After a June 13 inspection, an Iowa nursing home was cited for failing to protect residents from sexual abuse. State inspectors proposed a $15,000 fine against the facility, which was held in suspension.
According to the inspection report, a male resident of the facility with Alzheimer’s disease, anxiety disorder, and depression was known by the staff to wander the hallways, become physically and verbally abusive, and to exhibit inappropriate sexual behavior. Despite this knowledge, the staff failed to implement new safety interventions or increase supervision after incidents of sexual abuse on April 23 and physical abuse on May 23.
Due to the incident on April 23, the state cited the facility with an immediate jeopardy (IJ). The facility removed the IJ on April 24 after staff said they took steps to increase monitoring of the resident. The steps included installing a motion alarm and providing additional education to staff.
The May 23 incident involved a situation in which the male resident propelled his wheelchair toward a female resident, and then slapped her on the right side of the face. In another incident, he was discovered in a female resident’s room, exposing himself.
According to the state inspection report, two certified nurse aides (CNAs) and a registered nurse (RN) told inspectors that due to staffing levels, they weren’t always able to adequately monitor the male resident. The nursing home had previously been cited for insufficient staffing levels in June 2023, November 2023, December 2023, January 2024, February 2024, and April 2024.
During the June 13 inspection, state inspectors observed lapses in supervision, including the male resident sitting at the nurses’ station without staff present and without the alarm.
Compliance Perspective
Issue
Studies show that a considerable amount of unwanted sexual contact in nursing homes may be initiated by a resident who is sexually aggressive as a result of disease processes such as brain injuries or dementia. In addition, a resident may have a preoccupation for sexual activity, or have had a prior history of sexual abuse. The resident who is sexually aggressive may target a resident who is unable to protect him/herself. When a facility has identified abuse, the facility must take all appropriate steps to remediate the noncompliance and protect residents from additional abuse immediately. Facilities that take immediate action to correct any issues can reduce the risk of further harm continuing or occurring to other residents, thereby potentially preventing the scope and severity of the deficiency from increasing. Failure to take steps could result in findings of current noncompliance and increased enforcement action.
Discussion Points
- Review policies and procedures regarding the assessment and implementation of preventive measures for residents who have demonstrated any type of inappropriate behavior toward others.
- Train staff regarding the need to carefully monitor residents who have a demonstrated history of inappropriate behavior toward others to prevent assault against residents, staff, and visitors.
- Periodically audit the care plans of residents who have demonstrated inappropriate behavior to determine if measures have been implemented to monitor and prevent potential assaults or aggression toward other residents, staff, and visitors.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
