Other·July 28, 2022

Freedom from Abuse, Neglect, and Exploitation §483.12 Freedom from Abuse, Neglect, and Exploitation The resident has the right to be free from abuse, neglect, misappropriation of resident property, and exploitation as defined in this subpart. This includes but is not limited to freedom from corporal punishment, involuntary seclusion and any physical or chemical restraint not required to treat the resident's medical symptoms. §483.12(a) The facility must- §483.12(a)(1) Not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion. On 3/21/22, an unannounced visit was made to the facility to investigate a facility reported incident regarding the abuse of Resident 1. Resident 1 is a 51-year-old male who was admitted to the facility on 9/3/21 with diagnoses that included aphasia (difficulty speaking), anxiety disorder, and unspecified lack of expected normal physiological development in childhood. Based on observation, interview, and record review, the facility failed to ensure staff was not aggressive towards one of three sampled residents (Resident 1), when Licensed Vocational Nurse (LVN) 1 threw a cup with water in it, at Resident 1 hitting him in the chest. This failure resulted in Resident 1 suffering abuse. Findings: During an observation on 3/21/22, at 2;59 PM, in Resident 1's room, Resident 1 was laying in bed asleep. Resident 1 was not interviewable. During a review of the facility's 5 Day summary report, dated 3/24/21, the report indicated, "On 3/21/22, it was reported that on 3/20/22 at approximately 1:30 PM [Resident 1], was in the hallway. . .Charge Nurse [LVN 1], went to pass medication to [Resident 1]. [Resident 1] refused by putting his arm out. [LVN 1] waited and attempted again. Resident refused again and as he was extending his arm out, [LVN 1] was offering him the medicine cup and they made contact and the medication fell to ground. Medication was picked up and destroyed. [LVN 1] went around the staff assigned to [Resident 1] and took the cup that had water in it and tossed it in the direction of [Resident 1]. It made contact with his chest, wetting his shirt and the cup fell on the ground. . .Upon investigation, IDT feel that as this incident was witnessed it occurred" During an interview on 3/21/22, at 1:12 PM, with Administrator, Administrator stated, on 3/20/21, at approximately 12 PM, LVN 1 was witnessed by Business Office Manager (BOM) throwing a cup with water in it at Resident 1, hitting him in the chest. During an interview on 3/21/22, at 2:14 PM, with BOM, BOM stated, on 3/20/22 between 12 PM and 1 PM, she was the assigned 1:1 for Resident 1. BOM stated, Resident 1 and [BOM] were sitting outside the therapy room when LVN 1 was attempting to administer Resident 1's medications. Resident 1 put his hand up to indicate no and turned away, in the process Resident 1hit the pills out of LVN 1's hand and LVN 1 began walking away and then came from behind the BOM and told Resident 1, "Everyone may be afraid of you but I'm not," and threw the cup with water in it at Resident 1's chest and Resident 1 was wet. The cup fell to the floor, and LVN 1 stepped on the cup and said, "you are a bad man you deserve to be in jail." During a review of the facility's policy and procedure (P&P) titled, "Resident Rights" dated 2011, the P&P indicated, "Employees shall treat all resident with kindness, respect, and dignity. . .Federal and state laws guarantee certain basic rights to all resident of this facility. These rights include the resident's right to. . .be free from abuse, neglect, misappropriation of property, and exploitation." In violation of the above cited, the facility failed to ensure staff did not use aggressive actions towards Resident 1. This failure resulted in abuse. This violation had a direct or immediate relationship to the health, safety, or security of patients or residents and constitutes a class "B" citation.