Failure to Protect Resident from Verbal Abuse by Staff
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) was observed standing over a male resident with severe cognitive impairment, loudly talking and telling the resident, "you tripping," in response to the resident's statements. The resident, who had a history of cerebral infarction, ataxia, osteoporosis, hypertension, and radiculopathy, was wheelchair-bound and required varying levels of assistance with activities of daily living. The resident's care plan noted communication deficits, impaired cognitive function, and short-term memory loss, with interventions including task segmentation, cueing, reorientation, and supervision. Multiple staff members witnessed or were aware of the incident. One CNA overheard the loud and demeaning manner in which the CNA spoke to the resident, removed the resident from the situation, and informed the nurse. A licensed vocational nurse (LVN) also overheard the CNA speaking condescendingly and intervened by asking the CNA to clock out and leave, then notified the Abuse Coordinator. Written statements from these staff members corroborated the observations of patronizing and demeaning language directed at the resident. Interviews with the resident and his family revealed that neither recalled the incident or reported feeling unsafe, and the family had not observed any changes in the resident's mood or behavior. However, the facility's policy requires that residents be free from abuse, mistreatment, and neglect, and the actions of the CNA were inconsistent with this policy. The deficiency was identified based on staff observations and statements, as well as a review of the resident's records and care plan.