Failure to Protect Resident From Verbal Racial Abuse by Roommate
Penalty
Summary
The facility failed to protect a resident’s right to be free from abuse when one cognitively intact resident verbally abused a roommate using a racial slur. According to the facility’s 5‑day incident report, late in the evening a resident with diagnoses including malnutrition, anxiety disorder, blindness in one eye, and insufficient sleep syndrome, and with a BIMS score of 15 indicating normal cognition, was overheard by an LPN and a CNA yelling obscenities at the roommate and calling the roommate a “nigger.” A daily skilled progress note for that date documented that this resident was alert and oriented x3, had no active symptoms or treatments affecting mood or behavior, and that the resident yelled obscenities at the roommate, was redirected, and then proceeded to use the racial slur. The facility’s investigation substantiated verbal abuse, defined in facility policy as the willful use of disparaging and derogatory terms to or within hearing distance of residents. The roommate who was the target of the slur had diagnoses including hemiplegia and hemiparesis following cerebral infarction affecting the left non‑dominant side, asthma, and depression, and also had a BIMS score of 15 indicating normal cognition. Review of this resident’s progress notes revealed no documentation regarding the altercation that occurred on the date of the incident. Interviews with the witnessing LPN and the ADON confirmed that verbal abuse includes yelling, cursing, profanities, and racial or prejudicial remarks, and the Executive Director/Abuse Coordinator stated that the incident involved “colorful language” with racial verbiage and that the facility’s investigation substantiated verbal abuse. Facility policies on Abuse: Prevention of and Prohibition Against and Resident Rights state that residents have the right to be free from verbal abuse, including willful use of disparaging and derogatory terms, which was not upheld in this incident.
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