Unprofessional Social Services Interaction During Outbreak Masking Dispute
Penalty
Summary
The deficiency involves the facility’s failure to ensure the Social Services Director (SSD) acted in accordance with professional standards when interacting with a resident during an infectious disease outbreak. Resident 1, who had morbid obesity and hypertension and was assessed as having decision-making capacity and the ability to understand and be understood, required varying levels of assistance with ADLs but was cognitively able to communicate needs and preferences. On the date of the incident, the SSD entered Resident 1’s room after a family member (FM1) entered without a mask during an Influenza A outbreak, and the SSD instructed FM1 to wear a mask. According to progress notes and interviews, when Resident 1 asked the SSD what type of outbreak was occurring, the SSD responded that she could not disclose that information, and per Resident 1 and RN 1, also stated that Resident 1 should not worry because she was going to leave the facility. Resident 1 became upset and, as the SSD was exiting the room, called the SSD a “bitch.” The SSD then turned back, re-entered or attempted to re-enter the room, raised her voice, and questioned Resident 1 about why she had called her that name. RN 1 reported stepping between the SSD and Resident 1 to calm the situation, and Resident 1 later stated she felt threatened by the SSD’s behavior, describing the SSD as waving her arms, yelling, and seeming like she wanted to fight. Resident 1 reported being afraid of the SSD and stated that the SSD was not supposed to enter her room due to prior unspecified incidents and that the SSD’s behavior was unprofessional and disrespectful toward someone who was bedridden. Resident 2 corroborated that Resident 1 had called the SSD a “bitch” as the SSD was leaving and that the SSD then walked back and yelled at Resident 1, asking why she had to be called that. In her own interview, the SSD acknowledged returning to the room after hearing the insult, asking Resident 1 why she had to be called a “bitch,” and later stated she probably should not have gone back into the room and should have allowed RN 1 to deescalate the situation. The surveyors concluded that the SSD’s conduct did not meet professional standards of quality and had the potential to affect Resident 1’s psychosocial well-being, leading to emotional harm.
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