Failure to Prevent Resident-to-Resident Abuse
Penalty
Summary
A deficiency occurred when a resident with severe cognitive impairment and dementia was touched in the groin area by another resident during a facility activity. The incident was witnessed by an Activity Assistant, who observed one resident using his left hand to touch the lap near the groin area of the other resident. The staff member immediately intervened and separated the two residents. The resident who was touched had a history of cognitive communication deficit and dementia, with a Brief Interview of Mental Status (BIMS) score indicating severe cognitive impairment. The resident who initiated the contact had diagnoses of aphasia and hemiplegia, but was assessed as having intact cognition. The facility's policy prohibits any form of resident abuse, neglect, or mistreatment, but this policy was not upheld in this instance.