A 24-year-old employee was arrested on November 2, 2023, for allegedly physically battering an elderly resident with dementia at an assisted living facility (ALF) in Central Florida. According to police, the incident occurred late last month and was captured on surveillance video from the facility’s hallway.
The resident had been walking down the hallway of the facility at about 10:30 p.m. The video shows the employee taking the resident back to her room. When the resident became combative, the employee grabbed her by her hair and forcefully pulled her into the room, leaving the resident badly battered and bruised. The video also recorded the resident’s distress, as she screamed for about five minutes until another staff member entered the room to assist.
The employee and the assisting staff member each wrote up reports about the incident which said that the employee struck the resident’s face with an object and then slammed her face against the wall, which resulted in facial injuries and bleeding.
The resident was taken to the hospital two days later with severe bruising, and medical staff said that she had suffered fractures to her nose and face.
Compliance Perspective
Issue
According to F600 in the State Operations Manual, Appendix PP, residents have the right to be free from abuse, neglect, misappropriation of resident property, and exploitation. Abuse is the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. Instances of abuse of all residents, irrespective of any mental or physical condition, cause physical harm, pain, or mental anguish. The Centers for Medicare & Medicaid Services (CMS) does not consider striking a combative resident an appropriate response in any situation. It is also not acceptable for an employee to claim his/her action was “reflexive” or a “knee-jerk reaction” and was not intended to cause harm. Reporting abuse, neglect, and exploitation is mandatory for all nursing facilities. It is crucial that each nursing facility have a process in place for reporting violations. Staff members should understand their role in identifying, reporting, and investigating abuse. Failure to report in the appropriate time frame is a violation of F609 Reporting of Alleged Violations, and can result in citations at the immediate jeopardy level. Substantiated violations may be considered provision of substandard quality of care, resulting in sanctions and civil or criminal charges.
Discussion Points
- Review your policies and procedures on preventing, identifying, responding to, and reporting abuse. Update them as necessary.
- Train staff on an ongoing basis regarding how to provide care to persons with cognitive impairments, preventing abuse and neglect, reporting suspected incidents immediately to a supervisor or through the facility’s hotline, and timely reporting to the State Survey Agency and local law enforcement per regulatory requirements. Document that the training occurred, and record in each employee’s education file.
- Audit to ensure staff understand what to do if a resident resists care or demonstrates physical or verbal aggression toward them. Also audit staff understanding to ensure that they are aware of the steps they should take if they suspect or witness abuse, and their reporting options, including the use of the anonymous hotline.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
