IDPH has cited and fined Caseyville Nursing & Rehab after a resident fell and fractured a hip while going to the bathroom unattended.
The fact pattern which is described in this citation is a distressingly familiar one: a resident with musculoskeletal issues and impaired safety judgment attempts to go to the bathroom unattended and falls, suffering a hip fracture.
There were a number of issues with the care which this resident was provided leading to this nursing home fall which were immediately apparent:
- The resident was well-recognized as a fall risk and that she had impaired safety judgment. When a resident has impaired safety judgment, they cannot be relied upon to do things (such as wait for staff to go to the bathroom) which are necessary to assure their safety. Federal regulations relating to nursing home falls require nursing homes to provide supervision and assistance necessary to prevent accidents such as falls. When a resident cannot be relied upon to simply follow instructions to wait for staff, monitoring and supervision are required to address the deficits in their judgment for the own safety.
- Before the fall which resulted in the fractured hip, there were at least two prior falls involving this resident in the nursing home. Having one fall tends to beget additional falls and is also an indicator that the existing care plan is not working as well as hoped, so revision of the resident fall prevention care plan is required. This did not occur. The fact that there were no injuries in the first two falls in good luck, not good care. An improved care plan is a far better tool for assuring the safety and well-being of the residents than relying on good luck.
- At the time of the fall, her doctor had issued an order for a change in her psychiatric medications. These medications do have a role in fall risk and when medications are being changed (as opposed to when residents have been long-time users), the effect of these medications is not entirely certain, so it is a time when increased vigilance is required.
- She was also suffering from a urinary tract infection at the time of the accident. This is significant because urinary tract infections often have the effect of increasing confusion in a geriatric patient population which is a contributing factor to fall risk. It also has the effect of making a resident weak which increases fall risk. UTI’s are treated with antibiotics which can also cause digestive problems which can result in urgency to use the bathroom. All of these factors taken together draws the picture of a resident who requires the additional supervision.
- The most telling part of the citation was the comment which the resident made to the state surveyor – that she always has to “wait, and wait, and wait, so I just take myself.” This is one of the indicators that nursing home may be understaffed, which is something that leads to an increased rate of falls and a higher incidence of residents suffering bed sores.
Understaffing of a nursing home is one of the products of the nursing home business model. One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of nursing home residents are the inevitable result. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.
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