Failure to Revise Care Plan After Resident Abuse Allegation
Penalty
Summary
The facility failed to revise and update the care plan for a resident following an allegation of physical abuse by another resident. Despite the resident reporting emotional distress, fear, and flashbacks after being physically assaulted in his room, there was no evidence in the care plan that his psychosocial needs were assessed or addressed. The resident expressed feeling unsafe and reported keeping scissors under his pillow for self-protection, but the care plan only reflected previous behavioral concerns related to medication management and did not include interventions or measurable objectives to address his psychological well-being after the incident. Interviews with the resident and review of medical records confirmed that the resident was cognitively intact and able to communicate his experiences and feelings. Documentation from a nurse practitioner indicated that the resident was emotionally upset and fearful following the incident, yet no follow-up or support was provided by staff to address his mental and emotional health. The facility's policy required comprehensive, person-centered care plans that address all identified needs, including psychological needs, but this was not implemented for the resident after the reported abuse.