Failure to Protect Resident from Physical Abuse by CNA
Penalty
Summary
A deficiency occurred when a resident with Alzheimer's disease and cognitive communication deficits was not protected from physical abuse by a CNA. The resident, who was ambulatory and required standby assistance for ADLs, approached the CNA multiple times requesting to use the phone. The CNA, who was eating and taking medication at the time, became agitated and engaged in a confrontation with the resident. According to a witness, the CNA stood up, got in the resident's face, and pushed her, causing the resident to fall and sustain a head injury and contusion to her forehead. The resident was assessed by nursing staff, found to have a large hematoma, and was sent to the hospital for evaluation, where a CT scan revealed no intracranial abnormalities but confirmed a head injury and contusion. The incident was witnessed by another CNA, who provided a written and verbal statement that the CNA had pushed the resident with both hands, causing her to fall. The resident herself initially stated she was pushed and pointed to the CNA as the perpetrator. The involved CNA denied pushing the resident, claiming the fall was accidental and that the resident lost her footing. However, the witness's account was consistent and detailed, describing the CNA's actions as deliberate and not accidental. The police were notified, and an investigation was conducted, including interviews with staff, the resident, and family members. The facility's records indicated that the CNA had no prior history of abuse or complaints and had passed all required background checks. The resident's care plan included interventions for her cognitive deficits, such as using simple, directive sentences and providing consistent caregivers. Despite these interventions, the CNA failed to follow appropriate behavioral management strategies and instead engaged in a physical altercation with the resident, resulting in harm. The incident was confirmed as abuse based on the investigation and witness statements.