Failure to Prevent Resident Abuse by Staff
Penalty
Summary
The facility failed to protect residents from abuse, as evidenced by two substantiated incidents involving staff members. In the first incident, a geriatric nursing assistant (GNA) engaged in verbally abusive behavior toward a resident, including yelling and using inappropriate language while providing care. This was corroborated by the resident's roommate's family member, who overheard the GNA's remarks and described escalating verbal aggression when the resident asked the GNA to stop. The facility's investigation confirmed the verbal abuse based on statements from those involved. In the second incident, another GNA was observed forcibly taking tea bags from a resident's hands, resulting in a tugging motion that the resident described as forceful enough to potentially pull them from their chair. The resident, who was cognitively intact with a BIMS score of 15, reported increased pain and weakness in their hands and arms following the incident, with a pain score of 9 out of 10 documented later that day. The incident was substantiated based on the resident's and a witness GNA's statements.