Abuse Allegations

Specialties LTC Directors

Published

Just curious have other DON's handle abuse allegations. What is your process? Also, how are incident reports handled? The DON at my facility handles all of these and a lot are getting lost or not being investigated.

We do have policies and procedures for reporting incidents. The problem is the DON is controlling the process. When an allegation of abuse is reported by a staff member, the incident is reported to the DON for investigation. THe problem is a lot of them are lost, dismissed, or never follow up on. How does the regulatory agencies know if they never get reported? Also, when an "investigation" is conducted if other residents don't substantiate the allegation made by the resident then it is unsubstantiated. Also, my administrator told me falls resulting in fractures do not require reporting. He said that was done away with 15 years ago. How would I find out what is deemed reportable. Recently state resurveyed us and detected several residents who had falls so they asked the DON for all the falls for the last 3 months. She did not provide all the falls because she "misplaced" the incident reports and she signed and back dated incidents several of them. The DON is supposed to submit all incidents to our corporate office through a database reporting system. The problem is not all are being reported. It's a mess. Any suggestions

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Specializes in Gerontology, Med surg, Home Health.

If you have a corporate compliance hot line, call it the next time you go to work. If what you're saying is true, things are not right at the facility. Of course a fall with a fracture must be reported as must any other 'significant injury'.

I've had staff members complain about each other and then tell me I never investigated anything because they never 'heard' that I had. Most investigations are confidential. If someone accused you of abuse, would you want the whole building to know.

You are leveling some very serious charges against both your DON and administrator. You really should call someone at corporate and let them investigate. For all you know, they have already been told and are already investigating.

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Our agency does have a compliance hotline. I will voice my concerns to them. I have never used the compliance hotline but the last person in management who did was terminated for "other" reasons. The DON found out who the person was based on inside knowledge of the evidents that occurred. It was evident who the person was based on the information provided. Our facility has 5 G tags and 1 IJ. I agree that things are very wrong with this facility and not sure how to proceed. I realize what I'm saying is serious, that's why I need advice on what to do. I understand that investigations are confidential however when the DON is given an allegation of abuse concern and it's automatically dismissed before the investigation something is not right. When an allegation of abuse is given to the DON the response often is: Really? I find that hard to believe, yeah right?, If that really happened I think I would have been the first to know about it, high fiving CNA's when things are unsubstantiated, the list goes on and on.

I did not mean to infer my administrator was covering up incidents. My administrator truly believes that falls resulting in fractures are not reportable if the origin is known and doesn't involve neglect or abuse - such as resident was ambulating, lost balance and fell. The administrator said as long as it wasn't abuse or neglect of any kind then the incident is not considered a reportable to state. Do states vary when it comes to reportables. All reported occurances are tracked on our states CMS website. Only 1 out the 15 allegiations that I'm aware of is listed as of 6/12/11. The CMS website is updated daily.

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Specializes in Gerontology, Med surg, Home Health.

Our reportables aren't listed anywhere. CMS is a FEDERAL organization.

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Specializes in Geriatrics, Ambulatory Care.

Unless the self report is substantiated and sited they are not listed on the Department of Aging website only consumer complaints are.

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I agree with many of the advise & suggestions in the various posts. In our facility the person who investigates abuse are the social workers. Everyone is encouraged to report & follow-up on abuse charges, we take it VERY seriously!

As far as the facilty getting tagged; as painful as it is, maybe thats not such a bad thing. At least the allegation would be investigated. Sorry. :(

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Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

What's to stop an employee (you) from reporting something themself? You can call the state. It certainly will get you a survey though, but if you give names and dates then the state will be able to investigate and the first thing that will be asked is where the facility investigation is...then you will know if she is truly reporting or not and if the allegations are true or not. It is a rather harsh thing to do, but abuse and neglect of individuals that are depending on us to care for them and protect them is a serious matter. You can report confidentially but you have to give specifics.

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Specializes in Rehab, Infection, LTC.

nevermind this

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Specializes in Rehab, Infection, LTC.

About the company hotline....be careful.

I worked for a company that would forward the complaint call to the Administrator of the facility, who would then play it for the DON. They knew exactly who was calling.

I worked for a company that sent out surveys every year to rate your facility. They were supposedly anonymous. Copies of the surveys were sent to the Admin/DON to handle the complaints. Guess who could tell who wrote what?

I don't want to sound like I'm paranoid. I learned a lot at that job that made me realize a lot of things. The problem is, if you get blackballed for something like this, you won't work in that area again.

Pick your battles. That's all I'm saying.

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We do have policies and procedures for reporting incidents. The problem is the DON is controlling the process. When an allegation of abuse is reported by a staff member, the incident is reported to the DON for investigation. THe problem is a lot of them are lost, dismissed, or never follow up on. How does the regulatory agencies know if they never get reported? Also, when an "investigation" is conducted if other residents don't substantiate the allegation made by the resident then it is unsubstantiated. Also, my administrator told me falls resulting in fractures do not require reporting. He said that was done away with 15 years ago. How would I find out what is deemed reportable. Recently state resurveyed us and detected several residents who had falls so they asked the DON for all the falls for the last 3 months. She did not provide all the falls because she "misplaced" the incident reports and she signed and back dated incidents several of them. The DON is supposed to submit all incidents to our corporate office through a database reporting system. The problem is not all are being reported. It's a mess. Any suggestions

Do you have a corporate compliance officer or an anoymous reporting line for the company?These are very serious allegations, all staff are mandated reporters, call in your suspicions as per state/federal law, and notify your DNS /administrator in writing. Are you part of the management team? Do you help investigate these abuses? DON's are required to maintain incident logs and reports, these are easily accessed for state surveyors. We report everything now in this state.

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Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

Had a friend that staff came to with a concern. My friend (not a nurse) was unsure what to do so she called her supervisor and the supervisor told her to direct them to the hotline. My friend did not disclose the concern, just that it was an allegation of falsification of records and neglect. My friend advised staff to call hotline. Staff calls hotline. My friend and the staff got fired...my friend was fired for "insubordination", administrator was told about the hotline call and said she (my friend) should have told her (the administrator) first...the administrator was the one who the complaint was about!!!!!!! I do not trust hotlines. They are "by the company, for the company". The "supervisor" was corporate so I'm sure she told that a call would be coming on the hotline....so much for confidentality being anonomyous!

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Specializes in Gerontology, Med surg, Home Health.

Yeah....we have a compliance line and one of the corporate nurses told me it goes to her. So much for an unbiased view of things. Although, in her case, she usually is pretty fair minded.

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