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F600 - F610
Freedom from Abuse, Neglect, and Exploitation *Substandard QOC
| Question | Answer |
|---|---|
| F600 * Free from Abuse and Neglect The resident has a right to be free from A_____, N_____, misappropriation of Resident P_____, and E______> | The resident has the right to be free from ABUSE, NEGLECT, MISAPPROPRIATION of resident PROPERTY, and EXPLOITATION. |
| F600 * Free from Abuse and Neglect When a facility accepts a resident, the facility assumes responsibility to ensure the s___& w____ of a resident. | When a nursing home accepts a resident for admission, the facility assumes the responsibility of ensuring the safety and well-being of the resident. |
| F600 * Free from Abuse and Neglect Facility's Responsibility | It is the facility’s responsibility to ensure that all staff are trained and are knowledgeable in how to react and respond appropriately to resident behavior. |
| True or False? Neither physical marks on the body nor the ability to respond and/or verbalize is needed to conclude that abuse has occurred. | True. |
| Based on observation, interview, and RR staff the facility deprived residents of basic care, toileting, showers, and assistance with meals. This resulted in residents feeling dirty and humiliated F_? | F600 * Free from Abuse and Neglect /“Neglect,” “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.” |
| Based on interview and RR, the facility's staff failed to ensure that one of 11 sampled residents (Resident B) was free from verbal abuse by a staff member, by failing to ensure CNA 3 did not yell & argue with Res B when she assisted him. F_? | F600 * Free from Abuse and Neglect / The facility must— not use verbal abuse/ Examples of mental and verbal abuse include, but are not limited to yelling or hovering over a resident |
| M _ _ _ _ _ includes keeping and/or distributing demeaning or humiliating photos and recordings of a resident. If a photo or recording of a res, or the manner that it is used, demeans or humiliates a resident(s), regardless of consent cognitive status. | MENTALabuse includes abuse that is facilitated or enabled through the use of technology, such as smartphones and other personal electronic devices. |
| F602 The resident has the right to be free from abuse, neglect, misappropriation of res property, and exploitation Including freedom from corporal punishment, involuntary seclusion and any physical or chemical restraint. THE INTENT OF F602 IS? | INTENT OF F602: Each resident has the right to be free from misappropriation of property and exploitation. |
| EXPLOITATION " “taking advantage of a resident for P_ _ _ _ _ _ _ G_ _ _, through the use of M_ _ _ _ _ _ _ _ _ _ _, intimidation, threats, or coercion.” | “taking advantage of a resident for PERSONAL GAIN, through the use of MANIPULATION, intimidation, threats, or coercion.” |
| “Misappropriation of resident property,” “the D_ _ _ _ _ _ _ _ _ misplacement, exploitation, or wrongful, T_ _ _ _ _ _ _ _, or permanent use of a resident’s belongings or money without the resident’s consent.” | “the DELIBERATE misplacement, exploitation, or wrongful, TEMPORARY, or permanent use of a resident’s belongings or money without the resident’s consent.” |
| Based on obs, int, and RR, the facil failed to ensure freedom from misappropriation of property (use of a res’s belongings or money w/o the res’s consent) for one of three sampled residents (Res 5), when the SW used Res 5's bank card w/o permission. F_? | F602 The resident has the right to be free from abuse, neglect, misappropriation of res property, and exploitation |
| Based on observation, interview and record review, the facility failed to ensure resident's property was not misappropriated for 1 of 3 sampled residents (Resident 1) when a staff member took her cell phone away and used it for 4 days. | F602 The resident has the right to be free from abuse, neglect, misappropriation of res property, and exploitation |
| F603 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 & any restraint | The facility MUST—Not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion; INTENT Each resident has the right to be free from involuntary seclusion. |
| Based on interview and record review the facility failed to prevent abuse and the isolation of Resident 1, who communicated and received all stimulation through facial expressions, due to his face was covered with a pillow case. | F603The facility MUST—Not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion; INTENT Each resident has the right to be free from involuntary seclusion |
| “Involuntary seclusion” | is defined as 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, or the will of the resident representative. |
| Staff hold a door shut, from the opposite side of the door, in order to prevent egress; AN EXAMPLE OF Involuntary S____/ F_? | F603 Involuntary Seclusion |
| A resident is physically placed in an area without access to call lights, and/or other methods of communication AN EXAMPLE OF Involuntary S____/ F_? | F603 Involuntary Seclusion |
