Derogatory Staff Comment in Resident’s Presence Violates Dignity and Abuse Protections
Penalty
Summary
The deficiency involves a failure to protect a resident’s right to be treated with respect and dignity when a staff member made a derogatory statement about the resident within the resident’s hearing. The resident involved had diagnoses including moderate dementia with mood disturbance and a cognitive communication deficit, and an admission MDS assessment indicated the resident was severely cognitively impaired. A progress note documented that a staff member made an inappropriate statement about the resident to another staff member in front of the resident, and although the resident later stated he did not hear the statement and denied psychosocial distress, the incident was recognized as a concern for the resident’s psychosocial well-being. During interviews, a QMA reported that she had been at the nurse’s station holding the resident’s hand when a CNA approached and stated that the QMA should probably bleach her hands because she was holding the resident’s hand. This comment was made in front of the resident, who was next to the QMA and talking at the time, and the QMA perceived the statement as disrespectful and undignified. The QMA noted that, although the resident was cognitively impaired and might not have processed the remark, it was made within a distance that the resident could have heard it, and that if the resident had been cognitively intact, the statement would have hurt his feelings. In a separate interview, the CNA acknowledged that she had walked up to the nurse’s station and, seeing the resident touching the QMA’s hands and arms, muttered that she would use bleach wipes afterward, referring to the resident’s contact. She admitted the resident was within hearing distance when she made the remark but stated she did not intend for the resident to hear it and did not believe her statement was humiliating or demeaning. The DON and Administrator both indicated that the remark was made in the presence of the resident, was disrespectful and undignified, and had the potential to hurt the resident’s feelings, constituting verbal abuse and a violation of the resident’s right to a dignified existence and to be treated with respect.
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