Resident-to-Resident Physical Altercation Resulting in Facial Injury
Penalty
Summary
The facility failed to protect a resident from physical abuse when one resident punched another in the face during breakfast in the dining room. One resident, who was severely cognitively impaired, legally blind, and used a wheelchair, was seated at a table when another resident, also severely cognitively impaired and using a wheelchair, attempted to pass behind him. According to a CNA, the second resident’s wheelchair became caught on the first resident’s chair due to insufficient space, which led to an altercation. The CNA reported seeing both residents swinging and throwing punches, with the second resident throwing multiple punches. As a result of the altercation, the first resident sustained an abrasion and swelling to the lower lip, which was noted to be bleeding and later required cleansing and monitoring. Nursing notes documented the incident as an altercation in the dining room, the presence of an abrasion to the lower lip, and subsequent monitoring, including application of an ice pack and observation of a small amount of red drainage from the mouth area. The facility’s abuse, neglect, and exploitation policy defined physical abuse to include hitting, slapping, punching, biting, and kicking, yet the incident involved punching between residents, resulting in injury to one resident.
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