Nursing Home Resident Taunted by CNAs

Choosing to place a loved one in a nursing facility takes a lot of trust. What happens when that trust is violated and your mother ends up in a Snapchat video? Learn what happened to Margaret Collins and weigh-in on how cases of abuse and neglect against the elderly should be handled.

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Nursing Home Resident Taunted by CNAs

Leaving your mother or grandmother in a long-term care facility is challenging. For one Illinois family, it turned into a nightmare. A video taken in December of 2018 showed two certified nursing assistants taunting resident, Margaret Collins with a hospital gown. Jamie Montesa and Brayan Cortez posted a video to Snapchat that showed them repeatedly throwing a hospital gown on top of Collins with the caption, "Margaret hates gowns.” Collins, who has dementia, waved the gown away each time.

Resident's Rights

If you've been around healthcare for any length of time, you know that individuals living in skilled or long-term care facilities have many rights. The scenario above clearly violated several of Collins' fundamental rights as a resident of a long-term care facility.

Right to participate in care

Collins not only had the right to participate in her care, but she also had the right to refuse it. She clearly did not want the hospital gown. One could argue that she was agitated at the time. Even if this were true, she didn't have to wear the gown and could have been dressed in her own attire.

Right to privacy and confidentiality

Collins had the right to keep the details of her care private. Having a video of herself posted on Snapshot without her or her designee's explicit consent is a direct violation of this right.

Right to dignity and respect

Treating any human in the manner that Montesa and Cortez treated Collins greatly lacks both dignity and respect. She also has the right to be free of mental and physical abuse and to determine what activities she wants to participate in during her care. Both of the nursing assistants disrespected Collins in this case.

Right to make independent choices

Residents living in healthcare facilities have the explicit right to make decisions about what they want to wear or eat and how they want to spend their free time. Their choices should be accommodated and respected by all caregivers.

Legal Implications and Disciplinary Action

The two nursing assistants were initially given a six-day suspension. After further investigation into the incident, the facility determined that they violated internal policies and standards. Montesa also admitted to previously recording a video of Collins while she was in a wheelchair. When the investigation concluded, the two workers were terminated. In a statement, a representative from the facility said, "The privacy and dignity of our residents are of the utmost concern.”

The family of Margaret Collins is reportedly suing the Abington for $1 million in damages. The parent company of the facility and the two nursing assistants are also named in the suit. Collins has been moved from the facility. The family reported that she suffered from anxiety related to the incident.

Is Termination Enough?

Most people will agree that Montesa and Cortez received what they deserved when they were terminated. However, is it enough? During a search of the Illinois health care worker registry, it appears that both Montesa and Cortez remain certified in the state of Illinois. No administrative filings are on record for either worker. Of course, it can take months or even years for cases like these to come before the regulatory boards. These gaps in time could leave other vulnerable individuals in similar situations.

The incident with Collins leaves me wondering how difficult it would be to formally suspend a healthcare worker who is terminated for abuse or neglect. Could this be done? And, if it's done in error, what are the repercussions to the worker?

Cases like this may become more common as more people live longer with debilitating conditions such as Alzheimer's disease or dementia. At some point changes, need to be made by the facilities, training programs, or states who certify and license people who care for the elderly.

What are Your Thoughts?

What do you think? Did Montesa and Cortez get what they deserved? Should they be allowed to care for others in the future? And, how would you respond if this were your mother or grandmother? Add your thoughts in the comments below. We would love to hear what you're thinking about this despicable act.

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Melissa Mills

About Melissa Mills, BSN

Workforce Development Columnist

Melissa is a professor, medical writer, and business owner. She has been a nurse for over 20 years and enjoys combining her nursing knowledge and passion for the written word.

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When I was in high school we had a "Career Resource Center" where students could train to be CNAs in classroom and at a nearby nursing home in the afternoon after core classes. I was initially in it but had to leave because I was old enough to drive to the site. One of the girls was in my stats class in the morning and commonly shared information, names and even photos of patients she dealt with, another student and I reported it and the school dealt with it but it was barely a slap not the wrist. This is a major problem with assistive care personnel and as much as I hate the phrase, an example needs to be made of these women.

I will say I've noticed that ACP are much better behaved in the hospital setting. I think there should be more recognition for exemplary care from the ACPs so they have something to strive for.

