The West Virginia Attorney General announced on January 8, 2025, that the Medicaid Fraud Control Unit (MFCU) has filed criminal charges against two nursing home staff members related to the death of a nonverbal resident in January 2024.
The MFCU conducted an investigation and recommended charges, which were approved by Preston County Prosecuting Attorney Jay Shay and his team. The charges, filed against a certified nursing assistant (CNA) and a registered nurse (RN), include felony neglect of an incapacitated adult resulting in death.
According to the MFCU’s investigation, the incident occurred on January 4, 2024, when the CNA assisted the 61-year-old resident—who required 24-hour care—into a bathtub for a bath. The CNA allegedly failed to check the water temperature, leaving the man submerged in 134-degree water for 47 minutes. This exposure caused severe second- and third-degree burns on his feet and legs.
The RN, informed about the burns, reportedly failed to provide appropriate care, including pain management and other necessary treatments. The resident was later transferred to a hospital burn trauma unit but succumbed to his injuries on January 12, 2024.
The MFCU’s investigation focused on those directly involved in the resident’s care on January 4, 2024. However, the unit is also reviewing the actions of other individuals who may have violated state criminal statutes. If necessary, the MFCU will report these findings to the Preston County Prosecuting Attorney for further action.
Compliance Perspective
Issue
Many residents in long-term care facilities have conditions that may put them at increased risk for burns caused by scalding. These conditions include decreased skin thickness, decreased skin sensitivity, peripheral neuropathy, decreased agility (reduced reaction time), decreased cognition or dementia, decreased mobility, and decreased ability to communicate. The degree of injury depends on factors including the water temperature, the amount of skin exposed, and the duration of exposure. Safe water temperatures for nursing homes are generally between 100°F to 115°F. According to F689, the resident environment should remain as free of accident hazards as is possible; and each resident should receive adequate supervision and assistance devices to prevent accidents.
Discussion Points
- Review policies and procedures for resident safety, including maintaining safe water temperatures, and for providing appropriate and sufficient supervision to each resident to prevent an avoidable accident.
- Train maintenance staff to perform periodic testing of water temperatures throughout the facility, and train care staff to check the water temperature prior to a resident’s bathing or showering, without compromising the resident’s privacy.
- Periodically audit water temperatures throughout the facility. Also audit care staff to ensure that they know how to check water temperature and provide proper supervision of residents.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*
