Failure to Protect Resident from Verbal Abuse During Incontinence Care
Penalty
Summary
A resident with a history of cerebrovascular disease, depression, dementia, and chronic kidney disease, who was dependent on staff for toileting hygiene and was always incontinent of bowel and bladder, was subjected to verbal abuse by a Geriatric Nursing Assistant (GNA) during incontinence care. The resident had intact cognition, as indicated by a BIMS score of 13, and was known to experience feelings of depression and low energy. The care plan documented the resident's dependence on staff for incontinence care and noted behavioral concerns related to depression and anxiety. The incident occurred when the resident's family member, while on the phone with the resident, overheard the GNA use inappropriate and expletive language directed at the resident during incontinence care. The GNA questioned the resident in a derogatory manner about their incontinence, which caused the resident to become embarrassed, upset, and cry. The resident later confirmed to the social worker that the GNA used inappropriate language and expletives during care, and this was corroborated by behavioral health notes documenting the resident's distress over the interaction. The GNA denied using inappropriate language but admitted to making comments about the resident's actions during care. Facility documentation, including interviews with the resident, family member, and staff, as well as behavioral health progress notes, confirmed that the resident experienced verbal abuse during care. The incident was substantiated by the facility, and the resident reported feeling embarrassed and upset as a result of the GNA's comments. The facility's policy stated zero tolerance for abuse, but the actions of the GNA failed to protect the resident from verbal abuse during a vulnerable moment.