Health inspection·June 25, 2021

F600 §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. Title 22 Section 72527. Patients’ Rights. (a)Patients have the rights enumerated in this section and the facility shall ensure that these rights are not violated. The facility shall establish and implement written policies and procedures which include these right and shall make a copy of these policies available to the patient and to any representative of the patient. The policies shall be accessible to the public upon request. Patient shall have the right: (10) To be free from mental and physical abuse. The facility failed to follow its abuse prevention policy to prevent abuse and mistreatment for Residents 1 and 2 by ensuring the following were prevented: a. For Resident 1, Certified Nursing Assistant 1 (CNA 1) yelled at the resident, left the resident for several hours sitting in the wheelchair and told the resident a number of times the resident was acting like a baby while providing care to the resident. b. For Resident 2, CNA 1 yelled and threw pants at the resident, and forced the resident to speak English while providing care to the resident. As a result, CNA 1’s actions affected Resident 1 and 2’s the psychosocial well-being. Resident 1 felt insulted and disrespected by CNA 1 when CNA 1 yelled at the resident and was told he was acting like a baby. Resident 2 felt insulted by CNA 1 when the resident was forced to speak English while CNA 1 was providing care to the resident. a. A review of the Admission Record indicated Resident 1 was a 76-year-old male, who was admitted to the facility on 6/17/20, with diagnoses that included chronic obstructive pulmonary disease (a group of lung diseases that block airflow and make it difficult to breathe) and diabetes mellitus (high blood sugar). A review of Resident 1's Minimum Data Set (MDS- a standardized assessment and care planning tool) dated 3/21/21, indicated the resident was assessed with good short and long-term memory recall ability, required extensive assistance (staff provide weight- bearing assistance) in most levels of activities of daily living with one-person physical assist. During an observation on 3/30/21, at 2:35 p.m., Resident 1 was observed on low bed with non-skid mat on the floor on both sides of the resident’s bed. The resident was alert and coherent. Resident 1 stated, CNA 1 yelled at him and punished him by having him sit in the wheelchair the entire morning after he was found sitting on the floor in his room. Resident 1 stated, he had moderate pain in his back and bottom from sitting in the wheelchair for several hours. Resident 1 stated CNA 1 always yelled at him and a lot of times told him that he was acting like a baby when CNA 1 was providing care. Resident 1 stated, he felt insulted and disrespected by CNA 1. During an interview on 3/30/21, at 2:45 p.m., Resident 1's roommate (RM 1) stated, he witnessed CNA 1 yell at Resident 1 when CNA 1 told the resident, "You will stay outside of your room in the wheelchair all day." CNA 1 told RM 1, since he witnessed the incident, "If you get on me, you going to be homeless." RM 1 stated, he felt threatened by CNA 1. During a phone interview on 5/25/21, at 10:29 a.m., CNA 1 stated, she was the caregiver for Residents 1 and 2. CNA 1 stated, she left Resident 1 in the wheelchair for about five hours outside of his room because she did not want the resident to be on the floor again. CNA 1 stated, she tells Resident 1 that he is acting like a baby when the resident cried for no reason during care. CNA 1 stated, verbal abuse is consisting of yelling, shouting, threatening, intimidation and insulting a resident, when asked by the Surveyor what defined verbal abuse. A review of the facility's undated policy and procedure titled, "Abuse Prevention and Prohibition Program," indicated each resident has the right to be free from mistreatment, neglect, abuse, involuntary seclusion, and misappropriation of property. The policy indicated the facility would protect the residents from abuse including the facility staff. b. A review of the Admission Record indicated Resident 2 was a 76-year-old male, who was admitted to the facility on 12/01/20, with diagnoses that included diabetes mellitus and legal blindness to both eyes. A review of Resident 2's MDS dated 3/3/21, indicated the resident was assessed with good short and long-term memory recall ability, had severely impaired vision (no vision, eyes do not appear to follow objects), and required extensive assistance in most levels of activities of daily living with one-person physical assist. During an observation and concurrent interview, on 3/30/21, at 3:30 p.m., Resident 2 was observed sitting in the wheelchair in the resident’s room. Resident 2 was alert and spoke Spanish as a primary language. The Dietary Supervisor (DS) who was present at the time was the interpreter for Resident 2. Resident 2 stated, he was blind in both eyes and needed help when showering and dressing. Resident 2 stated, CNA 1 yelled at him and threw his pants on him telling him to put the pants on by himself. Resident 1 stated, he felt nervous when CNA 1 yelled at him and he felt insulted whenever CNA 1 had forced him to speak English during care. During an interview on 5/25/21, at 10:29 a.m., CNA 1 stated, her voice was naturally loud, and she spoke louder for the resident to be able to hear due to the noise from the television. CNA 1 stated, she always told Resident 2 to speak in English because she cannot understand when the resident spoke Spanish during care. A review of the facility's undated policy and procedure titled, "Abuse Prevention and Prohibition Program," indicated each resident has the right to be free from mistreatment, neglect, abuse, involuntary seclusion, and misappropriation of property. The policy indicated the facility would protect the residents from abuse including the facility staff. The facility failed to follow its abuse prevention policy to prevent abuse and mistreatment for Residents 1 and 2 by ensuring the following were prevented: a. For Resident 1, Certified Nursing Assistant 1 (CNA 1) yelled at the resident, left the resident for several hours sitting in the wheelchair and telling the resident a number of times the resident was acting like a baby while providing care to the resident. b. For Resident 2, CNA 1 yelled and threw pants at the resident, and forced the resident to speak English while providing care to the resident. As a result, CNA 1’s actions affected Resident 1 and 2’s the psychosocial well-being. Resident 1 felt insulted and disrespected by CNA 1 when CNA 1 yelled at the resident and was told he was acting like a baby. Resident 2 felt insulted by CNA 1 when the resident was forced to speak English while CNA 1 was providing care to the resident. These violations, jointly, separately, or in any combination, had a direct or immediate relationship to the health, safety, or security of Residents 1 and 2.