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long....looking for aaa information...substantiated neglect

LTC Directors   (4,518 Views | 14 Replies)
by pnurse68 pnurse68 (New) New

1,312 Profile Views; 13 Posts

Hi, Looking for someone who has had a similar experience as my state's local aaa office nor the main office can help. I am the DON of a facility that reports absolutely everything that could even remotely be construed as abuse: the demented lady that state "the father of the would be child slipped in the the night with his friend and 12 men raped her", I mean EVERYTHING. My thought process is that I would rather report and withdraw than not report and get tagged.

Recently while I was on vacation, a resident fell and sustained a hematoma. She is a long term resident with no fall history, no attempts at self transfer in the 9 months shes been with us, alert and oriented, transfers and ambulates with contact guard/supervison.

Nurse aide assisted to bathroom and left her to do her thing. By history she has always used the call bell when she was done. This time she leaned over to adjust her O2 tubing and fell. Minor injury, hospital eval and back in 3 hours.

I instructed the ADON via phone to report. DOH questioned if the the facility had followed the plan of care or was neglect suspected. I instructed the ADON to state plan of care was followed and no neglect or PB 22 needed. They accepted the report.

ADON also reported to Area Agency on Aging. They investigated and wanted to substantiate abuse against the nurse aide for not staying in the bathroom with the resident. I stood behind the nurse aide stating, he would not have needed to stay in the bathroom with the resident as that is not her plan of care.

She ended up not tagging the nurse aide. She substantiated neglect against ME as the DON, for not educating staff to stay with the resident. I am appealing and the road blocks are considerable, no one can even tell me who this is reported to, how it impacts my license nothing!

Anyone have similar experience??????

Edited by tnbutterfly
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CapeCodMermaid has 30 years experience as a RN and specializes in Gerontology, Med surg, Home Health.

2 Followers; 6,076 Posts; 61,619 Profile Views

We don"t have an AAA in Massachusetts. Everything here gets reported to the Department of Public Health. I've not heard of the DON getting cited for something like this. I, too, report everything. I had one woman fall 4 times with a trip to the hospital each time. Alert, oriented and demanded to have privacy in the bathroom. DPH didn't even come out to investigate.There has to be a process to follow to appeal an unfair tag. Can you call the AAA and ask them? They would have to tell you. I'd start by making a copy of the care plan and any PT notes and falls risk assessment. I'd repeat to them what you said here...that she's been with you for 9 months and never attempted to self transfer. How can they tag you for your CNA following the plan of care? Please let me know how you make out. PM me if you want.

Have you tried speaking to your ombudsman?

Edited by CapeCodMermaid
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Nascar nurse has 34 years experience as a ASN, RN and specializes in LTC & Hospice.

2,217 Posts; 32,434 Profile Views

Yikes! That's awful and very unfair. Also scary as hell. I've never heard of a DON being directly cited for something like this. I have no advice but will be very interested to hear how this turns out for you. Best of luck.

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CathRN has 15 years experience and specializes in everywhere.

144 Posts; 5,024 Profile Views

I don't where you are located, but in Texas, on each and every tag, when you receive your 2567, there should be a letter explaining the IDR (Informal Dispute Resolution) process. You always have the right to IDR anything. I hope this helps.

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13 Posts; 1,312 Profile Views

That is the interesting part DOH did not tag anything. Just area agency on aging. I am filing appeal but have been denied access to the investigation despite the Right to Know Law. Will be talking to legal counsel today and will keep you all updated. Thanks for the support.

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13 Posts; 1,312 Profile Views

ccm.....Thanks for the invite to PM...however I am still too new of a user to have that function enabled. Guess I will need to come up with more post topics:yeah:Spoke with legal today, a thankfully I work for a very supportive company that is willing to stand behind me. I have yet to speak to anyone who has seen this before. Kinda gives new meaning to the whole "your working under my license" line. Sometimes I wonder why anyof us give up the joys of floor nursing, heck even shift supervisor for this!

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Nascar nurse has 34 years experience as a ASN, RN and specializes in LTC & Hospice.

2,217 Posts; 32,434 Profile Views

pnurse68. just keep posting right on here. Make one right after another - I think you need 15? posts to get private messages. CCM gives great advice so you will want to see what she has to say.

My fingers are crossed that you win this battle.

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CapeCodMermaid has 30 years experience as a RN and specializes in Gerontology, Med surg, Home Health.

2 Followers; 6,076 Posts; 61,619 Profile Views

Nascar nurse is no slouch either when it comes to great advice!

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4 Posts; 987 Profile Views

ohhh how awful! that is so scary. it scares me a lot having so many LPN's and CNA's working under me. everyone is so quick to say that in ltc every nurse is the same, whether lpn or rn... but i've learned that if there is any way for someone to save their own butt, they'll throw you under the bus. i HATE that about nursing. people are sooo triffling!

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debRN0417 has 31 years experience and specializes in LTC, ER, ICU, Psych, Med-surg...etc....

511 Posts; 5,991 Profile Views

The area on aging in my "area" would have referred this to us and we would have investigated...I have never heard of them "citing" like that, but I guess its because its a different state??? We receive all kinds of F.Y.I's as we call them, from the ombudsman and adult protective services and we look at them on surveys but they are usually unsubstantiated little things.... If you were following the care plan then what is the neglect issue? Forgive me, I know we all agree on that I am just confused. I am not understanding this agency's authority to specifically cite a person or facility. In my state we are the ones with the enforcement authority and anything like that would have been referred to us for further investigation if they thought there was a problem.....I would appreciate any information that would enlighten me.

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VivaLasViejas has 20 years experience as a ASN, RN and specializes in LTC, assisted living, med-surg, psych.

8 Followers; 142 Articles; 9,775 Posts; 251,456 Profile Views

This is the first time I've ever heard of a substantiated neglect/abuse citation against an individual---where I live and work, only the DHS can do this, and citations are always issued against the facility itself. If there's evidence that a given nurse or CNA was to blame for a particular incident, this is reported to the BON, which will then do its own investigation into the incident.

But, all 50 states have different ways of doing things, so I don't know how it is that what sounds like an advisory group can wield the power of a state or federal agency. In the OP's place I would definitely consult my company's attorney to find out what this 'citation' can do to me, and what protections are available to me under the corporate umbrella.

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13 Posts; 1,312 Profile Views

Thought I would update for those of you kind enough to reply. My company's legal team has appealed this ruling and we are awaiting a hearing date.. It appears as if my name is now on some sort of watch list where it will sit for 3 years and then be removed. The watch list is not public, however this still is extremely concerning for me. I do intend to follow the appeal process to the very end. Hopefully we will be successful at the first level. The information we have been able to review so far seems to point to a less than accurate investigation ( politically correct verb choice ). Disturbing on many levels.

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