CNA Strikes Resident During Care in Response to Aggressive Behavior
Penalty
Summary
A deficiency occurred when a Certified Nursing Assistant (CNA) physically struck a resident during care. The resident, who had diagnoses including dementia, encephalopathy, hypertension, diabetes mellitus, and end stage renal disease, exhibited impaired cognition and required assistance with mobility, transfers, bathing, and feeding. The resident had a documented history of increased agitation and aggressive behaviors, such as hitting and kicking staff during care. On the date of the incident, the CNA was assisting the resident during breakfast when the resident became combative, swinging her arms and attempting to kick and bite the CNA. In response, the CNA held down the resident's arms and, when the resident attempted to bite, struck the resident in the face with an open hand to push her head back. Multiple interviews corroborated the incident, including statements from another resident and a CNA who witnessed the event. The CNA involved admitted to striking the resident, describing it as a knee-jerk reaction to the attempted bite. Review of the facility's Abuse Prevention Program Policy & Procedure confirmed that striking a resident is not acceptable under any circumstances, regardless of intent or whether the action was reflexive. The policy explicitly states that retaliation by staff is considered abuse and is not permitted.