Failure to Protect Residents and Prevent Retaliation
Penalty
Summary
Staff interviews revealed that a male resident was observed wandering into female residents' rooms and engaging in inappropriate touching. Multiple staff members, including LPNs and CNAs, reported witnessing this behavior and having to redirect the male resident away from female residents. Staff also reported that families had inquired about the male resident entering their family members' rooms. Despite these observations and concerns, staff were instructed by facility management not to discuss the incidents, not to talk to families, and not to file grievances. Some staff reported being threatened with termination if they spoke about the situation or reported it. The Nursing Home Administrator and Director of Nursing confirmed that the facility failed to protect female residents from the male resident's wandering and inappropriate behavior. There were no grievances or investigations available to indicate that the facility was aware of or addressing the situation. Additionally, staff did not feel safe from retaliation, as they were threatened with termination if they discussed the incidents, filed grievances, or communicated with families about the male resident's behavior.