cms_WV: 3920
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 3920 | BRIGHTWOOD CENTER | 515128 | 840 LEE ROAD | FOLLANSBEE | WV | 26037 | 2016-11-04 | 250 | D | 0 | 1 | VTNG11 | Based on resident interview, medical record review, staff interview, and policy review, the facility failed to ensure the provision of medically related social services were sufficient and appropriate to meet resident needs. The facility failed to identify and thoroughly investigate an alleged allegations of physical, emotional, mental and/or sexual abuse. This practice affected one (1) of one (1) residents reviewed for abuse and has the potential to affect more than a limited number of residents. Resident identifiers: #164. Facility census: 109. Findings include: a) Resident #164 During a Stage 1 interview with Resident #164 on 11/01/16 at 11:58 a.m., when asked the question: Has staff, a resident or anyone else here abused you, this includes verbal, physical or sexual abuse? She stated, Yes. She further stated, A gentleman here grabbed me on my arm either Friday or Saturday to put my hand on his privates, can't remember his name, but he was a friend of my husband. I told my speech therapist on Monday and she reported it. Upon further inquiry as to why she did not report it when it occurred, Resident #164 stated, Because it was embarrassing and it upset me because this gentleman used to be a friend of my husband. I was talking with my speech therapist on Monday and it just came out during our conversation. I should have told someone when it happened but it was just shocking and I could not believe it happened and he would do that. Speech Therapist (ST) #31 reported during an interview on 11/02/16 at 8:50 a.m., Resident name (Resident #164) reported the abuse to me on Monday 10/31/16 and I reported it to the social worker, for her (the social worker) to further investigate the reporting of abuse. Resident name (Resident #164) stated, He grabbed me. The resident stated she wasn't sure about reporting it because she had known him through her husband, but I explained that I needed to report this because it is considered abuse. The resident not seem upset about the incident and she had mentioned it during just our general conversation and told me it was Resident name (Resident #79). Review of the facility grievances/concern forms on 11/02/16 at 10:45 a.m. revealed a form dated 10/31/16 concerning Resident #164. Documentation of the incident stated (typed as written): Resident name (Resident #164) stated another resident (Resident initials of Resident #79) was attempting to grab her hand. She said she pulled her hand away. She said that she did not feel uncomfortable with the situation that it was no big deal. She said that (Resident initials of Resident #79) was a friend of her husband. Attached to the form was a statement by ST #31. Also attached was an interview statement of Resident #79 interviewed by the Nursing Home Administrator (NHA). The initial statement of the interview (typed as written) states; I spoke with (Resident #79) related to an alleged advance that he may have made on a female resident. During an interview with Social Services Director (SSD) #54 on 11/03/2016 at 8:22 a.m., she commented, the other resident (Resident #79) had been a friend of her husband and was grabbing for her hand. The SSD #54 said she informed the Director of Nursing (DON) and completed a grievance/concern form. She reported the resident did not seem uncomfortable, nor did she expand about the incident. Upon further inquiry SSD #54 stated, Since she (Resident #164) just said he grabbed my hand, I didn't ask her to expand on the situation. Sometimes when people know each other they will sometimes just grab your hands as a greeting, so I assumed that was all it was. When asked if SSD #54 used the word abuse during the resident interview was the word abuse used, the SSD #54 stated, No I just used the word unsafe because sometimes the word abuse will upset a resident, but I will interview her again. Maybe I didn't ask enough questions and ask her to explain more the first time. Upon further inquiry after reviewing the Grievance/Concern form, she did not reply when asked if it should have been investigated as an allegation of sexual abuse. SSD #54 stated, If she would have felt unsafe or uncomfortable about the incident I would have reported it. She did not reply when asked again if this allegation should have been investigated and reported as an alleged abuse allegation. She did state, The investigation is not complete yet because we just received it on Monday and no interventions have been put into place because it was just a concern nor was it seen as an incident or reported to any state agencies. Resident #164 commented tearfully during a follow-up interview with on 11/03/2016 at 9:06 a.m., that the Social Worker had just been in her room. The Resident stated, I told her the same thing I told you yesterday (11/01/16) and the same thing I had told her on Monday (10/31/16), that Resident name (Resident #79) grabbed my arm to pull my hand down toward his private area. I didn't tell you his name yesterday though because I didn't think you would know who he was, but I had told her (SSD #54) his name. His (Resident #79) room is down here somewhere and every time he goes past my room, he (Resident #79) just stares at me. Resident #164 was tearful and visibly upset during the interview stating, They just don't want to believe things like this happen here and how upsetting it is for this to happen to a person. SSD #54 reported on 11/03/2016 at 9:19 a.m., that she had spoken with Resident #164 and she (Resident #164) had stated, the male resident had grabbed her hands and she motioned toward down. SSD #54 commented she would talk with the NHA and report this issue now as an allegation of sexual abuse. She explained the process that each morning the incidents/accidents and grievances/concerns are reviewed in the department meetings and after reviewing these determine whether to report any allegations. The SSD #54 stated, Maybe I should have asked more questions on Monday (10/31/16) of the resident and completed a better investigation. Resident #164 has the capacity to make medical decisions as documented by her attending physician on admission to the facility. The admission minimum data set (MDS) with an assessment reference date (ARD) of 10/28/16 showed a brief interview for mental status (BIMS) score of 13, indicating the Resident #164 has intact cognitive function. Resident #164 has the capacity to make medical decisions as documented by her attending physician on admission to the facility. The NHA reported during an interview on 11/03/16 at 10:00 a.m., We are currently in the process of reporting the alleged sexual abuse to the appropriate state agencies. He agreed the facility did not identify the allegation as sexual harassment or abuse, report to the appropriate State agencies and investigate appropriately. Employees are educated annually to recognize and report abuse and neglect. Upon inquiry as to why the allegation was not reported when it was discovered, he stated, We went with the interview information that we had, but I did not realize it was insufficient. He did not reply when inquired as to why the verbiage advances was used in his interview with Resident #79, but not treated as an allegation of sexual harassment and/or abuse. A review of the facility Abuse Prohibition Policy and Procedure for the included the following: --Identification of possible incidents or allegations which need investigation. --Investigation of incidents and allegations. --Protection of patients during investigations. --Sexual Abuse includes, but is not limited to, sexual harassment, sexual coercion, or sexual assault. --Upon receiving information concerning a report of suspected or alleged abuse, neglect report to appropriate State agencies. --Conduct an immediate and thorough investigation that focuses on whether abuse or neglect occurred and to what extent. | 2020-04-01 |