Failure to Protect Resident from Verbal Abuse and Inadequate Staff Education
Penalty
Summary
The facility failed to protect a resident's right to be free from verbal abuse by a certified nursing assistant (CNA). An incident occurred in which a resident and a CNA engaged in a verbal altercation, with both parties yelling at each other. The CNA was reported to have antagonized the resident, and the resident accused the CNA of smelling like marijuana. The altercation was witnessed by a licensed practical nurse (LPN), who intervened and reported the incident to the nurse on call. Despite the altercation, the CNA continued to work the remainder of the shift on the same hallway as the resident, although did not provide direct care to the resident involved in the incident. The facility's policy requires that any staff member implicated in an alleged abuse event be immediately removed from resident care areas and suspended pending investigation. However, this procedure was not followed, as the CNA continued to work after the incident. Additionally, the incident was not reported to the Director of Nursing (DON) or Nursing Home Administrator (NHA) until several days later, and the state agency was not notified within the required timeframe. The facility's policy also mandates immediate assessment and protection of the resident, as well as timely reporting and investigation of abuse allegations, which did not occur in this case. Furthermore, the facility did not provide abuse education to all staff during the investigation of the incident. Only one LPN received education on abuse reporting and prevention following the event, while other staff members, including those directly involved or present during the incident, did not receive such education. This lack of comprehensive staff education and failure to follow established abuse prevention and investigation protocols contributed to the deficiency.