Hillcrest Care Fall with Fractured Hip

Resident at Hillcrest Care Suffers Fractured Hip
Resident at Hillcrest Care Suffers Fractured Hip

Fall From Bed Results in Fractured Hip at Hillcrest Care 

In a report from MDH, it was alleged that a client at Hillcrest Care and Rehabilitation in Mankato was injured when they rolled out of bed due to improper placement and use of an air mattress.

Substantiated Neglect Against Hillcrest Care 

Neglect was substantiated. The facility for maltreatment.  The DON confirmed the staff thought that the mattress was an overlay not an air mattress. The staff was educated on the protocol related to the resident air mattresses and proper set up and usage.  The facility staff was educated to identify interventions related to the resident’s specific risks and causes to try to prevent the resident from falling and try to minimize complications from falling.   The facility’s corrective actions identified in the facility’s post fall investigation, were verified as having been implemented as of 4/26/20 through interviews and record review.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves medication management and administration or injuries from fall and fractures. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection
Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

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Federal Requirements for Long Term Care Facilities

Federal Requirements for Nursing Homes and Long Term Care Facilities

 

Federal Requirements for Nursing Homes and Long Term Care Facilities

Federal Requirements for Long Term Care Facilities – 42 CFR 483

The federal requirements and regulations for long term care facilities also known as nursing homes are contained at 42 CFR 483.   Each regulation sets for the minimum standard of care which is then inspected by the Center for Medicaid Service and Minnesota Department of Health in surveys or complaint investigations.

Here is the Nursing Home Reform Act Federal Requirements for Long Term Care Facilities

These federal requirements for long term care facilities set the standard of care for the facility, staff and medical providers.

42 CFR 483

§ 483.1 Basis and scope.

§ 483.5 Definitions.

§ 483.10 Resident rights.

§ 483.12 Freedom from abuse, neglect, and exploitation.

§ 483.15 Admission, transfer, and discharge rights.

§ 483.20 Resident assessment.

§ 483.21 Comprehensive person-centered care planning.

§ 483.24 Quality of life.

§ 483.25 Quality of care.

§ 483.30 Physician services.

§ 483.35 Nursing services.

§ 483.40 Behavioral health services.

§ 483.45 Pharmacy services.

§ 483.50 Laboratory, radiology, and other diagnostic services.

§ 483.55 Dental services.

§ 483.60 Food and nutrition services.

§ 483.65 Specialized rehabilitative services.

§ 483.70 Administration.

§ 483.73 Emergency preparedness.

§ 483.75 Quality assurance and performance improvement.

§ 483.80 Infection control.

§ 483.85 Compliance and ethics program.

§ 483.90 Physical environment.

§ 483.95 Training requirements.

(1) Pressure ulcers. Based on the comprehensive assessment of a resident, the facility must ensure that—

Many of the quality of care issues are addressed in 42 CFR 483.25, which has many subparts each on a specific type of care issue including:

42 CFR 483.25 Quality of care.

Quality of care is a fundamental principle that applies to all treatment and care provided to facility residents. Based on the comprehensive assessment of a resident, the facility must ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the resident’s choices, including but not limited to the following:

(a) Vision and hearing. To ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities, the facility must, if necessary, assist the resident—

(1) In making appointments, and

(2) By arranging for transportation to and from the office of a practitioner specializing in the treatment of vision or hearing impairment or the office of a professional specializing in the provision of vision or hearing assistive devices.

(b) Skin integrity.

(i) A resident receives care, consistent with professional standards of practice, to prevent pressure ulcers and does not develop pressure ulcers unless the individual’s clinical condition demonstrates that they were unavoidable; and

(ii) A resident with pressure ulcers receives necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection and prevent new ulcers from developing.

(2) Foot care. To ensure that residents receive proper treatment and care to maintain mobility and good foot health, the facility must—

(i) Provide foot care and treatment, in accordance with professional standards of practice, including to prevent complications from the resident’s medical condition(s) and

(ii) If necessary, assist the resident in making appointments with a qualified person, and arranging for transportation to and from such appointments.

(c) Mobility.

(1) The facility must ensure that a resident who enters the facility without limited range of motion does not experience reduction in range of motion unless the resident’s clinical condition demonstrates that a reduction in range of motion is unavoidable; and

(2) A resident with limited range of motion receives appropriate treatment and services to increase range of motion and/or to prevent further decrease in range of motion.

