Assessment

1. Assess for signs of patient neglect. These include but are not limited to:

1. Unmet physical needs - i.e. overgrown fingernails or toenails; no

dentures, hearing aide or eyeglasses when wanted and needed;

incontinent and left unattended; unfed.

2. Inappropriate dress - i.e. - not wearing clothes or shoes; dirty or tom

clothing; clothing inadequate or inappropriate to the season that is

not of their own choosing.

3. Unmet psychosocial needs - i.e. requests for care, opinions

decisions ignored by staff, leading to withdrawal, depression or

"failure to thrive" syndrome.

Investigation Process

2.  Notification of the involved patient's legal guardian or responsible family member.

3.  Steps will be taken to prevent further harm to the patient while the

 investigation is in progress:

1. Any employees/volunteer alleged to be involved in suspected abuse,

neglect or misappropriation will be removed from direct care until

completion of the investigation.

2. In cases of patient to patient abuse, steps will be taken to prevent

further interaction between the parties involved.

4.  The results of any investigation will be reviewed by the Administrator

      within five working days of the incident or date of discovery, and

      reported to the Director of Health by phone or written report. According

      to instructions from the Director of Health appropriate agencies will be

      notified including:

a) Ohio Attorney General's Office

b) Cleveland Clinic Police Department ***

c) Cuyahoga County Department of Human Services

d) Nurse Aide Registry

e) Ohio Board of Nursing

 f) Other appropriate professional licensing agencies (i.e. Physical

Therapy, Occupational Therapy, Board of Pharmacy, etc.)

      ***Facility reporting of abuse of patient to the Department of Health       does not excuse or preclude facility from its responsibility to report the incident to other proper authorities; e.g., local law enforcement.

5.  If the alleged violation is verified, appropriate corrective action will be

      taken. (This includes cases of patient to patient abuse.)

6.  Complete, detailed documentation must be made of alleged violations,

     investigations, and outcome, and maintained on file. This record will be

     available for inspection at all times when requested by the Director of

     Health.

7. Facility investigation should include, but is not limited to:

1. Interviewing the patient victim.  Avoid use of leading questions.

2. Interviewing the alleged perpetrator.  (Accomplish before summarily dismissing employee).  

3. Interviewing all persons with first-hand knowledge of alleged incident.

4. Physical examination of patient victim for evidence of abuse or neglect. 

5. Physical audit of funds or other property in cases of alleged misappropriation.

6. Photographing evidence where appropriate.

7. Obtaining written statements from victim, witnesses, other persons with reported knowledge as appropriate.

8. Videotaping or, at a minimum audio recording interviews with patient victim where possible, appropriate, and with permission of patient.

9. Collecting, reviewing, and retaining pertinent facility documentation which may have a bearing on a full and proper investigation (e.g., schedules, work assignments, policies and procedures).   

Safety

8. Steps will be taken to prevent further harm to the patient while the

investigation is in progress:

1. Any employees/volunteer alleged to be involved in suspected abuse,

neglect or misappropriation will be removed from direct care until

completion of the investigation.

2. In cases of patient to patient abuse, steps will be taken to prevent

further interaction between the parties involved.

Education

9. Staff orientation, training and on going inservice programs include

detailed educational material regarding the protection of patient rights;

prevention, identification and reporting of abuse, neglect, mistreatment

and misappropriation of patients' property and fostering of quality of life

for all patients, including dignity, respect and individuality.

Reportable Conditions

10.  Any alleged violations involving mistreatment, neglect, abuse, or

        misappropriation including injuries of unknown source, must be reported

        immediately to the Administrator. All such alleged violations will be

        thoroughly investigated, while preventing further potential abuse, neglect

        or misappropriation while the investigation is in progress.

Prevention

12.  In order to prevent the employment of individuals with convictions or

        prior employment history of patient abuse, neglect or mistreatment, the

        following procedures will be taken:

- Employment background checks

• Criminal Background Check with the Ohio Bureau of Criminal

• Identification and Investigation for all new employees hired after 1/26/97, and/or FBI check for those not residing in Ohio previous

          five years

- Prior employment references are requested

- For nursing assistants - contact Ohio Nurse Aide Registry

• For licensed nurses - view current license, and contact Ohio Board of

Nursing to verify licensure status.

• Other licensed professionals - view current license, and contact

appropriate licensing agency to verify current licensure status.