Failure to Investigate Alleged Abuse Incident
Penalty
Summary
The facility failed to investigate a potential allegation of abuse involving a resident with dementia and diabetes mellitus, who was assessed as having moderate cognitive impairment but was independent in most activities of daily living. On the date in question, the resident reported to the Director of Social Services that a nurse entered their room, threw a shopping bag at them, and yelled, which left the resident upset and angry. The grievance was documented, and the Director of Social Services met with both the resident and the nurse, resulting in an apology from the nurse. The grievance form was signed by both the Director of Social Services and the Administrator. Despite the facility's policy requiring immediate and thorough investigation of any complaint, observation, or suspicion of abuse, including interviews and written statements from all involved parties, no further investigation or documentation was completed beyond the initial grievance form. The Administrator stated that he did not consider the incident to be potential abuse, viewing it instead as a customer service issue, and therefore did not suspend the nurse or initiate a formal investigation as outlined in facility policy.