Groups » How Do Long-Term Care Facilities Manage Patient Fall Injuries?

There is a lot of literature and guidance for large and small businesses regarding reducing the number slip and fall injuries on site. Following the appropriate guidelines that include warning signs, cordoning off areas during construction, and other essential steps, businesses have learned to minimize fall injuries from customers and staff and to cultivate safer work and recreational areas.

For a retail business, a service organization, or other public location, reducing the opportunity for falls requires management of the property and environment. However, for long-term care facilities or nursing homes – where more than 80 percent of residents require assistance, or have prohibitive mobility needs – fall injuries can become a daily occurrence.

Here, we discuss the law pertaining to healthcare institutions, and how long-term care facilities are liable while serving individuals who are more at-risk for falling than any other population segment.

When Are Nursing Facilities Deemed At-Fault or Negligent?

Despite the reality that most residents in a nursing or long-term care facility require assistance, use mobility devices, and are at a higher risk of tripping or fall injuries, American law does not exempt the facility from negligence or liability claims. All it takes is for the facility to be remiss in a policy or procedure that puts residents at increased risk of injury, or an employee at the long-term care facility who has failed to take “reasonable steps” to ensure the safety of patients.

1. Failure to Develop or Maintain a Care Plan That Addresses Mobility Needs

Nurses and health care staff who provide care for patients are required to develop a plan of action that is customized for the patients’ specific needs. While admitting staff may design a long-term care plan for new patients, in some cases – particularly in smaller facilities where demand is high but support staff levels may be lower – these care plans may not be frequently updated.

It's important to distinguish that any individual in a long-term care facility is there because activities of daily life need medical support and assistance. As the patient ages, and as different health conditions become part of the prognosis, the care plan must be updated on a regular basis. This ensures that changes in mobility, articulation, balance, cognition, and other factors that can contribute to a trip or fall injury are addressed. Can the patient be independent and travel to the bathroom for grooming or needs, or does he or she require ambulation with an assistive device, and health care staff?

When a trip or fall injury occurs, a long-term care facility can be found negligent and liable for a personal injury claim if a care plan has not been created for the patient, or if an existing care plan has not been documented and updated at regular intervals. If increased mobility needs were determined necessary by the health team, and additional mobility accommodations were not provided to the patient, the facility can also be held liable.

2. Handling by Unskilled or Untrained Staff

We would all like to believe that any individual who is placed in charge of the care of a patient has been medically trained to do so safely. However, with increased strain on the healthcare system, and an ever-growing demand for more retirement home care or long-term health care supports in institutions (or within the homecare system), finding qualified individuals can be challenging.

While doctors and nurses are regulated, other fields – including orderlies or kitchen service and meal preparation staff – may not be. Understaffing is also a frequent problem, and deemed to be an act of negligence that can be held in court as a deliberate and intentional choice to economize at the risk of improperly providing safety and service to patients.

Patients who are injured while under the supervision of staff in the dining room, or assistants (including student volunteers) who help with bathing, moving or therapeutic exercise, or cognitive activities may have grounds for a strong personal injury case

3. Failure to Maintain Alarms and Resident Call Buttons

Long-term care facilities have a number of software and hardware components that are wired to provide immediate assistance to patients when they require it. In addition to the presence of technology to assist with the supervision of patients, staff is required to maintain the hardware (batteries, routine testing, etc.) to ensure that it works the way it should for patient safety.

Smoke alarms, patient call alarms, and telecom systems built into patient rooms and bathrooms should be functioning at all times, and have a log that records the dates that the equipment was routinely inspected and tested. Consequently, the maintenance of adequate lighting in rooms, hallways, treatment areas, and high-traffic zones is required – including emergency flood lighting in the event of power outages.

Everything from the structure and type of furnishings to the tread and slip-rating of the flooring installed within the care facility is an opportunity for negligence at any time when a patient falls and injures themselves.

4. Failure to Monitor and Report a Fall Injury

Frequently in long-term healthcare facilities, residents who are aged 70 years and up are hesitant to report a fall injury. Despite the fact that they may experience some discomfort, many seniors feel embarrassed to have fallen, and can be unnecessarily but emotionally apologetic for needing the assistance that they require on a daily basis.

Nurses, doctors, and aides must be trained to inquire about a fall injury. During the course of regular care, any bruises, scrapes, or discomfort witnessed by the care provider should be followed up with an interview to determine if a fall occurred. Whether the fall is confirmed or not, a doctor should evaluate the patient for injuries, and file a complete report if the injuries were sustained as a result of a trip or fall incident.

In addition to the pain and discomfort of a fall injury, elderly patients are at increased risk of serious hip fractures, internal bleeding, and other health impacts. Family members should always be diligent and examine their relative often, and inquire about bruising, sprains, or other signs of physical discomfort that may indicate a fall injury has occurred. West Palm Beach slip and fall attorneys indicate that the first step for a suspected personal injury case is to acquire the official care facility report, and consult with a legal professional.

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