A lawsuit was filed against an Ohio nursing home after an elderly resident (Resident 1) was physically assaulted by another resident (Resident 2). The incident, captured on surveillance video, occurred in Resident 1’s room.
Resident 1 resided in the memory care portion of the facility that also housed patients with behavioral problems. According to the lawsuit, the nursing home failed to supervise its residents and allowed Resident 2 to enter Resident 1’s room and physically attack her while she slept. Both of Resident 1’s shoulders were broken when she was assaulted, ripped from her bed, and dragged across the floor.
The lawsuit alleges that nurses waited several minutes to stop the assault, failed to properly examine Resident 1, and did not call 911 or send her for any medical care. Over the following days, Resident 1 declined until she became unresponsive. Only then did the nursing home send her to the hospital, where she died three days later.
According to the lawsuit, the nursing home was responsible for ensuring the safety and well-being of its residents, particularly those with memory and judgment disorders. This duty included providing sufficient supervision and protection to prevent incidents like the one described in the lawsuit.
Compliance Perspective
Issue
Failure to prevent a resident from attacking another resident and failure to perform a Preadmission Screening and Resident Review (PASARR) to accurately assess a resident’s risk for aggressive behavior or provide adequate monitoring and services, may result in citations for immediate jeopardy and provision of substandard quality of care, in violation of state and federal regulations. Staff should monitor for any behaviors that may provoke a reaction by residents or others, which include, but are not limited to:
- Verbally aggressive behavior, such as screaming, cursing, bossing around/demanding, insulting to race or ethnic group, intimidating;
- Physically aggressive behavior, such as hitting, kicking, grabbing, scratching, pushing/shoving, biting, spitting, threatening gestures, throwing objects;
- Sexually aggressive behavior such as saying sexual things, inappropriate touching/grabbing;
- Taking, touching, or rummaging through other’s property; and
- Wandering into other’s rooms/space.
Resident-to-resident abuse could also involve a resident who has had no prior history of aggressive behaviors, since a resident’s behavior could quickly escalate into an instance of abuse.
Discussion Points
- Review policies and procedures for accurately assessing residents before and after admission for the risk of aggressive behavior and for ensuring adequate supervision and appropriate room assignment are provided based on their history and current status.
- Train staff about the risk for aggressive behavior by any resident and their responsibility to monitor and note changes or patterns of behavior that may indicate increasing aggression. Also train staff on behavioral health protocols and the importance of reporting distressing behaviors immediately to a supervisor. Teach the reporting process, including how to access the Hotline if anonymous reporting is preferred. Document that these trainings occurred and file the signed documents in each employee’s education file.
- Periodically audit the behavior documentation of residents to determine if new behaviors are identified, or if behaviors have changed, and update the care plan immediately. Also audit to ensure that all staff are knowledgeable of behaviors that should be reported immediately to a supervisor, and the process for reporting.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
