Failure to Immediately Report Alleged Abuse to State Agency and Administrator
Penalty
Summary
The facility failed to implement its Abuse Prevention Policy by not immediately reporting an allegation of resident abuse to the State Agency and the Administrator. A cognitively intact resident reported that about a month prior, a CNA threatened to throw a trash can at them and used abusive language. The resident stated they reported the incident to the prior DON, who allegedly terminated the CNA for abuse. However, there was no documentation in the resident's electronic health record or the facility's abuse investigations indicating that the administrator or the State Agency was notified of the allegation, as required by facility policy. Interviews with facility staff confirmed that the required reporting did not occur. The Administrator-in-Training stated they were on leave at the time, and the Regional Director confirmed that the prior DON did not report the allegation as mandated. The facility's policy requires immediate internal and external reporting of abuse allegations, but this process was not followed in this instance.