Verbal and Mental Abuse of Cognitively Impaired Resident by CNA
Penalty
Summary
A deficiency occurred when a certified nurse aide (CNA) verbally and mentally abused a resident with severe cognitive impairment and urinary incontinence. The resident, who had diagnoses including encephalopathy, obstructive hydrocephalus, and intracerebral hemorrhage, was observed urinating on themselves and their surroundings. The CNA, appearing frustrated, loudly expressed annoyance in the hallway and then entered the resident's room, yelling at the resident in a harsh, demeaning tone and threatening that the resident would be moved to another floor. The CNA's language and demeanor were hostile, impatient, and dismissive, and the incident was witnessed by another CNA and later reported to the social worker and nursing supervisor. Following the encounter, the resident became tearful, appeared saddened, and communicated that they did not like being yelled at by staff. Interviews with staff, including the CNA involved, other CNAs, the social worker, nursing supervisors, and the administrator, confirmed that the CNA's actions constituted verbal and mental abuse. Staff acknowledged that the resident could not control their incontinence due to their medical condition and that the CNA's behavior was inappropriate and could cause psychosocial harm. The facility's policy prohibits such mistreatment, and the incident was recognized as a violation of resident rights to dignity and respect. The investigation concluded that there was reasonable cause to believe that abuse had occurred, as the CNA's actions met the definitions of verbal and mental abuse outlined in facility policy. The incident was reported to the appropriate personnel, and the resident was monitored for psychosocial effects. The deficiency was determined to have caused psychosocial harm to the resident, as evidenced by their emotional response and statements following the event.