questioning state reporting regulations

[LPN9200]

I work in a not so desirable LTC facility in PA. We are "overly" friendly with DOH for numerous reasons. I had not realized the extent of just how poor of a facility it was until I was drawn in by the pay and conned into a year contract (I have currently negotiated it given numerous breeches of contract on their part but that's a whole other story.) Up until a few months ago, I worked on our dementia unit which quite honestly is more of a psychiatric unit given the degree of behaviors and issues we have. Primarily we have had a lot of resident to resident altercations and almost daily falls (sometimes upwards of 3+ a day.) management refused to listen to what we felt was the real issues causing these things and instead decided on staffing changes. Initially our policy was to report any RTRA to DOH due to it being a reportable incident. But today, our DON informed us that unless there is "substantial injury" we are not to be reporting this to DOH. Is this acceptable? Is that how it is supposed to be or is it like my gut feeling that they are just "sweeping it under the rug" to prevent even more attention from DOH? Which they have done in the past with another issue that I will not discuss but resulted in multiple nurses losing their nursing licenses and the facility almost being shut down. In order to be released from my contract, I must stay on PRN working one day a month for the remainder but something just doesn't feel right about this to me. Does anyone have any further knowledge on how the reporting of resident to resident altercations go? Does it only have to be if there is injury?

[CoffeeRTC, BSN, RN]

I'm in PA and I thought it was all interactions. Let the state evaluate it and determine if it is serious or not.

Do you have a compliance hotline to call?

[LPN9200]

I thought it all interactions had to be reported as well, but over the course of the last maybe 2 months there has probably been 9 or so alone. (I no longer work over there except casually when needed so I don't have an exact number) none of these have involved injury aside from a few bruises so my DON has informed us that those no longer be reported. I was unsure if maybe the state just got tired of them or what (unlikely, yes but who knows.) I do have a compliance hotline so maybe I will try that. I just didn't want to report something if in fact they were correct in how they were handling this.

[CapeCodMermaid, RN]

If the resident has significant dementia and there is no injury, it no longer needs to be reported

[ClearBlueOctoberSky]

I work in our secured neighborhood for Dementia, and we don't report every RTRA. For it to be reportable, the Resident has to demonstrate understanding of the incident and there has to be significant injury. I'm in Colorado, so even though our standards have tightened up in the last few years, it is probably different than where you are.