Should the Compliance Officer evaluate the quality of investigations performed regarding alleged resident abuse? [F600 Free from Abuse and Neglect; F609 Reporting of Alleged Violations; and F610 Investigate/Prevent/Correct Alleged Violation]
Compliance Perspective – Abuse of Resident
Policy/Procedure: The Compliance and Ethics Officer should review the policies and procedures regarding reporting and investigation of alleged abuse and neglect violations to ensure that they are thorough and complete.
Training: Staff must be trained on how to properly conduct an investigation, keeping in mind the facility’s responsibility to investigate, prevent and correct all alleged violations.
Audit: The Compliance Officer should periodically evaluate completed investigations from a quality perspective to ensure that they were thorough and complete, and that the related policies and procedures were followed.
A 56-year-old certified nursing assistant (CNA) is charged with a misdemeanor claiming reckless abuse of a resident causing bodily harm. The CNA is accused of causing the 73-year-old resident to injure her leg during the process of providing care when she turned the resident over too quickly, and the resident’s leg struck the wall next to the bed.
When the alleged incident happened, according to the complaint, another CNA heard the resident crying and went into the room. That CNA reported that she had changed the resident numerous times but had never observed the resident crying. The resident was reported in the complaint as saying that the accused CNA “tends to be rough and that she doesn’t feel safe” when the aide is caring for her.
The facility x-rayed the resident’s leg and made a preliminary determination that there was a fracture. The resident was sent to the hospital for further evaluation. The radiologist at the hospital reported that it was not possible to determine if the resident’s leg was fractured because it was so affected by arthritis.
The resident also has osteoporosis that makes her bones brittle. The resident has been confined to her bed since 2015 due to the bone disease and a breathing disorder.
The owner of the nursing home was very supportive of the CNA and told news media that he did not have any idea this rose to the level of a case, and that the CNA had been employed without incident for some time. He also reported that the State reviewed the case and found no issues.
The CNA was suspended when the owner learned of the charges filed against her.
Reiterating the finding by the hospital radiologist, the owner pointed out that a comparison of the hospital x-ray with a previous MRI scan of the resident’s leg indicated that there was no fracture or detectible changes.
The CNA has a November 12 court date. The maximum penalty if she is convicted is nine months in prison and a $10,000 fine.