| A res displays disruptive behaviors, such as yelling so staff remove & seclude the res in a separate location such as an office, leaving & closing the door w/o providing interventions to address the behavioral symptoms. Involuntary S____/ F_? | F603 Involuntary Seclusion |
| The fac failed to provide protection from abuse & involuntary seclusion, when LVN 2 locked Res 1 out of the fac for going outside. Despite pleas from Res 1, LVN 2 refused to open the door. Res 1 was left outside wearing only a gown for 1.5 hrs | F603 Involuntary Seclusion |
| During an interview on 1/4/2020 at 1105 hours the Administrator stated last CNA 2 shut Resident 4 in her room because Resident 4 was having an anxiety attack. | F603 Involuntary Seclusion |
| F604 Respect and Dignity. The resident has a right to be treated with respect and dignity, including:The right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience, | The facility must—Ensure that the resident is free from physical or chemical restraints imposed for purposes of discipline or convenience and that are not required to treat the resident’s medical symptoms. |
| “Physical restraint” is defined as any manual method, physical or mechanical device, equipment, or material that meets all 3 of the following criteria. | • Is ATTACHED or adjacent to the resident’s body; • CANNOT be REMOVED EASILY by the Resident; and • RESTRICTS the resident’s FREEDOM of movement or normal ACCESS to his/her body. |
| On xx at xx hours a concurrent observation & interview was conducted w/ LVN 2. LVN 2 stated Res 3 was in a reclining position in the reclining wheelchair to prevent the res from getting up and falling. LVN 2 stated there was no care plan developed. | F604 Free from physical restraints: When the use of restraints is indicated, the facility must use the least restrictive alternative for the least amount of time and document ongoing re-evaluation of the need for restraints |
| F605 *Right to be free from chemical restraints | F605 The resident has a right to be treated with respect and dignity, including: The right to be free from any physical or chemical restraints. |
| Resident 10 was prescribed phenobarbital (anti-seizure medication) to control her behavior (agitation & striking out). Non pharmacological interventions were not tried. She was sent to GACH for being over sedated. F_? | F605 The resident has a right to be treated with respect and dignity, including: The right to be free from any physical or chemical restraints. |
| F 606 *Not Employ/Engage Staff with Adverse Actions | The facility must— Not employ or otherwise engage individuals who—Have been found guilty of abuse, neglect, exploitation, misappropriation of property, or mistreatment by a court of law; or had disciplinary action in effect (for above); |
| Based on interview and record review the facility failed to ensure background checks were done prior to employment at the facility for one of four employee. Background checks for history of abuse was done two months after date of hire for RN 5. | F606 *Not Employ/Engage Staff with Adverse Actions |
| There was no documented evidence found in Employee 10's file to indicate a criminal background check from the State of Californian and the National Data Base was done. F_? | F606 *Not Employ/Engage Staff with Adverse Actions |
| F607 The facility must develop & implement written P&P that: PROHIBIT & PREVENT abuse, neglect, & exploitation of residents and misappropriation of resident property/ESTABLISH P &P to investigate allegations/INCLUDE training/ coordinate w/ QAPI | |
| Based on interview and record review, the facility failed to implement their abuse prevention policy by failing to conduct pre-employment screening prior to hiring. F_? | F607. Develop/Implement Policies/ SCREENING: The facility must have written procedures for screening potential employees for a hx of abuse, neglect, exploitation, or misappropriation of resident property. |
| The SSD observed Res 1 run over Res 2 w/ Res 1's wheelchair. During an interview with the SSD on xx at xx hours, the SSD stated, We do not need to report it to CDPH, as long as we investigated it. It is up to the DON to report it or not." F_? | F607. Develop/Implement Policies/REPORTING: The facility must have written procedures that must include: • Immediately reporting all alleged violations to the Administrator, state agency, adult protective services and to all other required agencies |
| Based on interview and record review, the facility failed to implement their abuse P&P for one of two sampled residents (Resident 5), when an allegation of rough handling by a certified nursing assistant (CNA) was not thoroughly investigated. F_? | F607 Develop/Implement Policies/INVESTIGATION: The facility must have written procedures for investigating abuse, neglect, misappropriation, and exploitation that include: |
| The facility failed to PROTECT the residents by allowing LVN 3 to continue working in the facility, after LVN 3 posted a picture of Resident 6's wound on social media. F_? | F607 Develop/Implement Policies/PROTECTION: The facility must have written procedures that ensure that all residents are protected from physical and psychosocial harm during and after the investigation. |
