Too many elderly and infirmed residents of nursing homes in the United States suffer preventable falls that result in further physical or mental deterioration, including fractures that may require surgery or even an untimely and unexpected death.
Many nursing home falls are foreseeable and preventable if nursing homes properly evaluate residents for their risk of falling when they are first admitted to the nursing home, and the nursing homes properly and consistently implement appropriate safety measures, on an ongoing basis, to reduce or eliminate the risk of falling, even if the admission is expected to be for a short period of time.
After the resident’s initial assessment by the nursing home to determine his/her risk of falling, it is necessary for nursing homes to re-assess and re-evaluate fall risk precautions when the resident’s circumstances change (for example, a resident who is able to walk without assistance and who has been assessed by the nursing home to be at a low risk for falling may be at a much higher risk for falling (and injuries) if there is a change in the resident’s medications that may result in physical weakness or a change in cognitive functioning).
When the nursing home determines that a resident is at risk for falling, it is necessary for the nursing home to timely and appropriate develop a plan of care to address the fall risk and other relevant issues involving each resident.
Medicare requires that nursing homes develop a care plan for each of their residents that must include: a health assessment (a review of the resident’s health condition) that begins on the day of admission and must be completed within 14 days of admission; a health assessment at least every 90 days after the first review, and possibly more often if the resident’s medical status changes; and, ongoing, regular assessments of the resident’s condition to see if the health status has changed, with adjustments to the care plan as needed. Medicare requires nursing homes to submit this information to the federal government for use in quality measures, nursing home payment, and state inspections.
A report by the Department of Health and Human Services, Office of Inspector General (OIG), dated February 2013, entitled, “Skilled Nursing Facilities Often Fail To Meet Care Planning And Discharge Planning Requirements,” emphasized that skilled nursing facilities (SNFs) are required to develop a care plan for each Medicare beneficiary and provide services in accordance with the care plan, as well as to plan for each beneficiary’s discharge. The OIG’s researchers found that for 37% of stays, SNFs did not develop care plans that met requirements or did not provide services in accordance with care plans, and that for 31% of stays, SNFs did not meet discharge planning requirements. Medicare paid approximately $5.1 billion for stays in which SNFs did not meet these quality-of-care requirements.
Too often the family of a nursing home resident receives a telephone call from a nursing home administrator, advising that their loved one fell and was injured (sometimes family members are not promptly advised that their loved one fell and was injured and only learn of the fall and injuries when they arrive for a visit and observe that their loved one is severely bruised, bandaged, or may have a cast on an arm or leg; in some egregious cases, it is a family member who discovers that their loved one has been suffering for days in excruciating pain as a result of an undiagnosed fracture of the hip or other very serious injury that the nursing home failed to diagnose after a fall).
Nursing home records often fail to document the detailed circumstances of a resident’s fall – the medical records may state only that the resident was found on the floor by the side of his/her bed without documenting the important underlying circumstances, such as a nurse’s aide negligently leaving the weak and confused resident alone and unassisted sitting on the side of the bed instead of helping the resident lie down in bed with the bed rails in the up position while the aide left the room for a few minutes to obtain something from another area of the nursing home (when the aide returned to the resident’s room, the resident had already fallen and was then on the floor beside his/her bed, but the medical records failed to state such).
Often when an unexplained event such as a nursing home resident’s unwitnessed fall occurs, the resident’s medical records will contain little if any information regarding why the resident fell, but details regarding the event may be contained in an incident report completed by the nursing home staff that is not part of the resident’s medical records and its existence is not even mentioned in the resident’s medical records.
Often, it is only after the family hires a local nursing home claim lawyer to investigate the nursing home’s actions surrounding a resident’s unexpected injuries or unexplained decline in physical condition or mental health that the family learns the truth about the cause of the situation.
If your loved one was injured (or worse) while a resident of a nursing home in the United States, you should promptly consult with a local nursing home claim attorney in your state who may investigate the matter for you and represent you or the injured resident in a nursing home negligence claim or nursing home abuse claim, if appropriate.
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