Failure to Timely Report Suspected Abuse Incidents
Penalty
Summary
The facility failed to recognize and report suspected abuse within the required two-hour timeframe for two of three sampled residents. According to the facility's policy, all allegations of abuse, neglect, misappropriation of property, exploitation, injuries of unknown source, and suspected criminal acts must be reported to the appropriate authorities within the prescribed time frame. Record review showed that a CNA witnessed incidents where one resident was forced to sit on the toilet and was subsequently pushed by a CNA after the resident pushed the CNA. In another incident, a resident was rolled into a wall during a bedding change, resulting in knee discoloration. These incidents were reported to the administrator but not submitted to the state health department within the mandated two-hour window. Interviews with the DON and administrator confirmed the expectation for immediate reporting and the requirement to notify authorities within two hours.