CNA Abuse, Neglect, and Mandatory Reporting 4

Question 1

A CNA sees bruises shaped like fingers on both upper arms of a resident with dementia. The CNA tells the charge nurse, who says, "I'll look into it, don't worry about it." Two shifts later the CNA learns that no report was ever filed. Under federal long-term care rules, what is the CNA's obligation now?

Accepted Answer

The CNA must report the suspicion directly to the state survey agency and/or law enforcement, because each covered individual has a personal duty to report

Answer

Under the Elder Justice Act (Section 1150B of the Social Security Act), every covered individual in a federally funded long-term care facility has a personal duty to report a reasonable suspicion of a crime against a resident. Telling a supervisor does not cancel that duty, especially when the CNA knows no report was made. Waiting for a meeting or investigating on your own delays the report and can compromise the investigation.

Question 2

Under the federal Elder Justice Act, how quickly must a reasonable suspicion of a crime against a long-term care resident be reported when the event resulted in serious bodily injury?

Accepted Answer

Within 2 hours of forming the suspicion

Answer

When serious bodily injury is involved, the report must be made no later than 2 hours after the suspicion is formed. Without serious bodily injury, the limit is 24 hours. The 5-working-day deadline applies to the facility's written report of its investigation results, not to the first report.

Question 3

A resident keeps shouting in the dayroom and upsetting the other residents. To calm things down, a CNA wheels the resident into their room, closes the door, and tells them they can come out "once they settle down." The resident is not hurt. How should this action be classified?

Accepted Answer

Involuntary seclusion, which is a form of abuse

Answer

Separating a resident from others against their will, or confining them to a room, is involuntary seclusion. Federal regulations classify it as abuse even when no physical harm occurs and the staff member meant well. Real redirection means guiding the resident toward a calming activity, not confining them as a 'time-out.'

Question 4

During a severely short-staffed night shift, a CNA decides to skip 2-hour repositioning for a bed-bound resident who is at high risk for pressure injuries so the CNA can answer call lights. The CNA has no intent to harm. Which statement is most accurate?

Accepted Answer

It may be neglect, because neglect is failing to provide care needed to avoid harm, and intent is not required. The CNA should tell the nurse right away instead of quietly skipping care

Answer

Neglect is the failure to provide the goods and services a resident needs to avoid physical harm, pain, or mental anguish. It does not require intent or an injury that has already happened. Short staffing is not a defense for quietly leaving out care-plan tasks. The right move is to tell the nurse immediately so care can be reprioritized or reassigned. Abuse involves willful acts, so 'abuse' is the wrong label here.

Question 5

A resident who is alert, oriented, and has decision-making capacity refuses a shower for the third day in a row and becomes angry when asked again. Which response would NOT be considered neglect or abuse?

Accepted Answer

Respecting the refusal, offering alternatives such as a bed bath or a later time, documenting it, and reporting the pattern to the nurse

Answer

A competent resident has the right to refuse care. Respecting the refusal while offering alternatives, documenting, and reporting keeps both the resident's rights and their safety intact. Forcing care is physical abuse. Quietly dropping the resident from the schedule without telling anyone can become neglect. Withholding a snack to gain compliance is coercion and counts as mental or emotional abuse.

CNA Practice Test

CNA Practice Test

CNA Abuse, Neglect, and Mandatory Reporting 4