IDPH has cited the Center Home for Hispanic Elderly in Chicago after one of its residents broke her arm in a fall, requiring surgery.
Nursing homes must have measures to avoid injurious falls among their residents. One of these measures is the fall risk assessment, which is the first step in every resident’s care planning process. Upon admittance to a nursing home, the resident goes through this evaluation to see whether they should be tagged as someone with a “fall risk” and should have a fall prevention care plan. The whole process is then redone every 90 days to ensure that the resident’s care plan is up-to-date.
Several factors are examined to determine a person’s risk for suffering falls. Two major factors are gait or balance dysfunction and intermittent or constant confusion.
In this particular case at Center Home, the resident underwent an incomplete fall risk assessment. Specifically, her gait assessment was never completed by the restorative nurse assigned to the task. Thus, the resident was not flagged for fall risk, and she did not have a fall prevention care plan.
Had the gait analysis been completed, the resident would likely have shown a risk of falling due to her polyneuropathy, a nervous condition that affects one’s gait and balance. In fact, she was already largely dependent on a wheelchair due to her physical weakness. Though her balance and gait were clearly compromised, the lack of a complete fall risk assessment meant that there was no fall prevention plan for her at the nursing home.
Five months after she was admitted, the resident suffered a fall that broke her arm. She was initially hospitalized for immediate treatment, and then a second time for surgical repair of the fracture.
It’s additionally notable that she had been in the home for five months and within that time, her care plan had not been revised to include fall prevention. Each resident’s care planning is supposed to be reviewed every 90 days, which means that this particular resident should have had at least one review during her stay. A proper review of her care plan would have shown her fall risk and hence put in place a fall prevention plan that might have prevented her injurious accident.
In short, this injury was avoidable at two different points: first, during the resident’s admittance and initial care planning, and second, during the quarterly review of the care plan. Yet in both instances, the nursing home failed to provide the fall prevention plan she needed.
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