I have an activities director that I think is trying to pull some poop. We have a resident who has a history of CVA and is know to have behavior towards staff. She has a history with a certain staff that they once got quite into it. This was way before I took over and the resident has been witnessed being verbally abusive to this staff member. Now I know that you never know what goes on behind closed doors but this particular staff member has risen to the challenges that I have given her and now is the lead CNA. This particular resident verbally abused this and another staff member earlier this week when she was left in the bathroom while staff responded to an emeergency. It was explained to the resident and they appologized for leaving her. She still was verbally abusive and then told her daughter that day that this staff member wasn't doing her right. It was explained to the daughter what happened and all seemed to be well. Then today, my bath aid had to put off this residents shower time till later in the day due to several reasons. Some were very ligit, but after I left the resident turned on the tears and the activities director wrote up the shower aid and left me a message saying that this was flagrent abuse and neglect and that if I didn't handle this that she would report it. Just today we spoke about this residents behaviors and that activites person was there.
I am trying to be fair, I don't see this as neglect or abuse just some communication problems and lack of understanding from resident. I have seen her in action and she can turn it on for her family. But now I get to meet with them tomarrow am and although I can't prove it I think the activites director called them and stirred them up. The resident is not able to (in my experience) be verbally articulate enough to explain a situation like this.
Part of this is to vent after a long week but i hope i'm being fair to all. I very much respect resident rights but also the rights of my staff. any thoughts

There seems to be one in every facility. It will get no better. (sorry to say).
My response to the activities person would be: "if this is abuse and you do not report it then you are as guilty as the person you "claim" abused this resident.". THat is what would be appropriate in my state. I am not sure i would not report this just to cover my ___. As long as you have addressed these issues on the resident's care plan; and as long as these incidents of resident to staff abuse are documented; then you should be covered. It has been most difficult in my state to Not report anything.
If you don't report it; they will cite you; even if you do not think it is abuse. I have come to believe that what we think doesn't count anymore. At least not in Mississippi. Good luck and keep the line of communication open with the resident's family. Be honest with them and if they believe this resident then tell them they may have to take the resident elsewhere and that you will assist them with finding other placement if she is so unhappy. That usually gets them to back off; at least for a few days.
Good luck!!
Judy

In my state, & I'm sure it is in most states, once an abuse allegation is made, you must report it to the state by telephone the next business day morning.
My state then sends out to you the necessary forms that you need to complete & return, during which time you are conducting your investigation & inservicing & documenting.

You really have no choice but to file the incident report on the abuse allegation. If then, your investigation deems the allegation to be unsubstantiated, the report is "withdrawn".

The biggest thing to remember is your documentation. Your investigation has to be documented & the more complete the documentation is, the easier it is to show why you do not believe there was abuse.
Past history of the staff members & resident involved can be included, if it was previously documented or otherwise comes up in the course of the investigation.

The family may try to threaten moving the resident elsewhere if you don't act.
The Activities Director may threaten something further if you don't act.
But what matters is that you cover yourself by filing the report, conducting a full & impartial investigation, & taking whatever action is warranted based on the information revealed in the investiagtion.

Flagrant Abuse?
I really question that, but what we don't witness we can't name.

Did the resident get a shower later in the day as "promised"?
Did the resident receive the care she required?
Does the resident recall the incident & does she feel it was abusive?
Were the reasons for delaying the shower legit? Could they have been avoided? & if so, how?

The resident was in tears. Why?

So many times we forget, many of our residents get frustrated with what is going on around them because they have no control or no choices.
BUT they also can be frustrated because someone is making a "big deal" of something that they don't feel or find to be much of a concern.

Even more, when a staff member tries to impose their beliefs on a resident, especially if that resident can not articulate or communicate sufficiently, the resident more often then not will become frustrated & upset & at times even come to tears......

Right or wrong, the CNA might have to go if your investigation can not clear them of the abuse allegation.
IF you believe it to be a false allegation, you can indicate in the various reports you are required to file, but your belief would only come into play if the "evidence" was neither incriminating nor clearing.

My course of action beyond that would be to look at the Activities Director. Did they violate any policies?
Is there an understanding (even if unwritten) in the facility that concerns of such nature should be taken up with the individuals direct supervisor before a write-up is issued?
Most supers don't like other department heads writing-up their staff without first discussing it with the super.

It is generally appropriate & expected that in non-emergent situation, the matter is taken thru proper channels. It does not sound like that was done in this case.

That being said, you might have some options in personnel actions you could take against the Activities Director as well. Doing so could help bolster your claim that the CNA was not guilty of the abuse claimed.

Connecticut requires even allegation of abuse to be reported to hotline and then faxed within 12 hours and a follow up in 3 days as to what the outcome of the investigation. EVEN if two residents get in to it and they are demented it gets reported.

Federal regs require every allegation to be reported and investigated. It seems your investigation revealed that no abuse happened. Tho a little difficult, any time I feel that a resident puts the employee at risk (with unfounded allegations or the risk for them) I simply require 2 staff members to be present when any care given or require the aide that doesn't gee haw to swap for another resident and stay out of that room- so far this has worked with the difficult residents.