Resident Restrained with Improper Use of Sheet and Clothing
Penalty
Summary
A deficiency occurred when a resident was found seated in a wheelchair with a sheet tied around their waist and secured in a double knot, and wearing johnny pants applied backwards with the ties also secured in a double knot. These actions were performed by a Certified Nurse's Assistant (CNA) who stated that the interventions were intended to deter the resident from accessing and removing their brief, as the resident had a history of shredding and removing it. The CNA admitted to tying the sheet and securing the clothing in this manner because a belt was not available, and confirmed that these interventions were not part of the resident's care plan. The facility's restraint use policy prohibits the use of physical restraints for discipline or convenience and specifies that fastening fabric or clothing to restrict a resident's movement meets the definition of a physical restraint. The CNA acknowledged having received training on abuse, neglect, restraints, and resident rights, but did not recognize the actions as inappropriate. The facility's internal investigation determined that the resident's rights were violated, and the actions constituted both the use of a restraint and resident abuse.