Failure to Protect Resident from Verbal Abuse by CNA
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) engaged in verbally abusive behavior toward a male resident with a history of psychotic and mood disturbances, anxiety, dementia, and other medical conditions. The incident began when the resident, who was cognitively intact according to his most recent assessment, used a racial slur toward the CNA. In response, the CNA pointed her finger close to the resident's face, made racially charged and derogatory remarks, threatened to remove the resident's refrigerator, and turned off the lights in the resident's room, telling him to "stay in the dark." The interaction was captured on a camera in the resident's room, and the resident's family was alerted to the commotion via a motion notification from the camera. The resident's care plan documented his communication difficulties, occasional resistance to care, and a history of unwanted behaviors, including aggression and use of inappropriate language. Despite these challenges, the care plan included interventions such as using simple language, allowing time for responses, and providing choices during care. On the day of the incident, the CNA did not follow these interventions and instead escalated the situation by responding to the resident's verbal aggression with her own verbal abuse and intimidation. The incident was witnessed by another CNA, who confirmed the resident's use of a racial slur but did not recall threatening or disrespectful language from the CNA involved, although video evidence and interviews contradicted this account. Following the incident, the resident was assessed and found to have no physical injuries or signs of emotional distress, and he later reported that while the CNA's behavior did not make him sad or angry, he did not feel good about the interaction. The CNA involved refused to provide a statement and left the facility, effectively self-terminating her employment. The facility's policies on resident rights and abuse prohibit such behavior, defining verbal abuse as the use of disparaging or derogatory terms within a resident's hearing, regardless of their ability to comprehend. The actions of the CNA were found to be in violation of these policies, constituting a failure to protect the resident from abuse.