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F0610
D

Failure to Protect Resident from Alleged Abuse Following Inappropriate Photograph

Fort Dodge, Iowa Survey Completed on 09-10-2025

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

Facility staff failed to protect a vulnerable resident from an alleged abuser after becoming aware of a photograph taken of the resident by a staff member. The resident involved had moderately impaired decision-making abilities, required substantial to total assistance with activities of daily living, and had diagnoses including anemia, hypertension, traumatic brain injury, depression, and bipolar disorder. The photograph, which was shared on social media, depicted the resident in bed with an exposed peri area alongside a staff member. Despite being made aware of the photograph during the shift, staff allowed the alleged abuser to continue working their entire shift and to have contact with the resident and other vulnerable residents. The staff member who was informed of the incident, a Registered Nurse and CNA instructor, did not notify facility administration or take steps to separate the alleged abuser from residents. The staff member later acknowledged not following proper procedures, attributing the oversight to focusing on her role as an instructor rather than as a facility nurse. The facility's policy prohibits staff from taking or distributing photographs of residents in any manner that could demean or humiliate them, including sharing on social media. The failure to immediately report the incident and remove the alleged abuser from resident care resulted in a lapse in protecting residents from potential abuse, as required by facility policy and regulatory standards.

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