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 If then, your investigation deems the allegation to be unsubstantiated, the report is "withdrawn".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.
