Failure to Ensure Respectful and Dignified Staff–Resident Interactions
Penalty
Summary
The deficiency involves the facility’s failure to ensure residents were treated with respect and dignity during verbal interactions, specifically in relation to two residents who reported being yelled at and cursed at by a CNA. Resident O, who had diagnoses including diabetes, anxiety, and bipolar disorder and was dependent on staff for most ADLs, reported that CNA 6 repeatedly came into her room and “barked out orders,” telling her to get up, get dressed, go to the bathroom, and go down to eat in a raised voice with a harsh tone and attitude. She stated that CNA 6 sometimes cursed at her and her roommate and could be heard cursing in the hallway. Resident O reported these concerns to the charge nurse and told CNA 6 not to come into her room again, but indicated that CNA 6 continued to provide her care despite her request. Her care plan, which included interventions such as emphasizing dignity, using soothing and kind speech, not rushing her, and providing care consistent with her schedule, did not document her request to avoid care from certain staff. Resident P, who was blind with additional diagnoses of dementia and stroke, and who was dependent on staff for ADLs, reported overhearing CNA 6 yelling at her roommate on several occasions and stated that the CNA also yelled at her. She responded by cursing at the CNA and telling her to get out of the room and reported her concerns to the charge nurse. Resident P stated that she felt like a child when yelled at, expressed anger and concern for her roommate, and indicated she did not want CNA 6 to provide her care. Her care plan, which included interventions to approach her calmly and explain care before providing it, also did not reflect her request to avoid certain staff. Confidential interviews indicated that some staff were not always respectful, with reports of staff yelling in hallways, yelling at residents, and cursing during care, and specifically identified CNA 6 as yelling at Resident O and cursing in the hallways. The Interim DON acknowledged awareness of prior verbal warnings to CNA 6 about her attitude and manner of speaking with residents but stated there were no formal written warnings in the employee file and that she had not been informed of the residents’ wishes not to receive care from CNA 6.
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