Failure to Protect Resident From Physical Abuse by Another Resident
Penalty
Summary
The deficiency involves the facility’s failure to protect a resident from physical abuse by another resident, resulting in injury. One resident with moderately impaired cognition and medical conditions including metabolic encephalopathy, COPD, and type 2 DM was punched in the face by another resident. According to nursing progress notes, the incident occurred in the early evening when the injured resident reported that the other resident had come to his room, knocked on his door, and then punched him when he came out. The injured resident was observed with a moderate amount of bleeding and sustained a laceration to the right lower lip, an open area on the right inner lip, and an abrasion to the right upper lip. CNA 1 reported that she was in the dining room assisting residents with meals and observed the injured resident waving his hands toward the other resident, who was about six feet away, as the second resident entered the dining room. While scanning the room, CNA 1 briefly looked away, and when she looked back, she saw the second resident punch the first resident in the face, immediately causing visible bleeding from the lip. Staff then separated and supervised the residents. Subsequent observation showed the injured resident with a scab on the right side of his lower lip, and the resident confirmed that another resident had punched him, causing the cut and leading to his transfer to the hospital for evaluation. The resident who delivered the punch had intact cognition and diagnoses including metabolic encephalopathy, COPD, and type 2 DM. Nursing progress notes for this resident documented that he admitted to hitting the other resident, stating he had been startled and did not know why he hit him and did not intend to do so. The DON acknowledged that residents have the right to be free from physical abuse and that the facility’s investigation substantiated that one resident hit another. The facility’s abuse, neglect, and exploitation policy stated that each resident has the right to be free from abuse and that residents must not be subject to abuse by anyone, including other residents.
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