Investigation of Alleged Violations and Protection of Patients

Sets out what the Agency does once an allegation of abuse, neglect, exploitation, mistreatment, an injury of unknown source or misappropriation is made: immediate protection of the patient and removal of the person suspected from patient contact, a prompt and fair investigation led by the director of nurses, corrective action, reporting verified violations to the Health Standards Section within 5 working days, the Direct Service Worker Registry process, facility cases, confidentiality and learning from allegations.

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About this policy

Policy number: LA-HSP-ANE-02
Version: 1.0
Main rule: 42 CFR §418.52(b)(4)
Library: Louisiana hospice · 60 policies
Category: Safeguarding
Sections: 19

In short

Every allegation against anyone working for the Agency is investigated at once, starting the day it is reported.
A staff member, contractor or volunteer who is accused is removed from all patient contact until the investigation is finished.
Keep the patient safe first: the nurse assesses the patient and the team makes a safety plan.
Do not change records or discuss the allegation with the person accused or with coworkers. Give the investigator what you saw.
Verified violations are reported to the Health Standards Section within 5 working days and lead to corrective action.

What's inside

19 sections. The full text comes with the One-time Policy Pack.

Full text with a package

Terms of Reference
1. Purpose
2. Scope
3. Definitions
4. Policy Statement (42 CFR §418.52(b)(4))
5. The First Hours: Protecting the Patient
6. Investigation
7. Findings and Corrective Action
8. Reporting the Outcome
9. Allegations Involving Facility Staff
10. Confidentiality and Fairness
11. Learning From Allegations
12. Responsibilities
13. Records and Compliance Monitoring
14. Staff Training
15. References
16. Related Policies and Forms
17. Approval
18. Revision History

An inspector may ask

Walk me through what happened after the last allegation of abuse or neglect: who investigated, what was done to protect the patient, and when the Department was told.
What do you do with a staff member who has been accused while the investigation is going on?

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Rules it follows

42 CFR §418.52(b)(4)LAC 48:I §8235.D.2.d-eLAC 48:I §8217.E.2.e.ii-iiiLAC 48:I §8217.G.1.hLAC 48:I §8235.C.5LAC 48:I §8205.ELAC 48:I §9202LAC 48:I §9273LAC 48:I §9275R.S. 40:2009.20R.S. 40:2009.17R.S. 14:403.242 CFR §418.52(b)(4)(ii)-(iv)42 CFR §418.112(c)(8)

Forms included

LA-HSP-ANE-02-A Allegation Investigation Record

Read a sample in full

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