Failure to Investigate Alleged Neglect After Resident Fall
Penalty
Summary
The facility failed to provide evidence of a thorough investigation into an allegation of neglect involving a resident who reported being left on the floor for an hour after a fall. The facility did not complete documentation of the resident's grievance, nor did they interview the resident or her roommate, resulting in an incomplete and inaccurate investigation. Additionally, the facility did not identify the alleged perpetrators or submit the required PB22 documents to the state agency. The investigation was further compromised by the facility's failure to implement a previously issued plan of correction related to ensuring residents are free from abuse and neglect. During interviews, the resident identified the staff members involved, including the DON and two nurse assistants. The lack of a thorough investigation prevented the facility from properly addressing and correcting the alleged neglect.