Failure to Timely Report, Investigate, and Protect Resident Following Abuse Allegation
Penalty
Summary
The facility failed to follow its abuse prevention policy in the case of one resident with a history of mental illness and prior abuse. After the resident returned from the hospital and made an allegation of assault against a staff member, the required immediate reporting to the administrator and to the Department of Public Health was not completed within the policy's specified timeframe. The administrator was notified via text message by the LPN, but did not respond, and the nurse did not follow up with a phone call as required. The administrator did not initiate the investigation or report the allegation to the state agency until the following day, missing the two-hour reporting window outlined in the facility's policy. Additionally, the staff member accused of abuse continued to have contact with the resident after the allegation was made, contrary to the policy that requires immediate removal of the accused from resident contact pending investigation. The administrator did not interview the resident about the incident, and the LPN did not gather further details from the resident. The initial and final abuse investigation reports were not sent to the state agency until days after the incident, further demonstrating a failure to follow established procedures for timely reporting, investigation, and protection of the resident during the investigation process.