05/16/03Health Services Division1 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. ABUSE PREVENTION

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05/16/03Health Services Division4 Types of Abuse:  Verbal Abuse  Sexual Abuse  Physical  Mental Abuse  Involuntary Seclusion  Misappropriation of Resident Property

05/16/03Health Services Division5 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

05/16/03Health Services Division6 SCREENING  Reference checks  Securing verification of current licensure, registration or certification (checking the Nurse Aide Registry)  Conducting criminal background checks and fingerprinting as applicable

05/16/03Health Services Division7 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.

05/16/03Health Services Division8 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

05/16/03Health Services Division9 Responses to Aggressive Behavior Verbal & Physical Sexual Aggression Mental Aggression Misappropriation of Resident Property

05/16/03Health Services Division10 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

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05/16/03Health Services Division12 Identify patterns or trends in the following systems:  Skin reports  Quality indicator reports

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05/16/03Health Services Division14  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.

05/16/03Health Services Division15 Protection of a Resident During an Investigation

05/16/03Health Services Division16 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

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05/16/03Health Services Division19 Pending completion of an investigation, appropriate follow up may include: Re-education Oral or written warning Suspension, or Termination