Nursing Home Litigation Proper lighting during the night is crucial if the resident
needs to get of bed to use the bathroom. Arranging furniture to make a clear path from the bed and avoiding clutter are essential safety protocols. Establishing a bathroom routine (called “toileting”) is also important as it will decrease the likelihood that the resident may arise during the night and fall. Placing the resident’s bed such that the resident exits on his or her stronger side is effective. It is also known that the elderly are particularly susceptible to falls during transition points in their continuum of care; i.e., upon admission or re- admission to the facility after a hospitalization.
Preventive Measures As outlined above, there are a variety of interventions that
should be applied if the resident is deemed as at risk for falls. However, it should be stressed that each resident’s needs must be considered in the context of the results collected from his or her particular assessment; there should not be a “one size fits all” approach. In general, some additional measures that can be implemented include: using treaded socks, placing the resident’s bed in a low position, placing a bedside floor mat, making sure that a call bell is within reach (assuming the resident is cognitively able to comprehend the process), providing appropriate assistive devices, and using bed alarms or contact alarms.
Liability After reviewing the records and other relevant materials,
your focus should be the following: 1. Was the resident at risk for falling? If so, was the resident properly identified as such?
2. If the assessments identified the presence of one or more predisposing factors, did the facility implement appropriate and timely interventions to prevent the fall?
3. If the facility initiated interventions, was there continued monitoring to ensure that the interventions were effective and amended if necessary?
If the answer to any of these questions is “no,” there may be a viable basis to pursue the matter. Tese inquiries reflect the CMS surveyor guidance
known as F-tag #323, whose purpose is to ensure that nursing homes provide a safe and hazard-free environment for their residents.4
CMS identifies a four-step approach the
nursing home facility should use to accomplish that goal: identifying hazards and preventing avoidable accidents; using and analyzing the information obtained to develop a plan; effective implementation of the interventions developed; and
monitoring and modification as may be needed to ensure safety. 4 See also, C.F.R. § 483.25 Quality of care, (H) (1) and (2) Accidents and Supervision and COMAR 10.07.09.08, 10.07.09.09, 10.07.02.12 and10.07.02.37.
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Conclusion Te gravamen of any nursing home fall case is the
facility’s failure to prevent an avoidable event. Building that case requires a thorough review and evaluation of the relevant nursing home records, which contain a wealth of information to support a viable cause of action.
Biography Louise A. Lock (Louise A. Lock, PA, Towson, MD) received
her JD from the University of Baltimore School of Law and an LLM in Health Law from the Widener University School of Law. She is a member of the MAJ President’s Club as an Eagle. Ms. Lock was most recently Co-Chair of the Nursing Home Section. She has also served as Chair of the MAJ Publications Committee, Editor-in-Chief of the Trial Reporter journal, Chair of the Membership Directory and Chair of the Membership Communications Committee. In 2007, Ms. Lock was a founder of the MAJ Public Awareness Committee and initiated the Public School Awareness Program (PASP). She also serves on the Editorial Advisory Board of Te Maryland Bar Journal. Her practice focuses in the areas of medical malpractice, nursing home negligence, product liability and serious, personal injury matters.
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