Failure to Timely Report Allegation of Abuse
Penalty
Summary
The facility failed to ensure that an allegation of possible abuse involving a resident was reported immediately to management and within two hours to the State Survey Agency, as required by both facility policy and federal regulations. The incident involved a resident with a history of depression, anxiety, delusions, and hallucinations, who reported to an LPN that someone had come into their room to rape them. The LPN documented the resident's statement and provided reassurance but did not notify supervisory staff or report the allegation as required. The resident's care plan was updated to reflect the statement, but there was no documentation of immediate notifications related to the allegation. The delay in reporting was identified when a nurse on a subsequent shift reviewed the previous note and notified the DON, who then initiated an investigation. The facility ultimately reported the allegation to the State Survey Agency more than 30 hours after the initial statement was made by the resident. Interviews with staff confirmed that they were aware of the requirement to report allegations of abuse immediately to supervisors and to the state within two hours, but the LPN did not follow these procedures because the resident did not name anyone and had a history of delusions. The failure to report the allegation in a timely manner constituted a deficiency in the facility's abuse reporting protocol.