Failure to Protect Resident from Physical Abuse by CNA
Penalty
Summary
A deficiency occurred when a Certified Nursing Assistant (CNA) hit a resident on the arm while attempting to assist with putting on a grip sock. The incident was directly observed by a surveyor, who noted that the resident, seated in a wheelchair and exhibiting signs of distress, began to flail their arms during the interaction. The CNA responded by slapping the resident's left forearm, which produced an audible sound and resulted in the resident displaying a scared and distressed facial expression. The resident, who has severe cognitive impairment, dementia, and anxiety disorder, was unable to effectively communicate their needs and had a documented history of behavioral symptoms and rejection of care. However, the care plan in place did not address these behavioral symptoms or provide interventions for managing rejection of care. The facility's abuse/neglect policy requires immediate reporting and investigation of suspected abuse, but the incident was only brought to the attention of staff after the surveyor intervened. The CNA denied slapping the resident, claiming instead that they were attempting to release the resident's grip. The resident was assessed and found to have no physical injuries and did not display ongoing signs of fear or mental anguish. Interviews with facility leadership confirmed that slapping a resident is not appropriate and that staff are expected to step away and re-approach residents who become combative during care.