Assault in Long-Term Group Home for Patients with Mental Disabilities

This case study examines the standard of care in a long-term group home where a resident with severe mental disability was assaulted by another resident with autism and violent tendencies.

ByWendy Ketner, M.D.

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Published on February 6, 2024

Person on injured on floor

Case Overview

This case summary delves into an incident involving an adult individual with a severe mental disability, who was a resident in a long-term care group home. The patient was assaulted by another resident known to have autism and a history of violent behavior.

This case focuses on evaluating the quality of care provided to patients with mental and intellectual disabilities, including autism, and with violent histories. An expert in long-term care administration was sought to review medical records and provide an opinion on the standard of care.

Questions to the Nursing expert and their responses

Q1

Can you briefly describe your experience with long-term care administration in a state comparable to Georgia, specifically as it pertains to the management and care of patients with mental and intellectual disabilities?

As an RN with over a decade's worth of nursing experience across various levels - from staff nursing to Director of Nursing at acute inpatient and residential facilities - I've worked extensively with patients ranging from pediatric to geriatric age groups. These patients had diagnoses spanning autism, schizophrenia, dementia, psychosis, cognitive delay, intellectual disability, bipolar disorder, depression, among others.

Q2

Briefly describe your experience with training protocols for staff in long-term care facilities for patients with mental and intellectual disabilities?

From my experience working in group homes like those in Georgia, I've observed that staff training is often inadequate. There are few established protocols for dealing with patients with mental or intellectual disabilities.

Q3

What pertinent policies and protocols should be in place to prevent incidents like this from occurring?

There should be comprehensive policies addressing how to manage residents displaying escalating behaviors. This includes strategies for removing other residents from harm's way. It also determines the probability of the resident becoming violent. It identifies what triggers such behavior, and outlines interventions likely to calm the resident down.

Q4

Have you reviewed a case similar to above? If so, please briefly describe.

Throughout my career, I've encountered several cases involving patients with mental and intellectual disabilities. However, most long-term care facilities tend not to accept patients with a history of violence due to the potential risks involved.

The specialty requested in this case was Long-Term Care Administration, which aligns with my extensive experience in nursing and managing acute inpatient and residential facilities.

About the expert

This expert boasts over a decade of experience in nursing, with a specialization in long-term care administration. They obtained their BS in Nursing from a prestigious university and later earned a certificate in adolescent and child psychiatry from another renowned institution. Their extensive career includes roles as a charge registered nurse at a behavioral health center, nurse manager at a hospital, director of nursing at various care centers, and most recently, the director of nursing at a notable facility in a state comparable to Georgia.

Expert headshot

E-1042520

Specialties:

About the author

Wendy Ketner, M.D.

Wendy Ketner, M.D.

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.

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