After two instances of resident-to-resident abuse, Poinsett Rehabilitation and Healthcare Center in Greenville, South Carolina, has been cited for preventing abuse of residents.
Both residents who attacked were on 1:1 supervision.
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The first resident was known as aggressive and had documented altercations with other female residents. She was sometimes unable to recall these incidents and was placed on 1:1 care to address risk for adverse/unprovoked behavior towards other residents.
This resident approached another resident during mealtime, making aggressive motions and trying to get out of her wheelchair. The other resident was cursing and shouting back, also making motions to fight. When the resident was unable to sustain her own body weight, she used a handrail in the room to continue toward the other resident.
One nursing assistant stated that the resident attacked another resident in her time up from the wheelchair; a nurse who was sitting in the dining room claimed, however, that the residents did not have any contact. A nursing assistant placed the resident back into her wheelchair, and the attacked resident has bruises and a skin tear on his wrists after the incident.
In another incident in the dining room, a resident took another resident’s cane and struck them on the front and back of the head, resulting in a hematoma on the resident’s forehead. The injured resident had been recorded to threaten the other resident with their cane, but had never acted on these threats. The attacking resident had never reacted to these taunts before, either.
As with the first incident in this nursing home survey, the attacking resident had been placed on 1:1 supervision. The resident had been known to wander and was an elopement risk. The Certified Nursing Assistant (CNA) assigned to this resident thought the meal was taking too long and went to get the resident’s meal tray, asking another CNA to watch the resident briefly. In this moment, the resident moved to take the other resident’s cane and hit them on the head.
In the first incident, residents known to be aggressive came into contact in the hallway outside the dining room. While nursing staff cannot anticipate every place where residents may have issues, there was a clear plan in place for the first resident. A nursing staff member was meant to be with her at all times, preventing altercations with calm redirection.
The report did not disclose who was assigned to the resident or where the resident’s personal chaperone had gone, but it took time for a nursing staff member to get to the resident after she left her wheelchair. Failure to follow the plan for 1:1 supervision resulted in abuse for the second resident. Failure to follow the care plan placed all residents in this area in danger.
Nursing homes create plans to anticipate danger and harm for residents so that residents are kept safe. It is a serious problem when staff ignore the roles they have to keep residents safe.
In both cases of physical abuse, the residents were on 1:1 supervision, and in both cases they were left by their staff members and took the opportunity to hurt another resident. This potentially shows a nursing home with a pattern of problems rather than a series of random and unrelated instances of abuse.
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