Fall Liability (Continued from page 24)
potential. Obviously, the higher the risk, the more aggressive the care plan and interventions should be for the resident. Interventions may include changes in medication, footwear, physical therapy, gait training, walking assistance devices, bed alarms, lowering a bed, safety mats near a bed and hip protectors. Once there is a change in the resident’s
medical condition or status, they would need to be re-assessed and revisions of the fall prevention plan would need to be made. Additional general violations of
OBRA are often cited by attorneys to show negligence and by state surveyors to support deficiencies. Some examples in fall cases include:
42 CFR § 483.25(a)—Based on a com- prehensive assessment of the resident, the facility must ensure that—
(1) A resident’s abilities in activities
of daily living do not diminish unless circumstances of the individual’s clinical condition demonstrate that diminution was unavoidable. This includes the resident’s ability to—
(i) Bathe, dress and groom; (ii) Transfer and ambulate; (iii) Toilet; (iv) Eat; and (v) Use speech, language or other functional communication systems.
(2) A resident is given the appropri-
ate treatment and services to maintain or improve his or her abilities specified in paragraph (a)(1) of this section; and, 42 CFR § 483.25(h)(1-2)—The facil-
ity shall provide each resident a safe and secure environment, with adequate supervision and assistive devices so as to prevent accidents. 42 CFR § 483.13(c)—The facility shall
not neglect a resident. 42CFR § 483.10(b)(10)—The resident’s physician shall be notified
immediately, and the resident’s respon- sible party promptly, whenever there is an accident/incident involving the resi- dent which requires potential medical intervention. 42 CFR § 483.30—The nursing needs
of the resident shall be met 24 hours a day, 7 days a week; and, there shall be sufficient staffing to enable the resident to attain or maintain her highest prac- ticable physical well being. Also, see the federal interpretive guidelines. 42 CFR § 483.20—Care plans shall
address the comprehensive needs of the resident. Care plans shall be followed. Care plans shall be revised quarterly as resident needs dictate. Also, see the federal interpretive guidelines. 42 CFR § 483.13(c)—All injuries of
unknown origin to a resident shall be reported to state authorities. 42 CFR § 483.40—Physician orders
shall be followed. 42 CFR § 483.75(1)—The facility
shall ensure that the resident’s medical records be consistent with professional standards. Nursing progress notes shall
Structured Settlements
For Your Client’s Financial Security Introduce Them to Someone With
• Integrity and Trustworthiness
• 20+ Years of Experience in Maryland • Quality and Knowledge Exceeding Expectations
Gary Blankenship 1-800-284-4650 26 Trial Reporter Tom Dolny
Summer 2007
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