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F0600
D

Failure to Protect Resident from Abuse During Care

Atlanta, Texas Survey Completed on 06-04-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure that a resident was free from abuse when a licensed vocational nurse (LVN) yanked the resident's left arm during care. The resident, an elderly female with diagnoses including parkinsonism, dementia with severe cognitive impairment, osteoarthritis, and chronic pain, required maximal assistance with activities of daily living. The incident was reported to have caused pain in the resident's left arm, which was already affected by chronic conditions, and was witnessed by another resident who described the action as abusive. Interviews and record reviews confirmed that the resident expressed feeling hurt and described the LVN as being mean and abusive, specifically mentioning repeated yanking of her left arm. The witness corroborated the account, stating that the LVN yanked the resident's arm in an abusive manner while administering pain medication. The resident reported ongoing pain in her arm following the incident, although she acknowledged pre-existing pain in that area. The facility's documentation included an incident report and a subsequent x-ray, which did not reveal acute injury but did confirm severe osteoarthritis in the affected shoulder. Staff interviews revealed differing perspectives on the incident, with the LVN denying any intent to harm and stating she was careful due to the resident's known pain. Facility leadership acknowledged the resident's sensitivity to her shoulder and noted that the witness supported the resident's account. The facility's abuse prevention policy requires protection of residents from all forms of abuse, but the actions described in the report indicate a failure to uphold this standard for the resident involved.

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