Methods of Investigating Incidents in a Long-Term Care Facility
Jeannine LeCompte, Compliance Research Specialist
Once an incident has been reported, it is the legal duty of any facility to conduct a timely and relevant investigation. The first step is to determine exactly what happened; identify the person or persons involved; the incident’s root cause; and responsibility, if applicable. This will allow the investigator to determine two important facts: (1) under which category it will be classed: for example, injury, abuse, data privacy, or criminal activity, etc.; and (2) to which next senior level the incident should be reported.
Speed is always crucial, as accurate facts are most readily available at the time of an event. Later reconstruction always runs the risk of faulty memories and missed details.
Once the nature of the incident has been established, the investigator must determine which person or persons are involved. For this purpose, a definite plan for reviewing evidence, establishing documentation records, and consistent interview questions and routines should already be in place.
Depending upon the severity of the incident, it is not necessary to investigate every event to the same depth. The key to determining severity levels is to know the federal and state definitions of abuse, neglect, exploitation, and mistreatment.
Interviews and witness statements are one of the most important tools used in any investigation. Interviews with concerned parties should therefore be conducted in quiet, private locations. Each person should be interviewed separately. Impartiality, discretion, and non-judgmental language are vital, and this might require prior training for the interviewer.
Once statements have been taken from all the parties involved, comparisons can be made. Events can then be confirmed, and if any discrepancies are noted, they can be investigated further.
Effective statement taking can follow one of two methods: narrative or question-and-answer. The narrative method uses open-ended questions to ask the witness about his or her observations and actions at a specific location and time, while the question-and-answer method uses a focused series of questions to obtain information about the witness’s observations and actions at a specific location and time. The latter method is preferable because it provides consistency in the interview process.
It should be kept in mind that it is unlawful to engage in any type of retaliation against anyone for making a good-faith report of a concern or participating in an investigation into the facts.
