Failure to Conduct Thorough Abuse Investigation
Penalty
Summary
The facility failed to conduct a thorough investigation into an allegation of physical abuse involving one resident. According to the facility's policy, all allegations of abuse, neglect, and mistreatment are to be investigated in a timely and objective manner. Documentation showed that a resident with intact cognition reported to the activities director that a staff member had slapped them. The incident was reported to the state health department, but the facility's investigation records did not include interviews with staff or other residents regarding the alleged abuse at the time it was reported. Further review revealed that the investigation materials provided by the administrator only included interviews conducted much later, and not around the time of the incident. The administrator acknowledged that, at the time of the investigation, they were new to the organization and had not received training on the abuse investigation process. As a result, the investigation did not include essential steps such as interviewing relevant staff and residents or addressing concerns about the alleged perpetrator.