Abuse and Neglect in Long-Term Care Facilities:
The Regulatory Agency's Responsibility

Wisconsin's Department of Health and Family Services has various tools to ensure that entities and individuals provide appropriate care to vulnerable individuals. Through its regulatory approval, inspection, and investigations, the department oversees the operation of health care entities and service providers, investigates allegations of individual caregiver misconduct, and provides technical support and coordinates its efforts with other county and local agencies that protect and advocate for the disabled elderly in Wisconsin.

by Linda Dawson

The scenario repeats all too often. With little more than a few weeks' training, a certified nursing assistant (CNA) assigned to provide direct care to 15 or more frail, elderly residents with dementia or other conditions requiring skilled nursing care in a nursing home is stretched too thin. A confused resident repeatedly pushes the call light because he wants to use the bathroom. His care plan requires that two persons assist with transfers. Several residents on the unit are calling out for attention; other CNAs are busy; the nurse is attending to another resident's medical needs. The CNA has to make a decision. If the CNA doesn't respond promptly, she could be disciplined. Should she wait for assistance as required by the resident's plan of care or try it alone? After all, the resident doesn't weigh much. The CNA knows that weakened residents who can no longer support their weight are hard for one person to safely handle. If she decides to try the transfer alone, rather than wait or use the equipment as required, a fall could result. Brittle bones break easily against hard surfaces in bathrooms or on floors. A broken hip in a frail, elderly resident often leads to the person's untimely death.

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