IDPH has cited and fined Sharon Health Care Elms nursing home in Peoria after a resident there suffered a brain bleed and a compression fracture of a vertebra in her neck after a fall that occurred while she was left unsupervised on the smoking patio.
People unfamiliar with nursing homes are sometimes surprised that nursing home residents are permitted to smoke. Even though nursing homes are health care institutions, they are also truly the homes of the people who live there, so people are permitted to smoke. Due to restrictions on indoor smoking, smoking must be done outdoors, usually on a deck or patio which has been designated as a smoking area.
However, beyond just the well-known negative health effects of smoking, there are additional risks associated with smoking for nursing home residents. This principally includes the risks of fires or getting burned, mainly due to careless handling of smoking materials by residents suffering from confusion or dementia or due to movement disorders such as Parkinson’s or due to smoke near compressed oxygen equipment.
A lesser known, but still present risk is a risk of falls. This is primarily associated with residents not paying attention to what they are doing due to anxiety or distraction associated with the desire to smoke.
Whatever risks are present associated with residents who smoke, this should be addressed through the resident care plan. Once a care plan is put into place it must be carried out on a day-to-day, shift-to-shift basis. One of the principal forms of addressing risk associated with smoking is by supervision of residents on the smoking patio. To facilitate this, many nursing homes set certain hours during which the smoking deck is open for use.
The resident at issue here was assessed as being a fall risk, in part because of diminished safety awareness and apparent significant visual deficits (per the citation, she told a fellow resident that she was going blind) which affected her ability to see and perceive things around her. Before the fall at issue, over the last year or so, she had four nursing home falls, all on the smoking patio. Her care plan included being supervised on the smoking patio as a fall prevention measure.
The resident fell at approximately 6:30 a.m. while on the smoking patio. She was on the patio unsupervised, having followed another resident who would sometimes give her cigarettes out onto the patio. There was no staff present. While she was out of the smoking deck, she tripped over a decorative landscaping and hit her head. There was immediate bleeding, including from the nose, so the other residents went into the facility and altered the nursing staff. When the nursing staff was unable to stop the nosebleed, they sent her to the hospital. There scans showed that she had a brain bleed and a fracture in her cervical spine. She was transferred to another hospital for advanced care.
This fall was a result of the resident not being supervised on the smoking patio. The lesson that should have been drawn from the prior falls is that her visual deficits and distraction while on the smoking patio left her particularly susceptible to falls. The resident care plan called for it, but there was a clear violation of the resident care plan.
Part of the reason that she was not supervised on the smoking patio is that even though there were supposed to be a set of scheduled hours when the patio was permitted to be used, there was no consensus as to when those hours were, not apparently, on who was supposed to be supervising residents on the patio.
The deeper question is of course why there was no supervision, and the root answer to that question is likely understaffing of the nursing home. More than one of the residents interviewed by IDPH told the surveyor that there was not enough staff on hand to provide regular care to the residents, let alone supervise them when they are smoking. Unfortunately, understaffing of nursing homes is a featured component 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:
Farmington Country Manor resident breaks leg due to failure to follow care plan