Failure to Protect Resident from Verbal Abuse by Staff
Penalty
Summary
A deficiency occurred when a resident with cognitive impairment and multiple psychiatric diagnoses, including dementia, anxiety, bipolar disorder, and schizophrenia, was subjected to verbal abuse by a staff member. The resident, who had a history of yelling behaviors, began screaming in the dining room while other residents were present. During this episode, a Certified Nursing Assistant (CNA) called out the resident's name in an attempt to calm her, but a Licensed Practical Nurse (LPN) then loudly yelled at the resident to "shut up." The LPN subsequently removed the resident from the dining room to the common area, and then to her room, where she was fed by the CNA. The incident was witnessed by the CNA, who reported it to a Registered Nurse (RN). The facility's investigation included statements from the involved staff and other residents. The LPN admitted she may have told the resident to "shut up" and described feeling overwhelmed by the situation. Other staff and residents confirmed hearing yelling from the staff member, though not all could specify what was said. The facility's policy defined verbal abuse as the use of disparaging or derogatory language within hearing distance of a resident, regardless of their ability to comprehend. The facility's investigation found that the LPN continued to work after the incident until the end of her shift, contrary to policy, which requires staff involved in possible abuse incidents to be removed from duty pending investigation. The administrator acknowledged the LPN's behavior as unprofessional but did not initially consider it abuse, citing a lack of negative outcome for the resident. The deficiency was cited for failure to protect the resident from verbal abuse as required by regulation.