Nursing Home Litigation (Continued from page 30)
by other residents; and, abuse by staff. Specific regulations, such as those set forth at 28 CFR 483, are often useful to analyze when evaluating whether or not the standard of care was breached. These may be summarized as follows:
1. Falls (a) 483.15(h) – the resident has the right to a safe, clean, comfort- able, homelike environment.
(b) 483.25(e) – based on the com- prehensive assessment, the facility must ensure (1) that limited range of motion, to the extent avoidable, does not develop, and (2) that limited range of motion is treated to increase the range of motion and prevent more decrease.
(c) 483.25(h) – the facility must ensure that “(1) The resident
environment remains as free of accident hazards as is possible; and, (2) Each resident receives adequate supervision and as- sistance devices to prevent accidents.”
(d) 483.70 – “The facility must be designed, constructed, equipped, and maintained to protect the health and safety of residents, personnel and the public.”
2. Pressure Sores 483.25(c) – Using the compre- hensive assessment, the facility must ensure that “(1) A resident who enters the facility with- out pressure sores does not develop pressure sores unless the individual’s clinical condi- tion demonstrates that they were unavoidable; and (2) A resident having pressure sores receives necessary treatment and services
to promote healing, prevent in- fection and prevent new sores from developing.”
3. Death (a) 483.25(n) – the facility must develop policies and proce- dures ensuring information on immunization, and immu- nization from influenza and pneumococcal. The resident has the right to refuse immu- nization, as long as the risks and the benefits have been provided.
(b) 483.65 – “The facility must establish and maintain an infection control program designed to provide a safe, sanitary, and comfortable en- vironment and to help prevent the development and transmis- sion of disease and infection.”
Pre Settlement Funding • Law Firm Financial Products
For Maryland regulations on disease control, see COMAR 10.07.02.21-4, which states, “All employees shall routinely use appropriate barrier precautions to prevent skin and mucous membrane exposure when con- tact with blood or the body fluids of any resident is anticipated,” in accordance with various guide- lines.
4. Malnutrition (a) 483.25(g) – provides for lim- ited use of naso-gastric tubes.
John Friedson President
P.O. Box 1339
Rockville, Maryland 20849 (301) 984-0600 Fax: (301) 984-0719
email:
john@creativefinancingsolutions.com www.creativefinancingsolutions.com
(b) 483.25(i) – based on the com- prehensive assessment, the facility must (1) maintain, to the extent possible, “accept- able parameters of nutritional status, such as body weight and protein levels” and (2) ensure “a therapeutic diet when there is a nutritional problem.”
(c) 483.25(j) – the facility is re- sponsible for ensuring proper hydration.
(d) 483.35 – “The facility must provide each resident with a nourishing, palatable, well-bal-
32 Trial Reporter Summer 2007
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76