Failure to Report Allegation of Abuse Involving Refusal of Toileting and Hygiene Care
Penalty
Summary
The facility failed to report an allegation of abuse to the state survey agency after a cognitively intact resident reported that a CNA refused to provide necessary toileting and hygiene care. The resident, who has diagnoses including Arnold Chiari Syndrome, craniofacial dysostosis, monocular exotropia, seizures, scoliosis, and dysthymic disorder, is usually continent of bowel and bladder, has limited use of extremities, uses a motorized wheelchair, and requires assistance with toileting and toilet hygiene per her care plan. She stated that when she requested toileting assistance and a shower because her menstrual period had started, the CNA told her to go to the toilet in her pants and did not change her menstrual pad. The resident reported this incident directly to the Administrator and stated the CNA later told her she would not have said that if she knew the resident was "in her right mind." The Administrator, who is identified as the abuse coordinator, acknowledged that he did not submit a report to the Illinois Department of Public Health after being informed that the CNA did not provide the requested shower and refused to change the resident’s menstrual pad. The DON stated that she heard the CNA refusing to toilet the resident and that she informed the Administrator of this refusal, although she did not recall when. Documentation in the CNA’s corrective action notice listed discharge for refusal to do work, including refusing to toilet a resident during her shift, taking long breaks, and attitude issues. Despite this, the Administrator stated that refusing to toilet an alert, oriented, continent resident is not abuse and confirmed that no report was made, contrary to the facility’s Abuse Prevention Program policy, which defines abuse to include deprivation of goods and services necessary to maintain physical, mental, and psychosocial well-being and requires accurate and timely investigative reports.
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