Verbal Abuse of Cognitively Impaired Resident by CNA During Care
Penalty
Summary
The facility failed to protect a resident from verbal abuse by a CNA during personal care. The resident was an adult male with schizophrenia, major depressive disorder, and generalized anxiety disorder, and had a BIMS score of 06 on a recent MDS, indicating severely impaired cognition. His care plan noted a potential for verbally abusive behaviors, with an intervention to notify the charge nurse of any abusive behaviors. On the day of the incident, the resident became upset when a CNA did not change the television channel as requested, and later during care an altercation occurred between the resident and the CNA. According to written statements from two CNAs, three CNAs, including the alleged perpetrator, were in the resident’s room to change him. One CNA reported that after they finished changing the resident, the involved CNA began cursing at the resident, telling him, "fuck me, no fuck yourself, you stupid ass. I have rights just like you," and appeared very upset. Another CNA stated that the resident had asked for the bed remote control, that it dropped on him, and that he yelled "Fuck you!" at the CNA. This CNA reported that the involved CNA yelled back at the resident, saying, "We are here cleaning your ass! Don't tell us Fuck you!," and that both the resident and the CNA were yelling at each other. The LVN on duty documented that a CNA reported the altercation to him and that he then spoke with the resident, who described what had happened. In a subsequent phone interview, the involved CNA acknowledged that she was assisting two other CNAs, that the bed remote dropped on the resident, and that the resident called her an "ugly fucking face." She stated that she told the resident he was not to speak to her that way and repeated his words back to him, and that the other CNAs only heard her repeating those words. The administrator later confirmed that an investigation determined the CNA had been verbally abusive to the resident, and that the CNA had previously received training on abuse/neglect and resident rights. The facility’s Abuse/Neglect Policy defined verbal abuse as the use of oral, written, or gestured language that willfully includes disparaging and derogatory terms to the resident.
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