| Based on interview and record review, the facility failed to implement their abuse P&P to protect and prevent further potential abuse. The facility allowed CNA 4, an alleged perpetrator to provide care to residents during an abuse investigation. F_? | F607 Develop/Implement Policies/PROTECTION: The facility must have written procedures that ensure that all residents are protected from physical and psychosocial harm during and after the investigation. |
| The facility failed to implement it P&P on "Patient Abuse" by failing to ensure employees received abuse prevention training. All 80 Employee files showed they were not trained on abuse prohibition and how to manage/respond to aggressive residents. F_? | F607 Develop/Implement Policies/TRAINING: The facility must have written policies and procedures that include training. Training should include understanding what Res behaviors increase chance of abuse. |
| F607 II. Training: The facility must have written policies and procedures that include training new and existing nursing home staff and in-service training for nurse aides in the following ABUSE topics which include: (Hint 5 elements) | 1. Prohibiting & Preventing 2. Recognizing signs of abuse 3. Identify what abuse is 4. Reporting abuse 5. Understanding Res behaviors that increase risk of abuse. |
| Yelling, Screaming, Resisting Care, and Eloping are behaviors that increase the risk of _ _ _ _ _ F_? | ABUSE F607: Develop/Implement Policies. The facility must have written P&P that include training. Training should include understanding what Res behaviors increase chance of abuse. |
| F608 *Reporting of Reasonable Suspicion of a Crime | The facility must develop and implement written policies and procedures that: Ensure reporting of crimes occurring in federally-funded long-term care facilities |
| True or False? F608 *Reporting of Reasonable Suspicion of a Crime Employee rights must be posted in an obvious place. | TRUE (Intent of F608): Post a conspicuous notice of employee rights, INCLUDING THE RIGHT TO FILE A COMPLAINT; and • Assure that any covered individual who makes a report to be made, or is in the process of making a report, is NOT RETALIATED against. |
| The facility failed to develop & implement written P&P that prohibit & prevent abuse when: The facility's P&P on abuse prevention did not contain provisions for the identification and monitoring of residents with behaviors that might lead to abuse F_? | F607. The facility must have written P&P that include training. The training must include: Understanding behavioral symptoms of residents that may increase the risk of abuse and neglect and how to respond. Yelling and Screaming are examples. |
| Based on staff interview and document review, the facility failed to implement its abuse policy when a law enforcement agency was not notified of an incident of staff-to-resident abuse which resulted in injury to Resident 2. F_? | F608. The facility must develop and implement written policies and procedures that: Ensure reporting of crimes occurring in federally-funded long-term care facilities. |
| The Administrator stated the facility did not have a policy and procedure regarding reporting of crimes to State agency and other law enforcement entities. F_? | F608 The facility must develop and implement written policies and procedures that: Ensure reporting of crimes occurring in federally-funded long-term care facilities |
| F608 Each covered individual shall report to the State Agency AND 1 or more law enforcement entities for the political subdivision in which the facility is located any reasonable suspicion of a crime against a resident or is receiving care. | |
| “Covered individual” | is anyone who is an owner, operator, employee, manager, agent or contractor of the facility |
| The facility failed to post a conspicuous notice of employee rights to file a complaint with the State SA if they believe the facility has retaliated against an employee or individual who reported a suspected crime & how to file such a complaint. | F608 The facility must develop and implement written policies and procedures that: Posting a conspicuous notice of employee rights, as defined at section 1150B(d)(3) of the Act. |
| F609 Reporting of alleged violations: Ensure all alleged violations involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property, ARE REPORTED ... | IMMEDIATELY, BUT NOT LATER than 2 hours after the allegation is made. |
| F609 if the events that cause the allegation DO NOT involve abuse or result in serious bodily injury, MUST BE REPORTED | NOT later than 24 hrs if the events that cause the allegation do not involve abuse and do not result in serious bodily injury, to the administrator of the facility |
| Who is required to report abuse or neglect? | Any covered individual, including the owner, operator, employee, manager, agent or contractor of the facility F609 |
| Based on xx, the facility failed to ensure all allegations or suspicions of abuse were reported no later than two hours to the facility's Administrator, CDPH, and local law enforcement. | F609 Ensure all alleged violations involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property, ARE REPORTED immediately and not later than 24 hours. |
