Staff-to-Resident Physical Abuse Resulting in Fall and Emotional Distress
Penalty
Summary
A staff-to-resident physical abuse incident occurred involving a resident with severe cognitive impairment, including frontotemporal neurocognitive disorder and aphasia, who was known to have potential for physical aggression when redirected. The resident was observed attempting to remove a Christmas decoration from the wall when a Certified Nurse Aide (CNA) intervened by physically removing the resident's hands from the decoration. The resident attempted to strike the CNA, who blocked the attempts and then placed his hand on the resident's abdomen and chest, ultimately making contact with the resident's upper chest/shoulder area in a forward rocking motion. This action caused the resident to lose balance and fall to the floor, coming to rest on his right side. The care plan for the resident specified interventions for managing agitation and aggression, including de-escalation techniques, providing distractions, allowing independence, and walking away if the resident became aggressive. The CNA did not follow these interventions and instead used physical contact, which was not in accordance with the care plan. The incident was initially not identified as abuse, but upon review of video footage, concerns for abuse were noted. The facility's policy prohibits any form of abuse, including physical abuse, and defines such actions as likely to cause psychosocial harm.