(3) A resident with limited mobility receives appropriate services, equipment, and assistance to maintain or improve mobility with the maximum practicable independence unless a reduction in mobility is demonstrably unavoidable.

(d) Accidents. The facility must ensure that—

(1) The resident environment remains as free of accident hazards as is possible; and

(2) Each resident receives adequate supervision and assistance devices to prevent accidents.

(e) Incontinence.

(1) The facility must ensure that a resident who is continent of bladder and bowel on admission receives services and assistance to maintain continence unless his or her clinical condition is or becomes such that continence is not possible to maintain.

(2) For a resident with urinary incontinence, based on the resident’s comprehensive assessment, the facility must ensure that—

(i) A resident who enters the facility without an indwelling catheter is not catheterized unless the resident’s clinical condition demonstrates that catheterization was necessary;

(ii) A resident who enters the facility with an indwelling catheter or subsequently receives one is assessed for removal of the catheter as soon as possible unless the resident’s clinical condition demonstrates that catheterization is necessary, and

(iii) A resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections and to restore continence to the extent possible.

(3) For a resident with fecal incontinence, based on the resident’s comprehensive assessment, the facility must ensure that a resident who is incontinent of bowel receives appropriate treatment and services to restore as much normal bowel function as possible.

(f) Colostomy, urostomy, or ileostomy care.  The facility must ensure that residents who require colostomy, urostomy, or ileostomy services, receive such care consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents’ goals and preferences.

(g) Assisted nutrition and hydration.  (Includes naso-gastric and gastrostomy tubes, both percutaneous endoscopic gastrostomy and percutaneous endoscopic jejunostomy, and enteral fluids). Based on a resident’s comprehensive assessment, the facility must ensure that a resident—

(1) Maintains acceptable parameters of nutritional status, such as usual body weight or desirable body weight range and electrolyte balance, unless the resident’s clinical condition demonstrates that this is not possible or resident preferences indicate otherwise;

(2) Is offered sufficient fluid intake to maintain proper hydration and health; and

(3) Is offered a therapeutic diet when there is a nutritional problem and the health care provider orders a therapeutic diet.

(4) A resident who has been able to eat enough alone or with assistance is not fed by enteral methods unless the resident’s clinical condition demonstrates that enteral feeding was clinically indicated and consented to by the resident; and

(5) A resident who is fed by enteral means receives the appropriate treatment and services to restore, if possible, oral eating skills and to prevent complications of enteral feeding including but not limited to aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal-pharyngeal ulcers.

(h) Parenteral fluids.  Parenteral fluids must be administered consistent with professional standards of practice and in accordance with physician orders, the comprehensive person-centered care plan, and the resident’s goals and preferences.

(i) Respiratory care, including tracheostomy care and tracheal suctioning.  The facility must ensure that a resident who needs respiratory care, including tracheostomy care and tracheal suctioning, is provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, the residents’ goals and preferences, and §483.65 of this subpart.

(j) Prostheses.  The facility must ensure that a resident who has a prosthesis is provided care and assistance, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents’ goals and preferences, to wear and be able to use the prosthetic device.

(k) Pain management.  The facility must ensure that pain management is provided to residents who require such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents’ goals and preferences.

(l) Dialysis.  The facility must ensure that residents who require dialysis receive such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents’ goals and preferences.

(m) Trauma-informed care.  The facility must ensure that residents who are trauma survivors receive culturally-competent, trauma-informed care in accordance with professional standards of practice and accounting for residents’ experiences and preferences in order to eliminate or mitigate triggers that may cause re-traumatization of the resident.

(n) Bed rails.  The facility must attempt to use appropriate alternatives prior to installing a side or bed rail. If a bed or side rail is used, the facility must ensure correct installation, use, and maintenance of bed rails, including but not limited to the following elements.

(1) Assess the resident for risk of entrapment from bed rails prior to installation.

(2) Review the risks and benefits of bed rails with the resident or resident representative and obtain informed consent prior to installation.

(3) Ensure that the bed’s dimensions are appropriate for the resident’s size and weight.

(4) Follow the manufacturers’ recommendations and specifications for installing and maintaining bed rails.

Consumer Voice produced a chart of changes and new federal nursing home rules and regulations.

