Failure to Investigate and Resolve Resident Grievance
Penalty
Summary
The facility failed to investigate and resolve a grievance reported by the responsible party (RP) of a resident with severe cognitive impairment. The RP reported the theft of the resident's phone charger to the Assistant Director of Nursing (ADON) during a visit. Despite this report, there was no follow-up or investigation conducted by the facility, and the grievance was not documented in the facility's grievance or complaint logs. The ADON confirmed that the grievance was reported to her and acknowledged that she did not follow up with the RP or initiate an investigation. The resident involved had a history of schizophrenia, chronic kidney disease, depression, anxiety, dysphagia, and schizoaffective disorder, and was assessed as having severely impaired cognition. The facility's grievance policy required prompt investigation and resolution of grievances, including documentation and follow-up with the complainant. However, these procedures were not followed in this instance, resulting in the grievance not being addressed according to policy.