SMQT- Fraud & Abuse Graded A+
Abuse Prohibition Review Overview
Description
The Abuse Prohibition Review assesses whether a facility has both developed and operationalized
policies and procedures to protect residents from: - Abuse - Neglect - Involuntary seclusion - Misappropriation of pr...
The Abuse Prohibition Review assesses whether a facility has both developed and operationalized
policies and procedures to protect residents from:
- Abuse
- Neglect
- Involuntary seclusion
- Misappropriation of property
This includes examining policies and procedures related to:
- Hiring practices
- Employee and volunteer training
- Ongoing supervision
- Reporting and investigating allegations of abuse
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### General Procedures
The review consists of evaluating the facility’s policies and procedures as outlined in the Guidance to
Surveyors. Key components to be included are:
- Screening of potential hires
- Employee training (for new hires and ongoing training)
- Prevention of abuse policies
,- Identification of incidents or allegations that require investigation
- Investigation protocols for incidents or allegations
- Resident protection during investigations
- Reporting procedures for incidents and facility responses
The general procedure for conducting the Abuse Prohibition Review involves following the Abuse
Prohibition Investigative Protocol.
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### Quiz Question: Objective of the Abuse Prohibition Review
Answer: The primary objective of the Abuse Prohibition Review is to determine if the facility has
developed and operationalized policies and procedures that prohibit:
1. Abuse
2. Neglect
3. Involuntary seclusion
4. Misappropriation of residents' property
---
### Investigative Protocol for Abuse Prohibition
The Abuse Prohibition Investigative Protocol is required for every long-term care standard survey and
includes the following steps:
1. Obtain and Review Policies & Procedures
- Collect and review the facility's abuse prohibition policies and procedures.
, - Ensure key components are included: screening, training, prevention, identification, investigation,
protection, and reporting/response.
- Note that these components may not be consolidated into a single document.
2. Interview Responsible Individual(s)
- Interview the individual(s) designated by the facility to coordinate the abuse prohibition policies.
- These individuals should be accountable for evaluating how each component is operationalized.
Interview Questions:
- How do you monitor staff during resident care to prevent neglect?
- How do you decide which injuries of unknown origin require investigation as potential abuse?
- What measures are in place to ensure that residents, families, and staff can voice concerns without
fear of reprisal?
3. Request Written Evidence
- Request documentation on how the facility has responded to alleged violations.
- Select two or three alleged violations from the period since the last standard survey, if available.
- Evaluate whether adequate procedures were implemented for:
- Reporting and investigating incidents
- Resident protection during investigations
- Provision of corrective actions
Note: Reporting requirements at §483.13(c)(2), (c)(4), F225 include notifying the State Survey Agency
of both the alleged violation and results of the subsequent investigation.
4. Interview Residents and Families
- Conduct interviews with residents and their families to gauge their awareness of abuse prohibition
policies and procedures.
- Determine if they know:
- To whom they can report allegations, incidents, or complaints.
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