Kindred Healthcare’s Policy

1. ABUSE PREVENTION • Kindred Healthcare’s Policy • It is Kindred Healthcare’s goal that every resident at a Kindred Healthcare Corporation Nursing Facility will be treated with respect and dignity by caregivers or employees. Each resident has the right to be free from verbal, sexual, physical and mental abuse, corporal punishment, involuntary seclusion, misappropriation of their property. Health Services Division

2. PURPOSE Health Services Division

3. Definition of Abuse and Types of Abuse Health Services Division

4. Types of Abuse: • Verbal Abuse • Sexual Abuse • Physical • Mental Abuse • Involuntary Seclusion • Misappropriation of Resident Property Health Services Division

5. Components of An Abuse Prevention Plan • Screening • Training • Prevention • Identification of Resident Abuse • Investigation • Protection of a Resident During an Investigation • Reporting and Response • Documentation & follow up Health Services Division

6. SCREENING • Reference checks • Securing verification of current licensure, registration or certification (checking the Nurse Aide Registry) • Conducting criminal background checks and fingerprinting as applicable Health Services Division

7. TRAINING • What constitutes abuse, neglect, and misappropriation • How to report their knowledge related to allegations • How to recognize signs & symptoms of burnout • Appropriate interventions to properly manage aggressive or other behavioral issues. Health Services Division

8. SIGNS & SYMPTOMS OF BURNOUT • Overly emotional/crying several times a week • significant negative change in work performance • Acts like a loner, isolated, poor peer support • Feels overwhelmed, drowning in their life’s problems • Misses work often • Suddenly becomes rude or disrespectful • Believes that the residents are the cause of their problems Health Services Division

9. Responses to Aggressive Behavior • Verbal & Physical • Sexual Aggression • Mental Aggression • Misappropriation of Resident Property Health Services Division

10. PREVENTION • Grievance Procedure • Posting of appropriate telephone numbers • Company compliance toll-free number • Ombudsman telephone number • State Reporting/Concerns Division number • Analysis of specific characteristics of the Center that are part of a prevention plan Health Services Division

11. IDENTIFICATION OF RESIDENT ABUSE Health Services Division

12. Identify patterns or trends in the following systems: • Skin reports • Quality indicator reports Health Services Division

13. INVESTIGATION Health Services Division

14. If Suspected Sexual Abuse: • DO NOT bath the resident before the examination. • Preserve the bed lines and clothing. • Notify the Administrator, Director Nursing Service and Social Services. • The Administrator/designee will notify the police and appropriate state agencies. Health Services Division

15. Protection of a Resident During an Investigation Health Services Division

16. A staff member(s) implicated in an abuse/neglect situation, regardless of discipline, will be: • Immediately rescheduled from any resident contact • Interviewed and version of event documented • Suspended pending Investigation results Health Services Division

17. Reporting and Response Health Services Division

18. Documentation and Follow Up Health Services Division

19. Pending completion of an investigation, appropriate follow up may include: • Re-education • Oral or written warning • Suspension, or • Termination Health Services Division