Failure to Investigate Alleged Abuse Thoroughly
Penalty
Summary
The facility failed to thoroughly investigate an allegation of abuse involving a resident who reported being struck by a television remote control thrown by his roommate, as well as being hit by a privacy curtain. The resident, who had a tracheostomy and was cognitively intact, communicated the incident to the nurse manager and expressed a desire for police involvement. Despite this, there was no documentation of the incident in the resident's medical record, and the facility did not obtain statements from either the resident or his roommate at the time of the incident. The initial response from staff included a witness statement from a registered nurse who did not observe the incident but concluded it was accidental after speaking with both residents. The administrator was aware of the incident but did not conduct a thorough investigation or collect direct statements from those involved. The facility's policy required immediate reporting and a detailed investigation of alleged abuse, but these procedures were not followed in this case. The delay in reporting the incident to authorities and the lack of proper documentation and investigation were evident. The administrator only reported the incident to the state agency and law enforcement several days after it occurred, and only after being prompted by the surveyor. The resident continued to express distress about the incident and the facility's handling of his concerns.