A report by the Georgia Department of Community Health recently revealed that a resident who assaulted another resident, allegedly causing that resident’s death, was admitted to the nursing home last year after being diagnosed with alcohol dependency, aphasia (the inability to understand or express speech), and “dementia with behavioral disorder.” The report indicated that the resident had demonstrated aggressive mental behaviors multiple times since last November and had been referred to the outpatient veteran’s clinic for evaluation of his aggressive behaviors by a physician’s assistant. However, due to the COVID-19 outbreak, the clinic was closed.
While the report did not identify the resident, inspectors found the nursing home deficient in following the agency’s rules for providing mental health services to one of its residents who demonstrated an increase in “aggressive behaviors.”
The resident might have been helped through telehealth, but that did not occur. At one point, the resident was referred to another healthcare provider who did not accept him as a patient “due to lack of payment source.”
Compliance Perspective
Failure by a nursing home to ensure that residents displaying or diagnosed with a mental disorder or psychosocial adjustment difficulty receive appropriate treatment to address the assessed behavior may be considered provision of substandard quality of care, in violation of state and federal regulations. Additionally, failure to provide sufficient, competent, direct care staff with the skills to ensure safety for all residents may be cited by surveyors as the inability to attain or maintain each resident’s highest practicable level of physical, mental, and psychosocial well-being.
Discussion Points:
- Review policies and procedures regarding appropriate provision of behavioral health services, including sufficient training of care staff to enable them to respond adequately during times of crisis, including the COVID-19 pandemic.
- Train staff about the need for monitoring a resident’s aggressive behavior toward staff and other residents, as well as the importance of documenting and reporting incidents, and implementing interventions.
- Periodically audit to ensure that incidents involving a resident’s display of aggressive behavior are addressed through thorough evaluation and implementation of care plans designed to protect others from assaults by that resident.