| F609 The facility MUST REPORT alleged violations r/t mistreatment, exploitation, neglect, or abuse, including injuries of unknown source & misappropriation of resident property & report the results of all investigations | The intent is the facility MUST report to authorities w/in PRESCRIBED time frames |
| F610 In RESPONSE to ALLEGATIONS of abuse, neglect, exploitation, or mistreatment, the facility must: 1. INVESTIGATE all alleged violations thoroughly. 2. PREVENT further potential abuse, neglect, exploitation, or mistreatment during the investigation | INTENT The facility must take the following actions in response to an alleged violation of abuse, neglect, exploitation or mistreatment: • Thoroughly investigate the alleged violation; • Prevent further abuse, neglect, exploitation and mistreatment fro |
| True or False? Even if an alleged violation was reported to law enforcement the facility must still conduct its own internal investigation in consultation with the law enforcement authority. | TRUE F610. The investigation would include conducting observations, interviews, and record reviews |
| If the events that cause the allegation involve abuse or result in serious bodily injury, it should be reported _______, but no later than _ hours. | ENSURE all alleged violations involving abuse, neglect, exploitation or mistreatment, MUST be reported IMMEDIATELY, but not later than 2 hours, if the events that cause the allegation involve abuse or result in serious bodily injury. F609 |
| Each covered individual shall report immediately, but not later than 2 hours after forming the suspicion, if the events that cause the suspicion result in serious bodily injury, F_? | F608The facility must develop and implement written policies and procedures that: |
| Each covered individual shall report immediately or not later than 24 hours after forming the suspicion, if the events that cause the suspicion do not result in serious bodily injury. F_? | F608 The facility must develop and implement written policies and procedures that: |
| True or False? A facility cannot prohibit or circumscribe a covered individual from reporting directly to law enforcement even if it has a coordinated internal system. F_? | FALSE F608: a facility CANNOT PROHIBIT or circumscribe a covered individual from reporting directly to law enforcement even if it has a coordinated internal system |
| The facility's policy and procedure titled ,"Abuse Reporting and Investigations," dated March 1, 2017, did not indicate any policy and procedure regarding reporting suspicion of a crime to State agency and other law enforcement entities. F_? | F608 The facility must develop and implement written policies and procedures that: Ensure reporting of crimes occurring in federally-funded long-term care facilities in accordance with section 1150B of the Act. |
| Based on xx, the facility failed to IMPLEMENT its abuse policy when a law enforcement agency was not notified of an incident within 2 hours of staff-to-resident abuse which resulted in a head injury and multiple rib fractures to Resident 1. | F608: Each covered individual shall report immediately, but not later than 2 hours after forming the suspicion, if the events that cause the suspicion result in serious bodily injury, |
| Based on xx, the facility failed to Implement its reporting policy for reasonable suspicions of a crime when a law enforcement agency was not notified of drug diversion within 24 hours. F_? | F608: Each covered individual shall report immediately, but not later than 24 hours after forming the suspicion if the events that cause the suspicion do not result in serious bodily injury. |
| The 3 Key Elements of F610 are I _ _ _ _ _ _ _ _ _ _ _, P_ _ _ _ _ _, & C _ _ _ _ _ _ | INVESTIGATE PROTECT CORRECT |
| The facility failed to investigate an allegation of abuse / Resident 5 reported to the SSD, a staff member tried to kill him by disconnecting the ven from his tracheostomy tube. The SSD did not report it and subsequently no investigation was done. F_? | F610:In response to allegations of abuse, neglect, exploitation, or mistreatment, the facility must:Have evidence that all alleged violations are thoroughly investigated. |
| Based on xx, the facility failed to PREVENT further abuse when CNA 2 was not removed from direct patient care during an abuse investigation. CNA 2 received 5 substantiated abuse complaints during the initial abuse investigation. F_? | F610: The facility must immediately put effective measures in place to ensure that further potential abuse, neglect, exploitation, or mistreatment does not occur while the investigation is in process. |
| The facility failed to PROTECT residents from potential abuse, when the facility did not suspend or remove from resident care, a staff member accused of abuse, pending the outcome of the facility's investigation of the abuse allegation. F_? | F610: The facility must immediately put effective measures in place to ensure that further potential abuse, neglect, exploitation, or mistreatment does not occur while the investigation is in process. |
Created by:
Seasons311