Failure to Timely Report Suspected Abuse, Neglect, or Theft
Penalty
Summary
Facility staff failed to report incidents of suspected abuse, neglect, or theft within required timeframes for multiple residents. In one case, a resident was lowered to the floor by a staff member, but the incident was not documented or reported as a fall. The resident's responsible party was not notified until the resident was sent to the hospital days later with a hip fracture. There were no nursing notes or investigation conducted immediately after the incident, and the staff member involved did not report the event, believing it did not constitute a fall. In another instance, a resident reported possible sexual abuse to a family member, who then informed facility staff. However, the facility did not report the allegation to the state agency within the mandated two-hour window after becoming aware of it. Additional deficiencies included a delay in reporting an allegation of neglect involving another resident, where the facility was aware of the situation but did not notify the state agency until several days later, following a formal grievance by the family. In a separate case, a staff member observed a resident in distress and exhibiting unusual behavior suggestive of possible abuse but did not immediately report this to a nurse or supervisor. The facility's investigation later noted that such behavior was considered baseline for the resident, but there was no evidence of timely reporting or documentation at the time of the incident.