Failure to Timely Report Alleged Abuse to Authorities
Penalty
Summary
The facility failed to ensure that all alleged violations involving abuse, neglect, exploitation, or mistreatment were reported immediately, but not later than two hours after the allegation was made, as required by federal regulations. Specifically, a resident with a history of schizophrenia, anxiety, schizoaffective disorder, and substance abuse reported to the admission coordinator that an unidentified CNA was verbally and physically aggressive and that he feared for his safety. The admission coordinator did not immediately report this allegation to the abuse coordinator or the administrator. Record review showed that the resident was cognitively intact and able to make himself understood. The resident alleged that a CNA entered his room, was yelling, being aggressive, would not let him call the police, and yanked the phone out of his hand. The incident was documented in a grievance/complaint report by the admission coordinator, but the administrator and DON were not designated to investigate until the following day. The facility did not report the allegation to the state agency until more than two hours after the admission coordinator was informed, which was outside the required reporting timeframe. Interviews with facility staff confirmed that the admission coordinator received the allegation but did not recall the exact time and did not immediately report it, despite being trained on abuse and reporting requirements. The administrator acknowledged that the delay in reporting placed residents at risk. The facility's own policies required immediate reporting of suspected abuse to the administrator and authorities, but these procedures were not followed in this instance.