Last month, after an 86-year-old resident in a Virginia nursing home was found stabbed to death, his 65-year-old roommate was arrested and charged with his murder. Since then, the Virginia Department of Health (VA-DOH) has been investigating the circumstances surrounding the incident.
The Centers for Medicare & Medicaid Services (CMS) are also keeping an eye on the situation, according to a CMS spokesperson, and they are in contact with the VA-DOH.
The court records revealed that the accused resident has a history of criminal behavior and mental illness, and he has previously been hospitalized in a state hospital that houses violent psychiatric patients.
The nursing home was contacted but declined to discuss any details except to say that they “monitor residents for behavior issues and address those with a ‘care plan.'”
A nurse reported to the news media that there had been previous confrontations between the two residents, and that they should have been moved into separate rooms. The nurse also indicated that the pair were not moved because the facility is short-staffed.
The facility received 24 citations in its most recent inspection and was recently rated “below average” due to staffing issues.
Compliance Perspective
Failure to perform a Preadmission Screening and Resident Review (PASARR) to evaluate residents for serious mental illness in order to ensure that they are in the most appropriate setting, failure to move residents who are having confrontation issues into separate rooms, and failure to maintain mandated levels of staff may be considered abuse and neglect and deemed provision of substandard quality of care, in violation of state and federal regulations.
Discussion Points
- Review policies and procedures regarding performance of a Level I PASARR at admission, the need for completion of a Level II PASARR, and performing periodic reviews via the Minimum Data Set (MDS).
- Train staff to report incidents of confrontation between residents, and take necessary precautions to prevent future incidents that may result in serious harm to one or both residents, particularly when one of the residents has a serious history of criminal behavior and/or mental illness.
- Periodically audit to determine if staff are ensuring a Level I PASARR at admission, if a required Level II PASARR is obtained and incorporated into the resident’s care plan, and if staffing levels comply with state and federal regulations.
FOR MORE INFORMATION ON THIS TOPIC: RESIDENT TO RESIDENT AGGRESSION AND WORKPLACE VIOLENCE PREVENTION AND RESPONSE
