Verbal Abuse of Cognitively Impaired Resident by CNA
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) verbally abused a male resident with vascular dementia, major depressive disorder, and generalized anxiety disorder. The resident, who had severe cognitive impairment and required assistance with activities of daily living, was observed by a surveyor as the CNA yelled at him in the hallway, telling him to do things himself and stating that no one else would help him. The CNA continued to raise his voice, disregarding a registered nurse's (RN) intervention to lower his tone, and justified his behavior as 'tough love.' The resident was observed holding his coffee cup, looking at staff, and displaying signs of emotional distress, such as looking down and having watery eyes. When interviewed, the resident confirmed through gestures and limited speech that the CNA's language and tone made him feel sad and embarrassed. Staff interviews revealed that the CNA had a history of being loud and had previously been told to tone down his behavior, but there were no prior reports or grievances of abuse from residents or staff. Other residents interviewed denied experiencing or witnessing similar behavior from the CNA. Facility records and staff interviews confirmed that the CNA's actions constituted verbal abuse, as defined by the facility's policies and resident rights statements. The incident was witnessed by multiple staff members, and the facility's documentation indicated that the CNA's conduct was not in accordance with the expected standards of respect and dignity for residents. The resident's care plan and medical history highlighted his vulnerability due to cognitive and communication deficits, further emphasizing the impact of the CNA's actions.