Failure to Timely Report Alleged Abuse to Law Enforcement
Penalty
Summary
The facility failed to develop and/or implement policies and procedures to ensure the timely reporting of a reasonable suspicion of a crime, specifically regarding an allegation of physical abuse involving a resident. Upon admission, the resident presented with a bruise and reported anxiety related to a neighbor who consumed alcohol. Documentation indicated that the resident attributed the bruise to this neighbor and expressed concerns about safety. Staff interviews and clinical notes confirmed that the allegation of abuse was reported internally, and the executive director was notified. However, there was no evidence that law enforcement was notified of the allegation, as required by facility policy, despite the policy mandating immediate reporting to law enforcement and other authorities. The investigation revealed that the facility reported the allegation to Adult Protective Services (APS) and the Ombudsman several days after the initial report, and the Department of Health Services (DHS) was notified via an online portal. However, review of facility documentation and the DHS complaint portal showed no evidence that the incident was reported to DHS on the date of the alleged incident. Staff interviews indicated confusion and uncertainty regarding whether law enforcement had been contacted, with some staff believing it had been done and others unable to confirm. The executive director ultimately decided not to contact law enforcement, reasoning that the incident occurred outside the facility and emergency services had already been involved. Throughout the period when the allegation was considered valid, the facility operated under the assumption that abuse had occurred, yet failed to follow its own policy requiring immediate notification of law enforcement. The care plan for the resident was not updated to reflect the risk or interventions related to the abuse allegation until several days after admission. The facility's policies clearly required immediate reporting to law enforcement and other authorities, but these procedures were not followed in this case, resulting in a deficiency related to the timely and appropriate reporting of suspected abuse.