Resident Rights Violated During Medication Administration
Penalty
Summary
A deficiency occurred when a Licensed Practical Nurse (LPN) administered medication to a resident with severe cognitive impairment and a history of acute respiratory failure, dementia, and cerebrovascular disease. During the medication administration, the LPN placed his hand over the resident's mouth and pinched the resident's nose to prevent the resident from spitting out the medication. This act was witnessed by a Certified Nursing Assistant (CNA), who observed the resident's face turning red and the resident struggling and moving their head from side to side in response to the force used by the LPN. The CNA considered the LPN's actions to be abusive and left the room to report the incident. Interviews with other staff members, including additional LPNs, the Unit Manager, the Social Worker, and the Director of Nursing (DON), confirmed that the resident had the right to refuse medication and that placing a hand over a resident's mouth to force medication was improper, could be considered abuse, and posed a risk of aspiration. The facility's own policies on medication administration and the Resident Bill of Rights explicitly state that residents have the right to refuse treatment and must not be subjected to coercion or force. Despite this, the LPN admitted to placing his hand over the resident's mouth to prevent the medication from being spit out, acknowledging that this was not appropriate and that the resident should have been allowed to refuse the medication. Following the incident, it was revealed that the LPN was suspended but returned to work without direct monitoring or oversight. There was no evidence that the facility took steps to ensure that the LPN did not repeat this behavior with other residents during medication administration. The lack of immediate and ongoing supervision after the incident, combined with the failure to protect the resident's right to refuse care, led to the citation of Immediate Jeopardy under F578 for violation of resident rights.