STATE OF NORTH CAROLINA IN THE OFFICE OF

ADMINISTRATIVE HEARINGS

COUNTY OF PITT 01 DHR 1274

SADINA HALL, )

Petitioner, )

)

v. )

) DECISION

CAROLINA HOUSE & )

NORTH CAROLINA NURSE AIDE )

REGISTRY, )

Respondent. )

This matter was heard before James L. Conner, II, Administrative Law Judge, on September 21, 2001, in Farmville, North Carolina.

APPEARANCES

For Petitioner: Sadina Hall, pro se

Greenville, North Carolina

For Respondent: Jane L. Oliver, Assistant Attorney General

Raleigh, North Carolina

ISSUE

Whether Respondent substantially prejudiced Petitioner’s rights when it determined that, on or about February 16, 2001, Petitioner, a personal care aide, abused M.S., a resident of Carolina House in Greenville, by grabbing the resident’s wrist and prying the resident’s fingers from the telephone, resulting in a skin tear on the resident’s wrist.

APPLICABLE STATUTES AND RULES

N.C. Gen. Stat. § 131E-255 and § 131E-256

N.C. Gen. Stat. § 150B-23

42 CFR § 483.156

42 CFR § 488.301

10 NCAC 3B.1001

EXHIBITS

The following exhibits were admitted into evidence without objection: Respondent’s Exhibits 1, 2, 3, 4, 5, 6, 9, 10, 11, 12, 14, 18 and 19.

FINDINGS OF FACT

Based upon the exhibits admitted into evidence and the sworn testimony of the witnesses, the undersigned makes the following findings:

1. Petitioner was employed as a personal care aide at Carolina House in Greenville, North Carolina, from October 2000 through February 2001. (T pp 9-10)

2. Petitioner received training to become a personal care aide through her employment at Carolina House. Petitioner’s training included instruction on resident rights. Petitioner also was taught how to work with demented residents and how to deal with agitated residents and problem behaviors. (T pp 11-19, 102-03; Resp Exh 1, 2, 3, 4, 10)

3. Petitioner’s job responsibilities included the provision of daily care to the residents, such as feeding, bathing and dressing. (T p 10)

4. On February 16, 2001, Petitioner worked the 3:00 p.m. to 11:00 p.m. shift on the Discovery Unit at Carolina House. The Discovery Unit is a locked unit for residents with Alzheimer’s disease and dementia. The residents on the Discovery Unit typically need more assistance than other residents at the facility. (T pp 20, 24; Resp Exh 5, 6)

5. During second shift, there were three staff members working on the Discovery Unit. At approximately 8:30 p.m., Petitioner and Cristina Wooten left the unit to take a dinner break together, leaving Latasha Crandall, the med tech, alone on the unit. A short time later, Ms. Crandall, called the break room to inform her co-workers that she was the only person working on Discovery and that one of them would have to come back to help her out. At least two people were supposed to be working on the Discovery Unit at all times. (T pp 26-27, 46-47; Resp Exh 5, 6, 9, 12)

6. Petitioner came back to the unit and was very angry. Petitioner grabbed the communication log from the nurses station and took it to the residents’ T.V. room to fill out. (T pp 46-47, 66-67; Resp Exh 9, 10)

7. Sandy Ennis, whose mother is a resident on the Discovery Unit, was in the TV area when Petitioner came in. Ms. Ennis could see that Petitioner was angry. Ms. Ennis left the TV room to tell Ms. Crandall that Petitioner was angry. (T pp 47-48, 62, 79-80)

8. While Ms. Ennis was talking with Ms. Crandall, the telephone in the nurse’s station rang. One of the residents, M.S., answered the phone. M.S., who was approximately 80 years old at the time, is demented and has the delusion that she was living in the home that her husband had built for her. She frequently acts as if she is a hostess to the other people on the unit, including the residents, staff and visitors. M.S. often asks people whether they have enough blankets or whether they want something to drink. When M.S. answered the telephone of the evening of February 16, 2001, she acted as if she thought she was answering her own telephone in her own home. M.S. identified herself and asked the caller, “How can I help you.” M.S. then turned to Ms. Crandall and said, “It’s for you.” As Ms. Crandall approached M.S. to get the phone, M.S. became agitated. Ms. Crandall asked M.S. to give her the phone. Ms. Crandall saw that M.S. was shaking and she tried to calm M.S. Ms. Ennis walked over to try to help. Ms. Crandall and Ms. Ennis tried to soothe M.S. while encouraging M.S. to let go of the telephone. Neither Ms. Crandall nor Ms. Ennis touched M.S. and they were able to calm M.S. down. (T pp 48, 50, 63-64, 69-71, 73-74, 83, 85, 99-100; Resp Exh 5, 6, 9, 10, 11, 12)

9. At about this time, Petitioner came around the corner to intervene and said, “Let me do it.” Petitioner was angry and she grabbed M.S.’s wrist with force and twisted. Petitioner then pried M.S.’s fingers off the receiver. M.S. looked confused and frightened. Her face got red. She said, “What are you doing? This is my phone.” M.S. became agitated and angry. M.S. let go of the phone and Ms. Crandall took the receiver to hang it up. Petitioner walked away. M.S. said, “She hurt me.” Ms. Crandall asked, “Who hurt you?” M.S. replied, “The lady hurt me that grabbed my wrist.” (T pp 48-51, 58-59, 71-72; Resp Exh 9, 10, 11, 12)

