Violence in a nursing home setting can take place at any time– at any facility. While there certainly are procedures that facilities can put into place to reduce the number of these incidents, each episode needs to be closely examined to determine the specifics behind the incident and to prevent the eruption of similar problems in the future.
While not every episode of violence may be physical in nature or result in injury to the patients involved, it is still incumbent on facilities to report and investigate these situations to prevent escalation and ensure patients remain free from physical and psychological harm.
Ignoring episodes of verbal or physical abuse in nursing homes does no more to improve patient safety than when episodes of severe neglect go ignored and un-investigated.
As a nursing home lawyer involved in nursing home violence matters, I was pleased to see how the Minnesota Department of Health handled a series of episodes involving violence Franciscan Health Center where residents at the facility were verbally and physically assaulted at the facility— though no residents required medical care for their injuries.
The department dispensed three ‘Level F’ deficiencies for the manner in which the facility handled a series of incidents occurring in August, October, and January– primarily for the delay in immediately reporting the incidents to the health department. Under the parameters of a Level F sanction, the deficiencies are indicative of “widespread deficiencies that constitute no actual harm with the potential for more than minimal harm that is not immediate jeopardy.
As part of the state’s protocol for these matters, the facility is permitted to respond to the findings in the form of a plan of correction to address the incidents and prevent future matters from arising.
According to a news article in the Deluth News Tribune highlighting these incidents, the following circumstances were documented:
- August 2011: A resident intentionally ‘bumped’ the wheelchair of another resident and attempted to prevent the resident from leaving the area. In retaliation the patient in the wheelchair hit the resident on the head.
- October 2011: A resident verbally threatened to punch another resident in the face.
- January, 2011: Resident physically assaulted a peer and indicated to staff that he intended further violence.
While the above incidents may seem relatively harmless given the lack of serious harm, these episodes have the potential to quickly escalate without the intervention of staff. Educating staff on the early signs of patient violence and the need to report these incidents as they would any other concerning act will hopefully improve the safety of patients at this facility.
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