Failure to Timely Report Alleged Verbal Abuse to Authorities
Penalty
Summary
The facility failed to report an alleged incident of verbal abuse involving a certified nurse assistant (CNA) and a resident to the California Department of Public Health (CDPH) as required. The incident occurred when a resident, who had diagnoses including hypertension and legal blindness and was assessed as having the capacity to understand and make decisions, was involved in a verbal altercation with CNA 1 at the nurse's station. According to progress notes and interviews, both the resident and CNA 1 exchanged inappropriate language, and the resident alleged that CNA 1 yelled and made an unprofessional remark. Multiple staff members, including a registered nurse (RN 1) and a licensed vocational nurse (LVN 1), witnessed or were aware of the incident. Despite the facility's policy requiring immediate reporting of suspected abuse to supervisors and the appropriate authorities, the incident was not reported to the CDPH. RN 1, who witnessed the event, acknowledged that yelling at a resident could be considered abuse and recognized the need to file a Report of Suspected Dependent Adult/Elder Abuse (SOC 341), but only reported the incident to the incoming RN on the next shift. RN 2, the incoming RN, stated that no such report was made to him, and LVN 1 did not escalate the incident further, assuming the supervisor was already aware. The facility's policy clearly outlines the requirement for anyone witnessing suspected abuse to report it immediately to a supervisor and for the administrator or designee to submit a written report to the Licensing and Certification Program District Office. The failure to follow these procedures resulted in a delay in notifying the CDPH and investigating the alleged abuse, as the incident was not reported through the proper channels as required.