10. Ms. Ennis looked at M.S.’s wrist and saw that it was bleeding. She told Ms. Crandall that M.S. was bleeding. Ms. Crandall examined M.S. and saw that she had a skin tear on her wrist. She also had a place on her wrist which was white and purple where a hematoma was developing. (T pp 49, 64-65, 79; Resp Exh 9, 10, 11, 12)

11. Ms. Crandall applied pressure to the wrist and put a bandage on the wound. Ms. Crandall asked Ms. Ennis to get Tracey Phillps, the supervisor in charge, who was working in another part of the facility. (T pp 49, 65; Resp Exh 9, 10, 11, 12)

12. After Ms. Phillips arrived on the Discovery Unit, Ms. Ennis suggested that she call Denise King, R.N., the Resident Care Director. Petitioner heard this comment and stated, “I don’t care what you tell Denise. I’m leaving.” (T pp 65, 97; Resp Exh 11, 12)

13. Dorothy Hudson, whose mother was a resident on the Discovery Unit, walked down the hall at about this time. She also saw M.S.’s wrist and thought that M.S. had fallen and perhaps had broken her wrist. She saw the cut in M.S.’s hand and a knot rising. Ms. Hudson saw Petitioner a little later and Petitioner still appeared angry. (T pp 88-89, 90-91; Resp Exh 12, 14)

14. Denise King came to the facility that evening. First, she examined M.S. to make sure that she was all right. Then, she interviewed Petitioner and Ms. Crandall together in the library before the end of the shift. Petitioner said that Ms. Crandall had caused the skin tear but Ms. Crandall knew that she had not injured M.S. because she had not touched M.S. during the incident. Ms. King asked both Petitioner and Ms. Crandall to prepare a written statement about what had happened. (T pp 53, 98-99; Resp Exh 5, 9, 11 , 12)

15. Ms. Crandall was bothered by Petitioner’s behavior and her showing her temper because she understands that demented residents cannot help that they have dementia. Furthermore, Ms. Crandall was concerned because displays of anger by the staff cause the residents to become frightened, which makes the job of caring for them more difficult. (T pp54-55; Resp Exh 9)

16. Ms. Ennis was also upset about what she had observed and considered calling the local TV station. She was fearful for her mother who had only recently been moved to the Discovery Unit. (T pp 72-74; Resp Exh 11, 12)

17. As a result of the facility’s investigation, Ms. King concluded that Petitioner’s actions towards M.S. constituted abuse. She reported her findings to the Division of Facility Services, Nurse Aide Registry and Health Care Personnel Registry Section. (T p 102; Resp Exh 15)

18. Catherine Allen, R.N., was assigned to investigate the allegation for the Health Care Personnel Registry. Ms. Allen visited Carolina House where she reviewed M.S.’s medical records, Petitioner’s personnel file, and the facility’s investigative documents. She also observed M.S. on the Discovery Unit. Ms. Allen interviewed Petitioner, Ms. Crandall, Ms. Phillips, Ms. Ennis, Ms. Hudson and Ms. King. Ms. Allen concluded that Petitioner had been properly trained in how to work with residents with Alzheimer’s and dementia. She also gave weight to the statements provided by the eye-witnesses. Ms. Allen concluded that Petitioner had abused M.S. by grabbing M.S.’s wrist forcefully and by prying her fingers from the phone. Ms. Allen concluded that Petitioner’s actions resulted in an injury, a skin tear, to M.S. (T pp 107-111; Resp Exh 18)

19. Ms. Allen notified Petitioner by letter, dated July 6, 2001, that Respondent had substantiated the allegation of abuse and that Respondent intended to list a finding on the Health Care Personnel Registry. (Resp Exh 19)

Based upon the foregoing Findings of Fact, the undersigned Administrative Law Judge makes the following:

CONCLUSIONS OF LAW

1. The Office of Administrative Hearings has jurisdiction over the parties and the subject matter pursuant to Chapters 131E and 150B of the North Carolina General Statutes.

2. All parties have been correctly designated and there is no question as to misjoinder or nonjoinder.

3. As a personal care aide working in a healthcare facility, Petitioner is subject to the provisions of N.C. Gen. Stat. § 131E-256.

4. “Abuse” is defined as “the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish.” 10 NCAC 3B.1001; 42 CFR Part 488.301.

5. On February 16, 2001, while employed as a personnel care aide at Carolina House in Greenville, North Carolina, Petitioner abused an elderly resident, M.S., by forcefully grabbing the resident’s wrist and prying the resident’s fingers from a telephone receiver thereby causing injury to the resident in the form of a skin tear, a hematoma and fear.

6. Respondent did not err in substantiating the allegation of abuse against Petitioner because there is sufficient evidence to support Respondent’s conclusion.

Based upon the foregoing Findings of Fact and Conclusions of Law, the undersigned makes the following:

DECISION

That the Respondent’s decision to place a finding of abuse at Petitioner’s name in the Health Care Personnel Registry be upheld.

ORDER

It is hereby ordered that the agency serve a copy of the final decision on the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27609-6714, in accordance with North Carolina General Statute 150B-36(b).

NOTICE

The decision of the Administrative Law Judge in the contested case will be reviewed by the agency making the final decision according to the standards found in G.S. 150B-36(b)(b1) and (b2). The agency making the final decision is required to give each party an opportunity to file exceptions to the decision of the Administrative Law Judge and to present written argument to those in the agency who will make the final decision. G.S. 150B-36(a).

The agency that will make the final decision in this contested case is the North Carolina Department of Health and Human Resources, Division of Facility Services.

This the 10th day of January, 2002.

______

James L. Conner, II

Administrative Law Judge

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