Failure to Protect Resident from Physical and Verbal Abuse by Agency CNA
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA), employed through an agency, physically and verbally abused a resident during the provision of incontinent care. Video footage captured the CNA being physically rough, verbally aggressive, and striking the resident across the forehead. The CNA was also heard making inappropriate comments and was observed unplugging and then plugging back in the in-room camera after the incident. The incident was discovered when the resident's family, who managed the in-room camera, reviewed the footage and notified facility leadership. The resident involved was an 82-year-old female with a history of Alzheimer's disease, anxiety disorder, a femur fracture, and significant self-care deficits requiring maximal assistance with activities of daily living. At the time of the incident, the resident was unable to participate in interviews due to cognitive impairment and later expired from unrelated causes. Physical findings after the incident included bruising and mild swelling, with imaging studies showing no acute fractures. The resident's care plan included the use of electronic monitoring in the room at the family's request, and signage was posted to indicate camera use. Interviews and record reviews confirmed that the CNA had received abuse and neglect training from both the agency and the facility, and background checks showed no prior disqualifying history. Other staff members and agency personnel reported no previous concerns regarding the CNA's conduct. The CNA admitted to being frustrated, burnt out, and not feeling well on the day of the incident, and acknowledged striking the resident. The incident was not witnessed by other staff, and the CNA did not seek assistance from colleagues or supervisors during the episode.