particularly for those with cognitive or behavioral issues.