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

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

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

4. 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. 5 Legal Definitions Misconduct AbuseNeglectMisappropriation Injury of Unknown Source

6. 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. 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. 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. 9 Incident-Specific Elements Physical Abuse Verbal/Psychological Abuse Sexual Abuse Neglect Misappropriation Resident-to-Resident Altercations

10. 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. 11 Top 10 Interviewing Tips 1. Ensure privacy6. Clarify 2. Prepare7. Ask open questions 3. Relaxed demeanor8. Stay on the subject 4. Informal seating9. Show empathy 5. Be clear & concise10. Listen well!

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

13. 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. 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. 15 Nursing Home Reporting Requirements Allegation of Misconduct Immediately report to NH Administrator and DQA (initial eval) Report reasonable suspicion of a crime to DQA & law enforcement Report investigation results to DQA within 5 days

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

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

18. 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. 19 Wrap-Up Questions? Evaluation CEU Application Attendance Certificates