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From Health Law Daily, August 4, 2016

Facility’s arguments weak after laziness in handling abuse reports

By Kayla R. Bryant, J.D.

The imposition of significant civil money penalties (CMPs) on a skilled nursing facility (SNF) is appropriate when noncompliance with abuse regulations and failure to investigate abuse reports puts residents in immediate jeopardy. The Departmental Appeals Board (DAB) affirmed an administrative law judge’s (ALJ) decision to uphold CMPs imposed on Rosewood Care Center of Swansea (Rosewood), finding that the evidence supported a finding of noncompliance (Rosewood Care Center of Swansea v. CMS, Docket No. A-16-35, Decision No. 2721, July 15, 2016).

Noncompliance. Rosewood was found to be not in compliance with three provisions of a regulation governing a facility’s duty to prevent abuse and neglect (42 C.F.R. sec. 483.13) after various incidents were uncovered by the Illinois Department of Public Health. In one case, two nurse aides caring for a 92-year-old patient that required assistance with all activities of daily living were involved in a feud that went on while they were providing care. They argued regularly in front of the patient and handled him roughly. When reported, the supervisor did not conduct an investigation or separate the aides.

In another situation, a resident’s wife reported that a staff member acted inappropriately toward the resident, but management did not investigate until the state survey agency intervened. Rosewood’s management failed to take a statement from the resident and did not interview his wife before concluding that the allegation was unfounded. In a third instance, a resident’s family member reported that his rings were missing, but staff failed to immediately notify the administrator (see SNF’s environment increased the probability of abuse, December 4, 2015).

ALJ’s analysis. The DAB noted that it was unclear whether Rosewood was challenging the finding of immediate jeopardy, or all of the findings of noncompliance. Upon review, it noted that the ALJ had reason to conclude that the staff verbally and physically abused a resident, and found no issue with the ALJ’s analysis of the evidence. The evidence also support the conclusion that Rosewood’s failure to implement a policy of immediately investigating and reporting alleged abuse or theft was in noncompliance with regulations. Finally, the immediate jeopardy determination was justified, as there were situations that had caused or were likely to caused serious harm. The CMPs were affirmed.

Companies: Rosewood Care Center of Swansea

MainStory: TopStory DABDecisions CMSNews AuditNews CoPNews QualityNews SNFNews

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