Failure to Protect Residents From Verbal Abuse by Staff
Penalty
Summary
The deficiency involves failure to protect residents from verbal abuse by staff. One resident with a history of heart failure, depression, and post-traumatic stress disorder reported that an activities assistant brought cigarettes to another resident and allegedly told that resident that she took advantage of others. When this was questioned, the activities assistant was reported to have become irate and responded with profanity, stating that she had bought the cigarettes and did not care who became upset, followed by additional profane language. The resident stated that this verbal attack upset her and that there had been three prior incidents involving the same staff member. The DON’s investigation, based on staff and resident interviews, substantiated the allegation and identified additional concerns about the staff member’s treatment of residents who were not considered “favorites,” including a separate instance in which the staff member was heard telling another resident that she would not give them anything even if they asked. In a separate incident, a resident with a history of stroke with left-sided hemiplegia, heart disease, depression, and dysphagia was subjected to verbally abusive language overheard directly by surveyors. While standing near the nurse station, surveyors heard a staff member loudly tell the resident to “get your s&it together and eat” and refer to the resident as a “grown a$$” individual, then observed the resident sitting in a geri-chair with a lunch tray and a blank expression as two staff walked away. When questioned, the resident stated that the nurse, identified as a nursing assistant, behaved like that with her sometimes and that she only sometimes felt safe in the facility. Although the resident later recanted, the NHA acknowledged that residents had expressed fear of retaliation from staff and confirmed that, based on the firsthand observations and written statements of the surveyor and survey coordinator, the abusive event occurred, and the allegation was substantiated even though the specific perpetrator could not be conclusively identified.
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