IDPH has cited and fined Pleasant Meadows Senior Living nursing home in Chrisman after a resident there was allowed to go to the bathroom without the required help and then fell while trying to get dressed, resulting in fractures to her eye orbit, her hip, and her wrist and a laceration to her head.
Nursing homes track a great deal of data concerning their residents. Much of it is strictly for internal use, but one piece – the Minimum Data Set, or MDS – is reported outside the facility. It is submitted under penalties of perjury to the federal government because the information that is in there forms part of the basis by which nursing homes are paid. It tracks information concerning the physical abilities and deficits of residents, as well as the levels of care that the nursing home is in fact providing to the resident.
For this resident, the MDS showed that the resident required the assistance of one staff member with transfers, walking, dressing, and toileting. It further reflected that the resident was not steady, used a walker, and was only able to stabilize with the assistance of staff while turning around, moving off/on the toilet, and for surface to surface transfers. The MDS also showed that she had severe cognitive impairments. This is a resident who was clearly at high risk for falls – she had well-documented issues with balance and mobility and also had severe cognitive impairments where she could not be counted on to follow instructions or make good decisions for her own safety.
On the day of this nursing home fall, the resident was walking to the dining room for lunch with an aide. The resident told the aide that she needed to use the bathroom. The aide allowed her to go the restroom unattended and unassisted. Shortly thereafter, a scream was heard and the resident was found on the floor of a different resident’s room with another resident’s pants half on. The resident’s own pants were found on the floor of the bathroom. Apparently the resident needed to change pants after using the bathroom and went into an adjoining room and took another resident’s pants and fell while putting them on.
When she was discovered on the floor, there was blood pooling on the floor from a cut to the head. The resident was sent to the hospital where she was diagnosed with a fractured orbital bone, a fractured hip, and a fractured wrist.
The basic issue with the care that was provided is that the resident required assistance with transfers, toileting, and walking. She was also unsteady when moving off and on the toilet. She required assistance with getting dressed. The aide knew that she was going to the bathroom – a time when she needed help getting on and off the toilet. She also needed help with dressing – something that was necessary after she apparently got her pants dirty or was otherwise unable to get them back on after going to the bathroom. Because the resident was left to handle all of these tasks without help when she needed, the fall and injury resulted.
When you have staff that is stretched too thin to provide necessary supervision and help to residents to avoid accidents, this raises fair questions as to whether this was an understaffed nursing home. Unfortunately, understaffing a nursing home is a basic feature of the nursing home business model. One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of nursing home residents are the inevitable result. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.
Other blog posts of interest:
Failure to follow care plan leads to fall and fractured hip at Piatt County Nursing Home
Unlocked furniture causes fall and broken leg at Mt. Vernon Countryside Manor
Unsupervised resident at Odd Fellow Rebekah Home in Mattoon suffers brain bleed in fall
Click here to file a complaint about a nursing home with the Illinois Department of Public Health.