Resident Subjected to Verbal and Emotional Abuse During Toileting Assistance
Penalty
Summary
Facility staff failed to protect a resident from verbal and emotional abuse during a toileting episode involving two staff members. Certified Nurse Aide (CNA) B repeatedly demanded that the resident perform toileting tasks independently, despite the resident's inability to do so. CNA B used aggressive language, telling the resident to turn around and sit on the toilet, and expressed frustration about the time being spent with the resident. The resident, who was cognitively intact but diagnosed with dementia and obsessive-compulsive disorder, required substantial to maximum assistance for toileting according to the Minimum Data Set (MDS) assessment. During the incident, CNA B forcefully grabbed the resident under the right arm and jerked the resident up to a standing position without the use of a gait belt, which is contrary to safe transfer practices. CNA B continued to use demanding and inappropriate language, stating that they could not spend more time with the resident and that the resident was not cooperating. The interaction was witnessed by another nurse aide (NA C), who confirmed that CNA B became rude and demanding, and by the resident's family, who recorded the incident on video. The deficiency was identified after the resident's family reviewed the video footage and reported the incident to facility staff. The video and subsequent interviews confirmed that CNA B's actions and communication were verbally and emotionally abusive, and that the resident was not provided with the necessary assistance for toileting as required by their care plan and assessment.