Investigating and Reporting Allegations of Misconduct in Nursing Homes

1. Investigating and Reporting Allegations of Misconduct in Nursing Homes presented by: University of Wisconsin Oshkosh CCDET WI Department of Health Services DQA

2. Welcome • Project Background/Staff Introductions • Reminder: Silence Electronic Devices • Agenda • CEUs • Evaluation • Certificate of Attendance • Participant Introductions

3. Learning Points • Misconduct Definitions • Developing an Investigation Protocol • Conducting an Internal Investigation • Interviewing Skills • Reporting Requirements

4. A Word about Prevention • Background checks are good but not enough • Key thoughts on preventing caregiver misconduct • Adapting keys to prevention in your facility

5. Legal Definitions

6. Developing a Process and Protocol • Develop a process • Review protocol steps 1 – 5 • Activity: checking your process A Protocol = A Plan of Action

7. Investigating the Allegation • An investigation is a fact-finding mission • Internal investigations should be written reports • Employment actions are internal entity decisions while the investigation is pending

8. Elements of an Investigation • Who, What, Where, When, Why, How • Contact Law Enforcement • Preserve Evidence • Document the Effect on the Victim • Document the Caregiver’s Duty • Diagram the Scene • Develop a List of Interviewees • Write your Report

9. Incident-Specific Elements • Physical Abuse • Verbal/Psychological Abuse • Sexual Abuse • Neglect • Misappropriation • Resident-to-Resident Altercations

10. Activity: Case Studies • Note some elements that are important to your investigation • Use your training materials to help remember/apply the elements • Assume that: • You have taken steps to protect the resident • You have taken action re: the accused caregiver

11. Top 10 Interviewing Tips

12. Activity: Interviewing Skills Video interview between a facility administrator and a witness Interview Video Compare the video conversation with the interview tips

13. Signs of Deception • No single telltale sign for a lie • Liars “might” have some things in common • Behavior during an interview vs. behavior under more normal circumstances

14. Reporting Misconduct in Nursing Homes Develop and operationalize written policies and procedures: • Written procedures contain specific elements • Everyone knows about the procedures • Staff trained to immediately report any incident to the NH Administrator

15. Nursing Home Reporting Requirements

16. More Reporting Info • Report Allegations Immediately Here • Initial Evaluation Permitted w/Conditions • Report Suspicion of a Crime to Law Enforcement • Report Investigation Results • Reports on Credentialed Staff • Unreported Incidents

17. More Reporting Info • Reporting Requirement Penalties • Reporting on Behalf of Adults-at-Risk • Caregiver Misconduct Registry

18. Resources • Wisconsin Caregiver Program Manual http://dhs.wisconsin.gov/caregiver/publications/CgvrProgMan.htm • Caregiver Abuse and Neglect Prevention Project Training www.uwosh.edu/ccdet/caregiver • Caregiver Misconduct Training Video http://www.dhs.wisconsin.gov/caregiver/training/intInvstTrng.htm

19. Wrap-Up • Questions? • Evaluation • CEU Application • Attendance Certificates