Verbal Abuse of Resident by CNA on Dementia Unit
Penalty
Summary
A deficiency occurred when a certified nurse assistant (CNA) used derogatory and abusive language toward a resident on the dementia care unit. The resident, who had diagnoses including schizophrenia and unspecified dementia, was dependent on staff for personal hygiene and required substantial to maximal assistance for mobility. The resident's care plan indicated behavioral symptoms and recommended a calm, slow, and understandable approach, but did not document any history of aggressive behaviors toward staff, aside from occasional refusal of medications. On the day of the incident, the CNA attempted to change the resident's incontinence brief. The resident yelled and refused care, at which point the CNA responded with loud, harsh, and profane language directed at the resident, including calling the resident a "fucking bitch" and a "fucking witch." These actions were witnessed by two other CNAs, who reported that the CNA continued to use abusive language even after the resident was on the floor by the bed. The resident did not appear hurt, but was visibly distressed and accused the CNA of being a "monster" and causing harm. Interviews with staff confirmed that the CNA's behavior was considered verbal abuse and that the resident did not typically display aggression toward staff. The CNA involved had previously been counseled for speaking gruffly to others, and both staff and residents had made complaints about the CNA's demeanor in the past. The incident was reported to the administrator, who initiated an investigation after receiving written statements from the witnesses.