Resident Barricaded in Bed Constitutes Involuntary Seclusion
Penalty
Summary
A resident with severe cognitive impairment, metabolic encephalopathy, and a history of falls was admitted to the facility and required maximal assistance with transfers. The resident's care plan included interventions such as using simple words, reinforcing the need to call for assistance, and providing assistance with activities of daily living. During the early morning hours, the resident became confused, attempted to get out of bed, and was yelling for their spouse. Staff reports and witness statements indicated that an LPN responded to the situation by verbally expressing frustration toward the resident and then physically arranged furniture and wheelchairs around the resident's bed, effectively blocking the resident from exiting the bed. Multiple staff members, including a nursing assistant and an RN supervisor, observed that the LPN had placed two wheelchairs and a nightstand against the sides of the resident's bed, with both quarter side rails raised, creating a physical barrier that confined the resident to the bed. The LPN later acknowledged that these actions prevented the resident from getting out of bed and admitted awareness that such measures could be considered involuntary seclusion or a restraint. The LPN did not attempt alternative interventions, such as getting the resident out of bed or contacting the physician, and believed the situation was being handled appropriately. Facility documentation and staff interviews confirmed that the resident was involuntarily secluded by being barricaded in bed with furniture and wheelchairs. The incident was witnessed by staff and reported to supervisory personnel, who subsequently removed the barriers. The facility's policies explicitly prohibit involuntary seclusion, including confining a resident by blocking exits with furniture, and the incident was substantiated as a violation of these policies.