Great article, thanks for sharing.

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Specializes in Perioperative, peds ,floor nurse,scl nurse.

My brother & I had placed our dearly loved aunt in a small home facility. She had severe dementia. When she called me screaming one night, saying that the aids were hitting her, I was close to going down there & committing mayhem. The aid tore the phone away from her & told me that my aunt was hitting them. I told her if anyone even gave her a dirty look, they would have to deal with me personally. We moved her to another facility in the next few hours. We had put her under supervision because she roamed & even living with family, she would get away from us. I had already lost an uncle who had left his nursing home, saying he was going home. We found his body 2 weeks later broiling in the hot August sun & I was not going through that again. I made it my business to tell each facility who I was, what I was, & what kind of care I expected. The first facility was chosen by my brother against my better judgement. When we placed her in the second facility, I was much more confident in the quality of care. This is what bothers me. We place our loved ones because we can’t care for them ourselves, their care is overwhelming & we feel extremely guilty doing it. It was for her safety & our peace of mind. Do not place your elderly anywhere that your gut tells you not to. I agreed the first time to avoid family BS & to this day, I regret it. The second place was lovely & she was happy there. I’m just sad that she went through that. She didn’t remember but I do !

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Specializes in Hospice Home Care and Inpatient.

Until our society starts treating our most vulnerable in a humane and compassionate way, this is going to continue to happen. I do not think this situation was unique. LTC staffing is ' bare bones'. I do not think there is a lot of education or support available to staff in geriatric care. There is not an excuse for this behavior, but I think there should be discussion about why they thought this was ' ok'.

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Specializes in Medsurg.

Definitely not enough. Throw them fools in prison, send a Kite to someone to say why they are in. Then it would be enough.

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Specializes in Hospice Home Care and Inpatient.

And what exactly would that accomplish? What they did was not acceptable by any stretch, but I don't this this situation was unusual.

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Specializes in Hospice Home Care and Inpatient.

What about a vision for society that made it possible for those who need care to receive it in a timely and dignified way? A SNF should not be about most pts and least staff possible. What about a ratio for CNAs AND ongoing education for them re most of the ' chronic' conditions that lead to placement. What about having nurses who could supervise care accurately instead of " no one fell this shift/ or whatever". I think our Society can do so much better than this. We just need to stop rationalizing " the norm". One day it is going to be us not wanting a hospital gown.

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Specializes in Psych (25 years), Medical (15 years).

"What do you think?... We would love to hear what you’re thinking about this despicable act."

I think and ask myself: What motivated Montesa and Cortez to commit "this despicable act"?

Everybody has a need to feel power and control over any given situation. Had Margaret Collins donned the hospital gown she was offered, M & C probably would have went on their merry way. When Mrs. C refused the gown, M & C felt no sense of power or control and reacted accordingly with inappropriate behavior.

What caused that inappropriate behavior to occur?

When stimulated, our sympathetic nervous system stimulates the brain that makes a reflexive decision to take either fight or flight response. M & C made a reflexive decision to fight. Once a reflexive decision is made, a domino effect occurs and Newton's Law of Motion is in effect.

Unless an external force changes the state of a motion, the motion will remain in action. M & C had synergism in that the two were on the same course of action, which fueled the motion. If either M or C would have said something like, "You know- it's her right to refuse to wear a gown. Let's leave her alone", the external force would have changed the state of the inappropriate motion and the motion would have ceased.

In the early '90's, I learned that certain anticonvulsants were being used to help control explosive disorders. An explosive disorder contains features such as "sudden episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which (an individual) reacts grossly out of proportion to the situation".

A neurologist affirmed my belief that an explosive disorder episode is not unlike a seizure, in that neurons are stimulated causing an out of control chain reaction.

Did M & C both experienced an episode of an explosive disorder? No- but they both experienced the stimulus that caused the inappropriate behavior and both did not possess the internal governing mechanism to cause the behavior to cease.

Locking the barn after the horse is stolen and punishing the thief is tact to take in preventing a parochial future crime. However, understanding the motivation and actions behind the theft will universally assist in preventing many more like crimes.

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Specializes in Psychiatry, Community, Nurse Manager, hospice.