If you have any questions about injury or assault or care provided at a nursing home or other type provider such as assisted living or memory care, contact Nursing Home Neglect and Abuse Lawyer Kenneth LaBore, toll free at 1-888-452-6589 or 612-743-9058 or by email at KLaBore@MNnursinghomeneglect.com.

Disclaimer

Nursing Home Abuse and Neglect Lawyer Kenneth LaBore Offers Free Consultations and Serves Clients Throughout the State of Minnesota Call Toll Free at 1-888-452-6589
Nursing Home Abuse and Neglect Lawyer Kenneth LaBore Offers Free Consultations and Serves Clients Throughout the State of Minnesota Call Toll Free at 1-888-452-6589

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The Geneva Suites Failure to Respond to Stroke Symptoms

Failure to Respond to Client Having Stroke at The Geneva Suites
Failure to Respond to Client Having Stroke at The Geneva Suites

Delayed Response to Change in Condition at The Geneva Suites

In a report from the MDH, it was alleged that a client at The Geneva Suites was neglected when the facility did not respond appropriately to reports of a client with a significant change in condition. The client was sent to the emergency room with signs and symptoms of a stroke. Additionally, it was alleged that the client was not receiving meal preparation services that were a part of the client’s care plan.

Neglect Substantiated Due to Care Issues

Neglect was substantiated. The facility was responsible for the maltreatment. Facility staff did not initiate a timely and appropriate response when the client had a significant change in condition. The direct care staff did not call 911 even after concluding the client needed emergency medical services. In addition, the nurse did not ask the unlicensed personnel detailed questions to assess the client’s condition, and did not arrive at the home during the shift to assess the client. 911 was called at the end of the shift, at which time the client was sent to the hospital with signs and symptoms of a stroke.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves medication management and administration or injuries from fall and fractures. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection
Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

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Saint Therese of Woodbury Resident Falls with Injuries

In a report from the MDH, St. Therese / Saint Therese of Woodbury was alleged to neglect a resident when the facility failed to follow the client’s service plan for toileting, resulting in a fall with injuries.

Fall Injury at Saint Therese Woodbury

Neglect is substantiated. The alleged perpetrator (AP) was responsible for neglect. The AP failed to toilet the client during the night shift and the client had a fall with injuries when the client toileted herself. The AP could not sign into the computer to access to client service plan, and therefore did not complete or document any scheduled client services. The AP did not contact the on-call nurse for assistance.

The investigation included interviews with facility staff, including nursing staff, unlicensed staff and family member. The investigator conducted observation of staff/client interactions toured the facility, spoke with additional clients, and reviewed documents, including policies related to implementation of service plans, nursing assessments, and falls prevention.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves medication management and administration or injuries from fall and fractures. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection
Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

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Maple Hill Senior Living – Multiple Falls

Resident at Heritage of Edina Suffers Shoulder Fracture in Fall
Resident at Maple Hill Senior Living Sustained Shoulder Fracture in Fall

Fracture to Shoulder of Resident at Maple Hill Senior Living

In a report from the MDH it is alleged that the Maple Hill Senior Living (AP) neglected the client, on two separate occasions, when the AP did not answer the call light for several hours. The first time, the client attempted to get out of bed, fell and laid on the floor for several hours. The client sustained a shoulder fracture.

Neglect was substantiated. The facility and the AP were responsible for the maltreatment. The AP neglected to provide the client a scheduled safety check and neglected to answer the client’s call pendant for approximately five hours. The client fell after attempting to transfer herself from the bathroom and laid on the floor for several hours. The client sustained a shoulder fracture.

Maple Hill Senior Living Resident – Fall Incident

In another MDH report it was alleged that Maple Hill Senior Living (AP) neglected to supervise a client who had multiple falls. It is also alleged that the facility neglected to provide the client with clean sheets or correct medications.

Neglect was substantiated. The facility was responsible for the neglect. The client had a fall that resulted in a broken facial bone and required hospitalization. When the client returned from the hospital, a nurse assessed the client to be a high fall risk, but failed to implement fall prevention interventions because the client was on the memory care unit and received hourly checks.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves medication management and administration or injuries from fall and fractures. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection
Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

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Vulnerable Client at Butterfly Bound Care Sexual Abuse Allegations

In a MDH report it was alleged that a client at Butterfly Bound Care was sexually abused when the alleged perpetrator (AP) abused a client when he had sex with the client, gave the client $100.00, and then told the client would get kicked out if she told anyone.

