Failure to Protect Resident Privacy and Confidentiality During Cell Phone Use
Penalty
Summary
The deficiency involves failure to protect residents’ rights to personal privacy and confidentiality when staff used personal cell phones to record and transmit images and video during care. Facility policy prohibited personal cell phone use on nursing units for any reason and specifically banned taking pictures or videos of residents for personal use or social media, with violations subject to disciplinary action. The facility’s resident rights policy stated that residents had the right to a dignified existence, to be treated with respect and dignity, and to receive care in a safe, clean, comfortable, and homelike environment. One incident involved a resident with severe cognitive impairment, aphasia, hemiparesis, and total dependence on staff for ADLs, who was always incontinent of bowel and bladder. During a video call among a CNA, another CNA, and the scheduler, the first CNA provided peri-care to this resident while on camera. The resident lay in bed wearing a shirt, brief, and socks; the CNA removed the brief, exposing the resident’s genitals and later the buttocks while cleaning. A second CNA joined the call from home with two young children visible on camera, and the children watched the CNA clean the resident’s buttocks before leaving the call. During the call, the resident was rolled to the side, exposed, and at one point held onto the CNA’s buttocks while the CNA moved his/her buttocks in a circle, looked back at the camera, and smiled, while the other CNA laughed. A second incident involved another resident with severe cognitive impairment, dementia, and multiple comorbidities, who used a wheelchair. A CNA took a photo of this resident sleeping in a recliner and sent it to a group chat that included both staff and non-staff members. The DON later identified the resident in the photo. Staff interviewed reported that the group chat was muted and that they did not see the photo, but the Regional Director of Clinical Services stated she was notified of the video and photos by email and that she would have expected staff in the group chat to report the videos when they occurred. Staff involved acknowledged receipt of the resident rights policy, but some reported they had not been oriented on resident rights and personal cell phone policies.
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