LAFOLLETTE, TN- CUMBERLAND VILLAGE CARE

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 40640

Based on facility policy review, medical record review, facility investigation review, observations, and
interviews the facility failed to protect the residents’ right to be free from physical abuse by another resident for 4 residents (Resident #17 and #5, #3, and #10) of 14 sampled residents reviewed for abuse. On 4/11/2024, Resident #18 hit Resident #17 and caused a laceration above his right eye and abrasion to his left elbow. On 1/31/2024, Resident #6 hit Resident #5 in the face causing a nosebleed. On 1/11/2024, Resident #4 struck Resident #3 in the head. On 4/29/2024 Resident #11 struck Resident #10 in the arm. The facility’s failure to protect the residents’ right to be free from physical abuse resulted in actual harm for Resident #17 and #5.

1. On 4/11/2024, Resident #18 hit Resident #17 and caused a laceration above his right eye and abrasion to his left elbow which resulted in actual harm for Resident #17.

Review of the Nurse’s Note for Resident #17 dated 4/11/2024, revealed .Nurse went to speak with [Resident #17] of situation with [Resident #18], [Resident #17] stated [Resident #18] had stolen his drink so [Resident #17] swung at [Resident #18] making contact .[Resident #18] swung back at [Resident #17] making contact causing an abrasion on his right eye and left elbow .

2. On 1/31/2024, Resident #6 hit Resident #5 in the face causing a nosebleed which resulted in harm to Resident #5.

During an interview on 9/4/2024 at 12:25 PM, Licensed Practical Nurse (LPN) D stated, .[Resident #6] accused [Resident #5] of being with her husband. [CNA F] witnessed [Resident #6] hit [Resident #5] in the nose. [Resident #5] had a small nosebleed .[Resident #5] is confused and didn’t realize what happened . there has not been any change in her routines .the psychologist .made the recommendation to send her [Resident #6] to the ER, she came back later that night with a diagnosis of a UTI [Urinary Tract Infection] .the incident was witnessed [Resident #6] hit [Resident #5] intentionally .

During an interview on 9/10/2024 at 2:45 PM, the DON confirmed Resident #5 received a nosebleed after a witnessed altercation with Resident #6. Resident #6 willfully struck Resident #5 in the nose causing harm to Resident #5.

3. On 1/11/2024, Resident #4 struck Resident #3 in the head.

Review of the NP’s Note for Resident #4 dated 1/11/2024, revealed .Nursing reports [Resident #4] hit [Resident #3] closed fisted in the head .prior to being able to redirect. [Resident #4] went into community room and began to hit the other resident. [Resident #4] indicates she hit [Resident #3] because she was making fun of [Resident #4] .

4. On 4/29/2024 Resident #11 struck Resident #10 in the arm.

Review of a comprehensive care plan for Resident #10 dated 6/20/2024, revealed the resident had an altercation when another resident (Resident #11) hit her on the arm.

Review of the Nurse’s Note for Resident #10 dated 6/20/2024 at 3:21 PM, revealed .[Social Services] spoke with [Resident #10] after a physical altercation with another resident. [Resident #10] stated she stopped and said Hello to her. [Resident #10] stated [Resident #11] said, You’re not on your hallway, and hit her in her left arm.

During an interview on 9/10/2024 at 1:25 PM, the Administrator stated, .this was a witnessed event and abuse was substantiated . During the interview the Administrator confirmed the facility failure to prevent abuse of Resident #10.