04
Overview of the Regulation The regulation states that:
Residents have the right to be free from abuse, neglect, misappropriation and exploitation.
Residents must be told about their rights.
The facility must promote the residents’ rights.
The facility must have policies and procedures and education for new and existing staff about freedom from abuse.<br>
05
Overview of the Regulation The regulations also state:
The facility cannot employ individuals who have been found guilty of abuse or have an abuse violation against their professional license.
Facility staff must be able to identify potential abuse and know what to do to protect residents .
Facility staff must know how and when to report suspected abuse.<br>
06
Updated Definitions Abuse = the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish.
Includes withholding goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being.
Includes verbal abuse, sexual abuse, physical abuse, and mental abuse including abuse caused through the use of technology.
Instances of abuse of all residents, irrespective of any mental or physical condition, cause physical harm, pain or mental anguish.
Willful = the individual acted deliberately, not that the individual must have intended to inflict injury or harm.<br>
07
Examples of abuse Group Discussion:
Describe—
Examples of physical abuse
Examples of verbal abuse
Examples of mental abuse
Examples of sexual abuse<br>
08
Definitions Exploitation. (NEW) Exploitation means taking advantage of a resident for personal gain through the use of manipulation, intimidation, threats, or coercion.
Group Discussion - Examples<br>
09
Definitions “Involuntary seclusion” is separation of a resident from other residents or from her/his room or confinement to her/his room (with or without roommates) against the resident’s will, or the will of the resident’s legal representative.
Emergency or short term monitored separation – what does this mean?
. Examples<br>
10
Definitions Misappropriation of resident property means the deliberate misplacement, exploitation, or wrongful, temporary, or permanent use of a resident’s belongings or money without the resident’s consent.
Examples<br>
11
Definitions Neglect is the failure of the facility, its employees or service providers to provide goods and services to a resident that are necessary to avoid physical harm, pain, mental anguish, or emotional distress.
Examples<br>
12
Definitions Injury of unknown source – resident injury that is not the result of a known accident or event.
Example<br>
13
First Things FIRST! *If you witness or are informed of abuse, you must first protect the resident, intervene and stop the abuse!<br>
14
Element 1 - Employee Screening The facility cannot employ or contract with anyone who:
Has been found guilty of abuse, neglect, exploitation, misappropriation or mistreatment.
Has a finding entered into the State nurse aide registry concerning abuse, neglect, exploitation, misappropriation or mistreatment.
Has a disciplinary action in effect against their professional license of finding of
abuse, neglect, exploitation,
misappropriation or mistreatment.<br>
15
Element 2 – Policy and Procedure The facility policy must describe how the facility will:
Prohibit and prevent abuse
Investigate any allegations of abuse
Provide training about abuse to staff
Coordinate with the QAPI Committee
Report suspected crimes in accordance with State laws
Annually notify covered individuals about following reporting requirements
Participate in annual training as required<br>
16
Element 3 – Report Suspected Abuse All alleged abuse, neglect, exploitation, mistreatment, injuries of unknown source and misappropriated resident property must be reported IMMEDIATELY to the Administrator -- and State agency:
Within 2 hours
Within 24 hours
Excluding Saturdays, Sundays, and holidays
Some states or facilities may have more strict reporting rules. See the next slide.<br>
17
Facility Reporting Requirements Insert your facility/state specific reporting process NO other state specific language NOTED<br>
18
Element 3 – Reporting Suspected Crime The federal regulations require that suspicion of a crime be reported to law enforcement officials against any resident:
No later than 2 hours after forming the suspicion if there is serious bodily injury to the resident.
No later than 24 hours after forming the suspicion if there is no serious bodily injury to the resident.
Your State or Facility may have more strict
reporting rules. See the next slide for
details.<br>
19
Add State Specific Reporting Requirements Here<br>
20
Element 4 – Prohibit Retaliation Residents must be protected from retaliation if they report abuse
It is not allowed for anyone to mistreat or intimidate the resident after reporting potential abuse.<br>
21
Element 5 - Investigation Every allegation of abuse, neglect, exploitation, mistreatment, injuries of unknown source and misappropriated resident property must be thoroughly investigated.
Residents, employees, family members, visitors, and other may be interviewed about their knowledge of events.
All health care workers are “mandatory reporters” of abuse, so it is important to share all the information that you have about the event(s).<br>
22
Element 6 – Prevent Further Abuse The facility staff must protect the residents from further abuse while the investigation is being competed.
This may involve suspending staff or assigning staff to work in other areas of the facility during the investigation.
This is for the protection of residents and staff
Suspension during the investigation does not mean that you are guilty of anything.<br>
23
Element 7 – Report Results The results of the investigation must be reported to the Administrator and other officials, according to State law, and the State Survey Agency within 5 days of the incident.
Each State has its own reporting rules and processes. See the next slide for more information about your State.<br>
24
Facility Investigation Report<br>
25
Your Role and Responsibilities Direct care givers are required to follow the nursing home regulations.
Healthcare workers are required to identify and report:
suspected crimes toward residents and
alleged abuse,
neglect,
misappropriation,
exploitation,
involuntary seclusion,
use of restraints without a medical symptom.<br>
26
Your Role and Responsibilities Monitor your own level of frustration or anger and ask for assistance if levels get too high.
Step in to assist others who may be frustrated or angry.
Monitor and assist residents with behaviors that might disrupt or frustrate other residents or staff.<br>
27
Your Role and Responsibilities Be aware of changes in residents’ mood or level of interaction. Report changes to the supervisor for investigation.
Safeguard residents’ belongings. Report high value items to the supervisor for safe-keeping.
Report all skin changes and injuries right away to the supervisor.<br>
28
Your Role and Responsibilities Understand the definitions of abuse related events that are reportable.
Know your facility’s abuse reporting policy and follow it.<br>
29
In Summary Know
Understand
Respond
Stop
Protect
Report<br>
30
Thank you for participating in this education session!<br>
