Injuries resulting from falls are the reason for almost 40 percent of all preventable hospital visits by nursing home residents, according to the Centers for Disease Control and Prevention. Too many of these falls go underreported. Even when they are reported, there is a false assumption that it’s simply a part of normal aging. It’s not. The risk of falls in nursing homes can and should be substantially minimized with proper policy and procedure, adequate staffing, the right equipment and appropriate supervision.
But the numbers tell us far too many nursing homes are failing when it comes to fall prevention.
Just recently, a Massachusetts nurse whom state health officials cited for failure to properly attend a nursing home patient who suffered a fatal fall agreed to surrender his license for three years (after which time he could re-apply for it). However, The Worcester Telegram reports the nurse failed to sign off on the resolution prior to the deadline, so now it’s unclear if he’s still holding his license. Part of the agreement was that he would concede that while working as a licensed practical nurse (LPN) at a nursing home, he did not properly assess a patient who had fallen and he also failed to document or report the fall. This admission would have been acknowledgment that his conduct was not aligned with standards set forth by the state board of nursing.
Investigators concluded it was a certified nursing assistant (CNA) who discovered the patient on the floor sometime after the fall. The man had struck his head on the corner of the nightstand. The CNA later told investigators he chose not to report the fall in his chart because the LPN in question instructed him not to. The CNA (later fired) told investigators that he and the LPN simply helped the man up off the floor, took him to the bathroom and then placed him back in bed. Nursing home policy dictated that what the pair should have done instead was to leave him on the floor until they had an opportunity to rule out any serious medical emergency. Here, the staffers did not notify the man’s family or his physician – both of which is required by policy.
This, the board of nursing concluded, resulted in a significant delay in emergency care and hospital evaluation that might have saved his life. It wasn’t until six hours later, at breakfast, that the man told other staffers that he’d fallen in the night and his head hurt. Later that day, his family visited him. His speech was slurred. He told them his neck hurt. He was taken to the hospital, where it was discovered he had suffered a traumatic subdural hemorrhage. Because of his advanced age and progressive decline of neurological function, doctors deemed surgery simply too risky. He did the very next day.
The nursing home later paid a federal civil fine of $91,000, but it’s not clear if decedent’s family are pursing a nursing home wrongful death lawsuit. It’s likely they would have a strong case as there does seem to be substantial evidence that critical care after this serious fall was delayed.
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Facing discipline after Worcester nursing home patient’s fatal fall, nurse still holds license, April 19, 2018, By Elaine Thompson, The Worcester Telegram
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