Failure to Protect Resident from Verbal Abuse by CNA
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) engaged in verbal abuse toward a resident who had multiple complex medical conditions, including cerebral infarction, stroke, peripheral vascular disease, diabetes, heart disease, COPD, kidney failure, and dementia with behavioral disturbances. The resident was cognitively intact, required partial to moderate assistance with mobility and transfers, and had documented impairments in range of motion. The incident took place when the CNA entered the resident's room and used loud, profane, and derogatory language, instructing the resident to get up off the floor and onto the bed in a manner that was both forceful and inappropriate. The CNA's statements included explicit language and commands, and the interaction was captured on video by the resident's family, who had installed a camera in the room. The CNA admitted to making inappropriate comments out of frustration, acknowledging that her language and behavior were not suitable while caring for the resident. The video evidence confirmed that the CNA used profane language and spoke loudly and disparagingly in the presence of the resident. Although the resident did not report feeling disrespected or abused during subsequent interviews, the CNA's conduct met the facility's definition of verbal abuse, which includes the use of oral or gestured communication that is disparaging or derogatory, regardless of the resident's perception or response. The incident was initially discovered by the resident's family, who shared the video with facility administration. The investigation revealed that the CNA had been allowed to return to work after an initial suspension, and the full extent of the incident was not immediately recognized by all facility leadership. The Director of Nursing (DON) and former administrator did not view the complete video until later, and the investigation was not thoroughly conducted at first. The deficiency was cited based on the failure to protect the resident's right to be free from verbal abuse by a staff member.