Report that Client abused, then paid, the threatened at Care Facility

According the MDH abuse was substantiated against Butterfly Bound Care and the AP were responsible for the maltreatment. The facility failed to ensure that the AP completed training on staff/client boundaries. The AP told the client that if she had sex with him, he would make sure that she was not kicked out of the home. The AP gave the client $100 and then told her that is she told anyone about the incident she would be kicked out of the home.

On the evening of the incident, the AP gave the client a back massage. The AP then asked the client to have sex with him. The AP told the client he would give her $100 for sex. The AP took the client in his car to the bank and to Walgreens. The AP left the other clients alone in the facility.

The AP brought the client back to the Butterfly Bound Care facility where they engaged in sex. Afterward, the AP told the client not to tell anyone or he would make sure she was kicked out of the facility. The client moved out of the facility about two weeks later.

Police Contacted Concerning Assault / Abuse at Butterfly Bound Care

During an interview, the client said she reported the incident to a county worker, who contacted the police.

The investigation with the Minnesota Department of Health resulted in the conclusion that abuse was substantiated.

For a Free Consultation with an experienced elder abuse and neglect attorney call Kenneth LaBore at 612-743-9048.

A common form of neglect in elder care facilities involves medication management and administration or injuries from fall and fractures. Most forms of elder abuse are preventable with proper care and supervision.

Report Suspected Elder Abuse

Click Here For Link To Report Abuse To Adult Protection
Click Here For Link To Report Abuse To Adult Protection

If you have concerns about care provided to a resident in a nursing home, assisted living or any other type of elder care provider contact Attorney Kenneth LaBore for a Free Consultation to discuss your legal rights and options.

Disclaimer

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Pressure Injuries Sores Decubitus

Decubitus Pressure Injuries Sores are Avoid Unless Underlying Clinical Reason for Sores

Avoiding Nursing Home Pressure Ulcer Injury

Nursing homes are established to provide the elderly with the assistance and care they need. In many instances, your loved one may become sick or bed ridden due to an accident or disease, or suffer from a pressure injuries sores or other neglect.

If your loved one is currently on bed rest or disabled, it is critical that they are receiving the adequate nursing care, including sufficient food and hydration as well as personal attention from the nursing home staff, to ensure they have adequate movement to shift the weight bearing locations on their bodies.

A lack of mobility leading to prolonged periods of time of increased pressure on a resident’s heels, lower back and shoulders can lead to ulcerations, often called decubitus ulcer, pressure ulcer or bed sores.

Pressure Injuries Sores / Ulcers are often a sign that the nursing home staff is not assisting the residents to move freely or not turning them as they are meant to. This is a serious form of nursing home abuse that should be dealt with right away. Contacting a nursing home abuse lawyer is your first step against this type of mistreatment.

The Freedom from abuse, neglect and exploltationwhich regulation governs nursing homes considers pressure ulcers to Be “AVOIDABLE” and therefore preventable: Pressure ulcers / sores. Based on the comprehensive assessment of a resident, the facility must ensure that—

(1) A resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable; and
(2) A resident having pressure sores receives necessary treatment and services to promote healing, prevent infection and prevent new sores from developing. Freedom from abuse, neglect and exploltation.

Understanding Pressure Injuries Ulcers – Bed Sores

Bed sores also referred to as decubitus ulcers and pressure sores, are areas of damaged skin and tissue that develop due to a reduction in circulation often accompanied by excessive periods of unrelieved pressure on the affected area. In order to properly track the care provide for a pressure sore, it is essential that the staff understand the correct way to identify and chart the stages of pressure wounds.

The National Pressure Ulcer Advisory Panel (NPUAP) serves as the authoritative voice for improved patient outcomes in pressure ulcer prevention and treatment through public policy, education and research.

Pressure Ulcer Stages Revised by NPUAP

NPUAP Stage 1 Pressure Ulcer Injury: Non-blanchable erythema of intact skin Intact skin with a localized area of non-blanchable erythema, which may appear differently in darkly pigmented skin. Presence of blanchable erythema or changes in sensation, temperature, or firmness may precede visual changes. Color changes do not include purple or maroon discoloration; these may indicate deep tissue pressure injury.

