Failure to Protect Resident From Verbal Abuse by CNA
Penalty
Summary
The deficiency involves the facility’s failure to protect a resident from verbal abuse by a CNA. A cognitively intact resident with a history of left leg above-knee amputation, depression, and post-traumatic stress disorder reported overhearing a male CNA tell another resident to “shut the [expletive] up” while responding to that resident’s repeated requests. The resident who was the target of the alleged verbal abuse had severe cognitive impairment with a BIMS score of 3, dementia, hearing loss, and chronic kidney disease stage 3, and was known to be impatient, verbally repetitive, and demanding of staff. On the evening in question, the cognitively intact resident was in her room across from the cognitively impaired resident’s room, heard the impaired resident repeatedly calling out and using her call light, and then heard a male voice respond with the profane directive. The cognitively intact resident wheeled herself to her doorway and observed the identified CNA standing by the cognitively impaired resident after hearing the profane statement. She later reported this to facility staff, stating she recognized the CNA’s voice and confirming his presence at the scene. The social worker interviewed both residents the following day; the cognitively impaired resident did not recall the incident and reported feeling fine, while the cognitively intact resident consistently described hearing the CNA tell the other resident to “shut the [expletive] up” and reiterated that the other resident had been calling out and demanding immediate help. Multiple staff, including the DON, LPN, and RN, described the cognitively intact resident as a reliable and truthful reporter. Additional staff interviews and record reviews supported concerns about the CNA’s interactions with residents. A CNA coworker reported that on the evening of the incident the CNA appeared irritated, overwhelmed, and in a bad mood, and that he had been rude to her, though she had not previously heard him swear at residents. An LPN reported having previously observed the same CNA yell at an exit-seeking resident and stated she had used that prior event as a teaching moment, but she had not reported it to management at the time. The facility’s abuse and neglect policy defines verbal abuse as the use of disparaging or derogatory language within a resident’s hearing, regardless of the resident’s ability to comprehend, and states that residents have the right to be free from verbal abuse by anyone. The incident as reported and corroborated by staff interviews demonstrates that the resident was subjected to verbal abuse in violation of this policy and resident rights.
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