Failure to Timely Report Abuse Allegation and Remove Accused CNA From Resident Contact
Penalty
Summary
The deficiency involves the facility’s failure to follow its abuse, neglect, exploitation, and misappropriation reporting and investigation policy for a resident who alleged abuse by a CNA. The resident had dementia, a UTI, moderately impaired cognition, and was dependent on staff for toileting hygiene and bathing. On the date of the incident, two CNAs reported that the resident complained a CNA had grabbed the resident’s upper arm, with documentation in the progress note that there was a small area of redness, although the CNAs stated the redness was present before they assisted the resident. A change in condition evaluation documented that a CNA grabbed the resident’s upper arm, resulting in a small area of redness, and that the resident did not know the current location, situation, or date/time. A post-event review later documented that the resident alleged a CNA scratched or ripped the resident’s arm and that the resident, who had dementia and an active UTI, provided inconsistent statements. Staff interviews showed that the allegation was reported internally but not handled in accordance with the facility’s written policy. CNA 1 reported the allegation to LVN 1 and the infection prevention nurse (IPN), and both LVN 1 and the IPN assessed the resident’s skin and reported finding no new marks, scratches, or redness. The incident time was variably recalled as around early to mid-afternoon. Despite the facility policy requiring that suspicions of abuse be reported immediately to the administrator and other officials within two hours and that any employee accused of abuse be placed on leave with no resident contact, the allegation was not reported within the required two-hour timeframe, and CNA 1 was not removed from resident contact and re-entered the resident’s room after the allegation. The DON confirmed that staff should have reported the allegation immediately and that CNA 1 should have been suspended from resident contact in accordance with the policy.
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