Failure to Protect Resident from Further Potential Abuse
Penalty
Summary
The facility failed to protect a resident from further potential abuse after the resident alleged that a night shift CNA had thrown her against the wall while assisting her to bed, causing her to hit the left side of her head. The resident reported the incident to multiple staff members, including a hospice RN, an LPN, and another CNA. Despite these reports, the alleged perpetrator, identified by the resident as a night shift CNA (though the name used was not found on the staff roster), continued to work primarily as the resident's CNA until resigning from the facility. The facility did not suspend the alleged perpetrator pending investigation, nor did they implement protective measures such as increased supervision or staffing changes as outlined in their abuse prevention policy. Multiple staff members failed to report the resident's allegations to facility administration as required. The hospice RN stated she reported the allegation to the ADON, who denied receiving it, and another CNA admitted to not reporting the allegation at all. The facility's policy requires immediate action to protect residents from further harm during abuse investigations, including examining the alleged victim and making staffing changes if necessary. However, these steps were not taken, and the alleged perpetrator remained in contact with the resident until her resignation.