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Abuse in senior living communities

Nursing homes and assisted living communities have the responsibility to protect their residents from physical and sexual abuse at the hands of employees and volunteers. If they fail to do so, their negligence could result in irreparable harm to the people in their care and costly lawsuits. Church Mutual has extensive experience providing risk management resources for senior living communities. The following are guidelines from Centers for Medicare and Medicaid Services (CMS) for lowering risk of abuse:

  1. Screening – Before employees, volunteers, contractors or students begin interacting with residents, they should undergo extensive screening. CMS requires organizations to have written procedures detailing the type of screening that takes place. While conducting the investigation, organizations should attempt to contact a potential employee’s previous employer and check with the applicable licensing boards and registries, maintaining documentation of all the screening that has occurred.
  2. Training – Proper training is essential for preventing unacceptable incidents of elder abuse. Organizations should provide training on a regular basis for both existing and new staff that identifies what constitutes abuse and how to recognize signs of abuse in residents. This training should also teach the behavioral symptoms of residents that could make them susceptible to abuse, such as aggressive reactions and resistance to care.
  3. Prevention – Sexual and physical abuse prevention starts with ensuring an appropriate number of staff on each shift, and that supervisors are both competent and watchful. Staff should feel comfortable reporting understaffing situations without fear of retribution. Additionally, senior living staff should clearly identify any residents who may have an increased risk of abuse, such as those with a history of wandering or aggressive behavior.
  4. Identification – Organizations should have written policies in place that enable staff and supervisors to identify instances of abuse, even when they do not specifically witness the abuse. This could include noticing a resident’s suspicious injury or sudden, unexplained change in behavior.
  5. Investigation – Any individuals investigating an alleged incident should identify staff responsible, exercise caution in handling evidence that could be used in a criminal investigation, interview all people involved, and document everything.
  6. Protection – Organizations should move to protect the involved individuals immediately following an allegation of abuse. This could include examining the alleged victim for injury, changing his or her room assignment, providing increased supervision, and offering emotional support and counseling to the resident.
  7. Reporting – Whenever an incident occurs, the organization has a responsibility to provide a full report to the state nurse aide registry and any other agency that would have a need for this information. Internally, the organization should also document everything that occurred, including remedies for making sure it doesn’t happen again.

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