Resident Subjected to Physical and Verbal Abuse by Agency CNA
Penalty
Summary
A deficiency occurred when a resident with moderate cognitive impairment, non-Alzheimer's dementia, depression, and hoarding disorder was subjected to physical and verbal abuse by a certified nursing assistant (CNA) employed through an agency. The resident, who was known to display verbal and physical behaviors and to reject care, was being assisted by three CNAs to prepare for bed. During the interaction, the resident became combative and grabbed one CNA by the neck. In response, another CNA restrained the resident by pinning their arms behind their back and dragging them to a chair, despite objections from the other staff present. The same CNA also grabbed and squeezed the resident's wrist and verbally antagonized the resident by encouraging them to strike out at staff. Witness statements from the other CNAs present confirmed that the agency CNA repeatedly used physical force to restrain the resident, even after being told to stop by colleagues. The resident was heard yelling for help and expressing pain, and staff noted that the resident's behavior escalated while the agency CNA was present but calmed after the CNA left the room. The incident included both physical restraint and verbal provocation, with the resident being encouraged to hit staff members. The resident initially complained of arm pain but later denied discomfort and refused further assessment. Interviews with the involved CNAs and the Director of Nursing (DON) confirmed that the actions of the agency CNA were considered abusive. The DON stated that the agency CNA had worked at the facility for about a month and that the facility provided orientation materials and abuse prevention training to all staff, including agency personnel. However, the facility was unable to locate the completed orientation packet for the agency CNA involved in the incident.