Citations of Nursing Home Abuse and Neglect
At an April 12, 2018 meeting with the Department of Health (DOH), LeadingAge NY raised a question related to recent citations of abuse/neglect, F600. Based on conversations with a member and the review of Statement of Deficiencies (SOD), the Department is citing facilities for neglect in all situations where the neglect was solely related to individual culpability.
The Interpretive Guidelines, under Determination of Findings and Potential to Foresee Abuse, read as follows:
It has been reported that some facilities have identified that they are in compliance with F600-Free from Abuse and Neglect because they could not foresee that abuse would occur and they have “done everything to prevent abuse,” such as conducted screening of potential employees, assessed residents for behavioral symptoms, monitored visitors, provided training on abuse prevention, suspended or terminated employment of the perpetrator, developed and implemented policies and procedures to prohibit abuse, and met reporting requirements. However, this interpretation would not be consistent with the regulation, which states that “the resident has the right to be free from verbal, sexual, physical, and mental abuse…” Therefore, if the survey team has investigated and collected evidence that abuse has occurred, it is appropriate for the survey team to cite the current or past noncompliance at F600-Free from Abuse and Neglect.
DOH has shared that, based on their discussions with CMS, even in situations where training, staffing, screening, etc. would be judged to be satisfactory, when actions of an individual result in a negative outcome to a resident, a citation would be issued to the nursing home. LeadingAge NY is concerned about this interpretation, as in the past, those situations where an individual employee used poor judgment and all other structures and processes were met were viewed as instances of individual, not facility, culpability.
We are continuing to pursue discussions with DOH over this interpretation and the significant impact that it would have on all nursing homes. In addition, we have reached out to LeadingAge National to determine if the New York State interpretation of F600 is consistent with how CMS is interpreting it nationally. We would like to hear from any members who have been cited for F600, where the nursing home provided the appropriate steps/actions and either the omissions or commissions of an individual employee were responsible for the negative outcome to the resident.
Contact: Elliott Frost, efrost@leadingageny.org, 518-867-8832