Failure to Investigate Alleged Abuse and Neglect
Penalty
Summary
The facility failed to investigate incidents of possible abuse and neglect involving one resident. According to facility policy, staff are required to assess, document, and investigate all alleged abuse and neglect, including interviewing witnesses and other relevant individuals. In this case, a resident reported that a nurse entered her room and performed a blood glucose finger stick while she was sleeping on two occasions. The Director of Nursing confirmed that the incident occurred, but the facility did not conduct a full investigation as required by policy. Specifically, the facility did not interview the accused employee, any possible witnesses, other staff members present, or other residents who may have received care from the same employee. The resident involved had diagnoses including diabetes, obesity, and high blood pressure, and was re-admitted to the facility prior to the incident. The failure to follow investigative procedures was confirmed by both the Director of Nursing and the Nursing Home Administrator.