Failure to Timely Report Alleged Resident-to-Resident Abuse
Penalty
Summary
The facility failed to report an allegation of physical abuse to the California Department of Public Health (CDPH) within the required two-hour timeframe after the allegation was made. A resident with moderate cognitive impairment and a history of osteomyelitis reported an altercation with his roommate, during which he claimed his arm was twisted and he was scratched, resulting in visible scabbed marks above his wrist. The incident was documented in a social service progress note, and the resident expressed feeling unsafe that night. The roommate confirmed there was a heated exchange but denied physical contact, while a Licensed Vocational Nurse (LVN) stated she was informed by the resident that he had been scratched and reported this to the RN Supervisor, instructing her to notify the DON. Despite the facility's policy requiring all alleged violations to be reported immediately, but no later than two hours after the allegation is made, the Social Service Director became aware of the incident approximately eleven hours after it occurred. The administrator confirmed that abuse allegations should be reported to CDPH within two hours, but this protocol was not followed in this case. The delay in reporting the incident constituted a failure to comply with regulatory requirements for timely reporting of suspected abuse.