Use of Profanity During Resident Care Undermining Dignity and Respect
Penalty
Summary
The deficiency involves the facility’s failure to ensure that a resident was treated with respect and dignity and cared for in an environment that promoted quality of life. The resident was an elderly female with COPD, dementia, congestive heart failure, and a documented communication deficit related to being hard of hearing. Her MDS showed severely impaired cognition with a BIMS score of 5 and a need for varying levels of assistance with ADLs, including maximal assistance for bathing and lower body dressing. During an observation of incontinent care provided by one CNA with assistance from another CNA, the primary CNA dropped a glove on the floor and audibly exclaimed “God damn it” while in the resident’s room. The CNA then put on a new glove and continued care. The resident did not appear to react at that time and did not show any observable emotional response during the incident. In interviews following the event, the assisting CNA reported not hearing any profanity during the care and stated she had not heard staff use profanity in or around resident care areas. The CNA who used the profanity acknowledged she had not realized she said it during care but agreed that profanity should not be used around residents because it could be offensive even if not directed at them. The resident later stated she did not hear the specific profanity during that episode of care but reported that such language “happens all the time,” describing frequent personal conversations among staff and hearing profanity in the hallway near her room, though she could not identify specific staff or details. Record review showed that the same CNA had previously been documented as cursing in front of another resident in that resident’s room, and had received coaching to be mindful of others and not to curse, as well as attending a customer service in‑service. The facility’s resident rights policy stated that each resident has a right to a dignified existence and to be treated with respect and dignity in a manner and environment that promotes maintenance or enhancement of quality of life.
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