Stage 2 Pressure Injury: Partial-thickness skin loss with exposed dermis Partial-thickness loss of skin with exposed dermis. The wound bed is viable, pink or red, moist, and may also present as an intact or ruptured serum-filled blister. Adipose (fat) is not visible and deeper tissues are not visible. Granulation tissue, slough and eschar are not present. These injuries commonly result from adverse microclimate and shear in the skin over the pelvis and shear in the heel. This stage should not be used to describe moisture associated skin damage (MASD) including incontinence associated dermatitis (IAD), intertriginous dermatitis (ITD), medical adhesive related skin injury (MARSI), or traumatic wounds (skin tears, burns, abrasions).

Stage 3 Pressure Injury: Full-thickness skin loss Full-thickness loss of skin, in which adipose (fat) is visible in the ulcer and granulation tissue and epibole (rolled wound edges) are often present. Slough and/or eschar may be visible. The depth of tissue damage varies by anatomical location; areas of significant adiposity can develop deep wounds. Undermining and tunneling may occur. Fascia, muscle, tendon, ligament, cartilage and/or bone are not exposed. If slough or eschar obscures the extent of tissue loss this is an Unstageable Pressure Injury.

Stage 4 Pressure Injury: Full-thickness skin and tissue loss Full-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage or bone in the ulcer. Slough and/or eschar may be visible. Epibole (rolled edges), undermining and/or tunneling often occur. Depth varies by anatomical location. If slough or eschar obscures the extent of tissue loss this is an Unstageable Pressure Injury.

Unstageable Pressure Injury: Obscured full-thickness skin and tissue loss Full-thickness skin and tissue loss in which the extent of tissue damage within the ulcer cannot be confirmed because it is obscured by slough or eschar. If slough or eschar is removed, a Stage 3 or Stage 4 pressure injury will be revealed. Stable eschar (i.e. dry, adherent, intact without erythema or fluctuance) on the heel or ischemic limb should not be softened or removed.

For a free consultation with an experienced nursing home neglect attorney concerning pressure injuries, injury from mechanical patient lift, assault or other neglect contact Kenneth LaBore at 1-888-452-6589.

Nursing Home Abuse and Neglect Lawyer Kenneth LaBore Offers Free Consultations and Serves Clients Throughout the State of Minnesota Call Toll Free at 1-888-452-6589
Nursing Home Abuse and Neglect Lawyer Kenneth LaBore Offers Free Consultations and Serves Clients Throughout the State of Minnesota Call Toll Free at 1-888-452-6589
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Hoyer Mechanical Patient Lift Fall Injuries

Hoyer Type Lift Neglect Fall From Patient Lift
Hoyer Type Lift
Neglect Fall From Patient Lift

How to Avoid Injury From Mechanical Patient Lifts

Nursing Homes have a legal duty to ensure that all the patient lifts also known as Hoyer Lifts and other medical equipment, including the staff training, is up to the standards. It is important that all medical equipment be checked and serviced by professionals and that all staff are properly trained and qualified for their positions. In fact, Freedom from Abuse Neglect Federal Regulation mandates they should be “as free of accidents as possible”. Patient lift injuries are some of the most common injuries in nursing homes since the residents often require assist with transfers many time a day. Often patient lifts called by generic terms such as: “hoyer lift”, “inva-lift”, “pro-lift”, “valero” and others – this can or cannot be the actual manufacturer of the lift.

Federal Regulation Mandates Concerning Falls – Patients Lifts

Freedom from Abuse Neglect Federal Regulation (h) Accidents. The facility must ensure that—

(1) The resident environment remains as free of accident hazards as is possible; and

(2) Each resident receives adequate supervision and assistance devices to prevent accidents.

Improper Patient Lift and Other Medical Equipment Concerns

There are a number of different problems surrounding the improper use of mechanical patient lift and other medical equipment in nursing home and other care facilities. Some of the cases we handle include the following:

  • Hazardous equipment – this includes patient lifts, beds, bathroom facilities and common room facilities
  • Lack of safety devices – bed rails, wheelchairs, etc.
  • Inadequate bedding – unclean sheets and linen, rickety beds, missing bed rails
  • Lack of hygiene and cleanliness
  • Lack of proper specialized care medical equipment including bariatric patient lifts, oxygen carts, tracheal suctioning equipment, etc.
  • Inadequate training and supervision of staff

