Failure to Protect a Resident From Verbal Abuse During Shower Care
Penalty
Summary
The deficiency involves the facility’s failure to protect a resident from verbal abuse by a CNA during shower care. During a shower, a QMA reported that the CNA was rude and demanding, pushed the resident into the corner of the shower away from the showerhead, and refused to allow the resident to use the showerhead, stating staff had been told not to let him have it. The QMA indicated she had never been told the resident could not have the showerhead. When the resident stated he needed to urinate, care was paused and then resumed. The CNA then threw a washcloth at the resident and told him to wash his “junk,” while the QMA assisted the resident with cleaning his private area. The resident reached for the showerhead again, and the CNA and resident engaged in a tug-of-war over the showerhead, with the CNA jerking it away from the resident. The resident, who had diagnoses including vascular dementia without behavioral disturbance, anxiety, and a prior cerebral infarction, was documented as moderately cognitively impaired with impaired function on the left side and dependence on staff for toilet hygiene, bathing, dressing of the lower body, footwear, personal hygiene, and transfers. His care plan included maintaining a consistent routine and caregivers to decrease confusion. During the incident, the resident became upset, expressed that he did not think he had done anything wrong, and stated that he had never been told he could not have the showerhead. He also stated that other staff allowed him to do what he could for himself and then assisted him. The facility’s self-reported incident and interviews corroborated that the CNA refused to allow the resident to use the showerhead, took it away from him, threw a washcloth at him, and used a sarcastic tone when responding to his thanks after the shower. The resident reported that the CNA had jerked the showerhead away, dumped shampoo on his head instead of into his hand, and told him to wash his “junk,” while other caregivers allowed him to participate in his own care. The QMA present during the incident considered the encounter abusive, noted the resident was upset, and did not intervene to stop the CNA or ask her to leave. The facility’s policy states that each resident has the right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, exploitation, involuntary seclusion, mistreatment, neglect, and misappropriation of property, and that residents must not be subject to abuse by anyone.
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