Failure to Remove CNA From Resident Care After Verbal Altercation
Penalty
Summary
The deficiency involves the facility’s failure to remove a CNA from resident care areas after he engaged in a verbal altercation with a resident. On the date of the incident, Resident 1, who had an intact mental status with a BIMS score of 15 and was able to clearly express ideas and understand others, was in the TV dining room when another resident (Resident 2) began crying out for help. Resident 1 asked CNA 1, who was sitting in the room, to help Resident 2. According to Resident 1, CNA 1 responded in a rude tone, asking, “We got a problem?” and used a loud, angry tone. Social Services Director 1 reported hearing a commotion and, upon entering the TV room, observed Resident 1 and CNA 1 yelling and shouting at each other and exchanging profanities, with CNA 1 described as hot headed. SSD 1 documented in the progress notes that Resident 1 had a verbal altercation with CNA 1, and she noted that Resident 1 was trembling from anger after the incident. CNA 1 acknowledged that he raised his voice at Resident 1 during the incident and stated he had previously been counseled about being professional and lowering his voice with residents. The DON confirmed that CNA 1 had a generally loud voice and had been told in the past to treat residents with respect. Despite the altercation occurring around midday, staffing records and the CNA’s timecard showed that CNA 1 continued working his full shift from approximately 7:00 a.m. to 3:30 p.m., providing direct care to nine assigned residents for more than three hours after the incident. The Administrator, who served as the Abuse Coordinator, stated that if the incident occurred around noon, CNA 1 should have been sent home immediately and suspended during the investigation, and that the facility’s abuse prevention policy required immediate removal of an employee suspected of abuse from the care or vicinity of the resident. The failure to remove CNA 1 from resident care areas after the altercation constituted the cited deficiency.
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