Elderly, vulnerable, and feeble residents in nursing homes are in most cases confused and completely reliant upon the facility’s staff for their well-being. The entire purpose of surrendering the loved ones by their families to the nursing home is to take individualized care of admittees according to applicable federal and state standards. The facility gives promises and signs a contract with the admittees to provide such 24/7 care and medical treatment according to treating physicians’ orders. The facility fails to meet its standard of care if it does not keep the residents safe and secure by taking reasonable steps to identify the risks and prevent accidental injury or death by eliminating these risks.
Nursing home staff must comply with:
Facility/ company’s policies, practices, and business decisions relating to resident care.
Federal and state standards of care to avoid abuse or neglect suffered by a resident
Individual’s care plans, required monitoring and supervision orders by the resident’s treating doctor, the nursing home administrator, nurses, dieticians, CNAs, physical or occupational therapists, wound care doctors, etc.
Nursing home regulations require an interdisciplinary approach to a care plan and assessment incorporating the collective (not any individual’s subjective) knowledge of a resident’s representative, physician, and staff members most knowledgeable about the resident. When risk factors change, the resident should be re-assessed, and the plan changed to address the resident’s needs and implemented to prevent accidents / falls. A Minimum Data Set (MDS) is an interdisciplinary assessment tool required by federal regulations for use in nursing homes to determine what care a resident requires. The MDS identifies some of the risk factors for falls, including a history of falls, dizziness, wandering, presence of dementia, ability to ambulate, restraint use, and use of drugs in high-risk classes.
Pertinent legal standards require that the nursing home provide “adequate” staffing to meet the needs of the residents. If a resident requires close supervision, but there is insufficient staff to provide that level of care, the facility has violated this “adequacy” standard. But often the facility’s understaffing results in the nurse assistants’ (CNAs) inability to promptly respond to a bedridden admittee’s urgent alarm buzzer call for one- or two-person assistance in using a restroom, taking a shower, or getting off a wheelchair or out of bed. Consequently, the pain intolerant residents, who are at risk of falling, fulfill their needs without the staff’s assistance and in doing so sustain fall-caused fractures, brain injury, death, irreversible health deterioration, loss of cognition and independence in their activities of daily living.
Nursing Home’s arguments that an injurious accident was “unavoidable” or unanticipated are untenable because:
Facility did not take reasonable steps to identify the risk and to implement an appropriate plan to mitigate it
Prior similar accidents involving this or other similarly situated residents gave the facility notice and set a pattern,
Facility had to adopt and try new interventions as it must adjust its approach to meet the resident’s changing needs/ risks if prior approaches prove ineffectual.
In sum, residents’ injuries at a nursing home facility are predictable and preventable, particularly for demented, bedridden or wheelchair bound residents who need to be guarded from development Stage IV bedsore wounds, fall-caused bone fractures and traumatic brain traumas.