“Not guilty!” And still, the facility must pay.
Christine Mitchell, 70, was in Grace Healthcare of Tucker, Ga. for long-term care following debilitating strokes. A non-restraint facility, Grace Healthcare had rules in place requiring that two aides perform bedmaking duties together. This time, however, only one aide was present, and Christine accidentally rolled off the mattress when the aide moved her to finish changing the bottom sheet. Mitchell fell to the floor, suffering a serious head injury, and was transferred to a hospital. She died a month later. Because of the length of time between the accident and her death, the defense team argued in court that she died from numerous causes related to her general poor health, not directly due to the accident. They prevailed in court and won their case. Nevertheless, the jury found the nursing home liable for inflicting pain and suffering during Christine Mitchell’s final days. “Everyone has a right to live and to die with dignity,” the plaintiff’s lawyer declared during the trial. The jury agreed, and awarded the family $1.8 million in damages. In the Georgia case, rules weren’t followed, a patient died, and the SNF was severely financially impacted.
Another case occurred recently at Emerald South, a nursing facility in Erie County, New York: supervisory inattention led to a security lapse, a female dementia patient wandered into the room of a male dementia patient with a history of acting out, and he assaulted her. Patient-on-patient violence resulted in a fatality, a tragedy that also ultimately shut down the facility.
Protect patients, your loved ones, and yourselves
Skilled nursing facility inpatients and the facilities that care for them aren’t the only ones at risk from failure to follow procedures. It could be the caregiver who ruptures a disc or a knee while handling a patient incorrectly. Or a frail senior living independently with part-time nursing support could injure themselves due to inattention by their care providers.
New trends, changing risks
With “aging in place” on the rise, home health care aides now are the primary caregivers for a rapidly increasing patient population, and the home environment comes with its own unique hazards. For instance, the bathroom is where about 80% of all falls occur, according to a recent National Institute on Aging report. And unlike the dedicated care setting with its standardized and specialized facilities and equipment, home bathrooms are much more likely to have risk factors such as uneven or loose floor surfaces, inadequate patient support equipment, sharp corners and poor lighting. A recent home visitor witnessed this serious incident: while both aides left the patient alone for less than a minute to talk in in the kitchen, a supposedly “bed-bound, sleeping” patient managed to get up and hobble to the bathroom—silently, unsupervised, with slippery stockings on and without any mobility aids. Luckily, the patient was escorted back to safety with no harm done. But it was a close call, and it took only a momentary failure to follow the rules for the lapse to occur.
Bottom line: Recent lapses in procedure and safety have led to severe consequences, and changes in long-term care trends have changed the risk factors as well. Let’s redouble our efforts to follow proper procedures and protect ourselves, our patients, and our facilities.
Next month we’ll discuss the four main human risk factors for accidents in the workplace.
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