Agree that M and C should have been fired. We can't let employers dictate what happens to people's certifications and licenses though. That opens healthcare workers up to abuse by employers, which is already a problem some places. I've heard from many nurses on these threads who have been threatened with bogus patient abandonment charges if they refuse to take extra shifts or work overtime.

We need a board that will take the time and diligence to complete investigations for healthcare workers accused of abuse and neglect.

Many UAPs in SNF are making pennies above minimum wage and are overworked to boot. We need to recognize the value of their work and pay what it's worth if we want quality workers.

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On 8/14/2019 at 7:28 PM, MSO4foru said:

And what exactly would that accomplish? What they did was not acceptable by any stretch, but I don't this this situation was unusual.

So because you think this sort of behavior is common, it's ok?

What punishment accomplishes is that the perpetrators get punished.

They will either be bitter or they will realize the error of their ways.

Maybe their being punished will be a deterrent to others who might foolishly think this behavior is ok.

They need to be banned from "caring for " the defenseless population. That would be a more appropriate approach to the nursing home to have taken with them, in addition to firing. You know, reporting them to state regulators.

I can't believe you think that this kind of thing being common makes it ok. What if YOU were that patient? Your child? Your parent, grandparent, other loved one?

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3 hours ago, FolksBtrippin said:

Agree that M and C should have been fired. We can't let employers dictate what happens to people's certifications and licenses though. That opens healthcare workers up to abuse by employers, which is already a problem some places. I've heard from many nurses on these threads who have been threatened with bogus patient abandonment charges if they refuse to take extra shifts or work overtime.

We need a board that will take the time and diligence to complete investigations for healthcare workers accused of abuse and neglect.

Many UAPs in SNF are making pennies above minimum wage and are overworked to boot. We need to recognize the value of their work and pay what it's worth if we want quality workers.

I agree they are seriously worked very hard and not paid well enough. How to fix that?

If I were the owner of a facility:

- free or low cost child care onsite for kids from a few weeks of age through preschool (up to age 5) This benefits not only parent and kids, but also the elderly, who often love to have kids around. all shifts, 7 days per week

- sick care on site for kids, while the parent is at work, for all shifts, 7 days per week, by a licensed nurse, who can give meds, check temps

- adequate staffing

- respect toward UAP's, the same being required from them

- tuition (either paid partially up front, via payroll deduction, or reimbursed for a B or better in a class that helps them work toward LPN, LVN, RN, maybe Med Records or other cert or degree that would benefit not only my facility but the worker, too

- free bus passes or car allowance

- transportation that goes to actually pick up the worker and kids who will be in child care or sick child care, and that actually takes them home again

- premium pay for weekends, holidays, overtime

- free meal every shift

- plenty of lifts, gloves, linens, etc. and various assistive devices that work and are available

- free uniform and shoes every year and upon hire, or cash in lieu of these

- quarterly recognition of worker birthdays via a party to which they can bring their kids or a different guest; goal is recognize their BD and help them have family time over a nice meal and fun event

- cash or gift card to buy groceries at Christmas, Thanksgiving, maybe another couple of holidays at other times of the year

- monetary award, at a ceremony, for being chosen "worker of the quarter" or some similar achievement; chosen by the nurses anonymously; gala affair with food and recipient's family invited;

- party for workers' kids on premises - petting zoo, food, balloons, crafts, face-painting, wading pool, etc. during Summer vacation; residents are also invited, of course; fun for all

Probably cost a small fortune, but likely worth it to get and keep the best workers.

I would include other low-paid staff in these things - laundry, kitchen, housekeeping, etc.

What would I do for nurses? Fire UAP's who sass them and refuse to follow legitimate orders. Oops, I said the "O" word! Yes, I do believe nurses are/should be actually in charge.

Nurses can get in on transportation and child care, holiday gifts, uniforms, tuition.

I'm thinking about letting each worker do a load of personal laundry each week, at work, for free. Have to monitor closely to prevent abuse.

Sigh. Dream on...

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Specializes in Hospice Home Care and Inpatient.

No Kooky Korky- I do not think this behavior is acceptable. See my post above. All of the suggestions you made are very good. And would make a pleasant work environment, which would improve staff turnover, (and morale) leading to better care for the residents.

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