Resident-to-Resident Physical Abuse Resulting in Jaw Fracture
Penalty
Summary
A deficiency occurred when a resident with schizoaffective disorder and severe cognitive impairment physically assaulted another resident, resulting in a fractured jaw. The incident began when the cognitively intact resident, who also had schizoaffective disorder and anoxic brain damage, grabbed the arm of a CNA. The first resident, who was walking with the CNA, told the other to let go, but when the request was ignored, the first resident kicked and punched the other in the jaw, causing the resident to fall and sustain a fracture to the mandible. Multiple staff and resident interviews confirmed that the altercation involved deliberate physical contact, including kicking and punching, after an attempt to remove the resident's hand from the CNA's arm. The assaulted resident was sent to the emergency room, where an x-ray confirmed a fracture to the left jaw. The incident was witnessed by several staff members, including CNAs and an LPN, who described the sequence of events leading to the injury. Facility records and interviews with the DON, ADON, NP, and Administrator all acknowledged that the event constituted abuse as defined by facility policy and regulatory standards. The facility's abuse prevention policy specifically prohibits abuse by anyone, including other residents, and defines physical abuse as willful infliction of injury. The investigation substantiated that the physical altercation met the criteria for abuse, resulting in harm to the resident.