Resident Privacy Violated by Unauthorized Photograph During Care
Penalty
Summary
A deficiency occurred when a certified nurse aide used their personal cellphone to take a live photograph of a resident during incontinence care, capturing the resident's exposed buttocks without consent. The incident took place while two certified nurse aides were providing care and became overwhelmed by the odor, leading to gagging and laughter, which was then photographed by a third aide who entered the room. The photograph was subsequently shown to multiple staff members, some of whom confirmed that the resident was identifiable in the image, even though the face was not visible. The act was considered a violation of the resident's privacy and dignity, and staff interviews indicated that the presence of cellphones in resident care areas was a known concern. The resident involved had significant medical and psychological vulnerabilities, including diagnoses of dementia, major depressive disorder, anxiety disorder, and a history of traumatic abuse. The resident's care plan documented mood problems, anxiety, and a history of trauma, with interventions to monitor and support their emotional well-being. Staff and family interviews highlighted that the resident would have felt exposed, degraded, and potentially retraumatized if aware of the photograph, given their history and current cognitive state. Multiple staff members, including licensed nurses and aides, acknowledged that the incident constituted abuse and a serious breach of privacy. The incident was not immediately reported by staff, despite several being aware of the photograph and the Assistant Director of Nursing being present during its sharing. Staff interviews revealed a reluctance to report due to perceived supervisor awareness. The event was eventually brought to the attention of facility leadership, who confirmed through investigation that abuse had occurred. The deficiency centered on the failure to protect the resident from abuse facilitated by technology, as well as the lack of immediate reporting and intervention by staff who witnessed or were aware of the incident.