Inadequate Medical Equipment Training

In addition to hazardous medical equipment concerns, you also need to be sure that the nurses, the doctors and the caregivers in the facility are properly qualified and trained. Because of the rise in the aging population, more and more nursing facilities are hiring people off the street that do not have the education, the qualifications or the background to work in this environment. For more information see: patient lift injuries. If a nursing home is not providing an adequate level of health care and support including the use of proper patient lifts and other medical equipment then it is important that the authorities be notified right away and that the nursing home neglect stops immediately. It is also important to have an attorney experienced with handling nursing home and patient lift injury cases to hold the facility accountable. If you or someone you love has suffered an injury from a patient lift or any abuse or neglect in a nursing home, then contact Attorney Kenneth LaBore locally at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com or fill out the form on this page. Disclaimer

Patient Lift Injuries are Preventable

Many falls and the serious injuries that can occur from mechanical patient lifts are preventable using the medical lift as outlined in the manual including the proper number of aides required for the transfer.

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UTI Complications Infections

Complications Can Be Serious

As a result of UTI complications many residents can require hospitalization and can die from blood poisoning known as sepsis.

Bladder and Urinary Infection Information

Urinary Tract Infection, UTI complications, Infectious Disease
Urinary Tract Infection, UTI complications, Infectious Disease

According to the Mayo Clinic in an article concerning urinary infections, UTI complications, the most common urinary infection occur mainly in women and affect the bladder and urethra. Urinary tract infections UTI are unfortunately common in nursing home and other elder care settings. UTIs can be very serious and if left untreated can result in sepsis leading to death. Infection of the bladder (cystitis) is usually caused by Escherichia coli (E. coli), a species of bacteria commonly found in the gastrointestinal tract. Sexual intercourse may lead to cystitis, but you don’t have to be sexually active to develop it. All women are susceptible to cystitis because of their anatomy — specifically, the close proximity of the urethra to the anus and the short distance from the urethral opening to the bladder. Infection of the urethra (urethritis) can occur when the gastrointestinal bacteria make the short trip from the anus to the urethra. In addition, because of the female urethra’s proximity to the vagina, sexually transmitted diseases (STDs), such as herpes simplex virus, gonorrhea and chlamydia, also are possible causes of urethritis. Often the use of a catheter without proper care can lead to a serious bladder or urinary infection. The infection can spread to the blood and cause the person to become septic. The Mayo Clinic defines sepsis as a potentially life-threatening complication of an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammation throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail. If sepsis progresses to septic shock, blood pressure drops dramatically, which may lead to death. Anyone can develop sepsis, but it’s most common and most dangerous in elderly people or those with weakened immune systems. Early treatment of sepsis, usually with antibiotics and large amounts of intravenous fluids, improves chances for survival.

Male and Female Urinary Systems from Mayo Clinic

Female Urinary System Male Urinary System

Risk factors for Urinary Infection

Some people appear to be more likely than are others to develop urinary infections. Risk factors include:

• Being female. Half of all women will develop a urinary tract infection at some point during their lives, and many will experience more than one. A key reason is their anatomy. Women have a shorter urethra, which cuts down on the distance bacteria must travel to reach the bladder.

• Aging. After menopause, urinary tract infections may become more common because tissues of the vagina, urethra and the base of the bladder become thinner and more fragile due to loss of estrogen.

• Kidney stones or any other urinary obstruction.

• Diabetes and other chronic illnesses that may impair the immune system.

• Prolonged use of tubes (catheters) in the bladder.

Recommendations for Prevention of Urinary Infection

These steps may reduce your risk of urinary tract infections:

• Drink plenty of liquids, especially water. Cranberry juice may have infection-fighting properties. However, don’t drink cranberry juice if you’re taking the blood-thinning medication warfarin. Possible interactions between cranberry juice and warfarin may lead to bleeding.

• Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.

• Avoid potentially irritating feminine products. Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.

PHIL Image 15234
Bacteria Infection Culture
Federal Regulations Concerning Urinary Infection

Freedom from abuse, neglect and exploltation Urinary Incontinence. Based on the resident’s comprehensive assessment, the facility must ensure that—

(1) A resident who enters the facility without an indwelling catheter is not catheterized unless the resident’s clinical condition demonstrates that cathertization was necessary; and

(2) A resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections and to restore as much normal bladder function as possible.

If you or a loved one has suffered an injury from bladder or urinary infection or other neglect or abuse in a nursing home or other care facility that serves the elderly in Minnesota, Kenneth LaBore provides a free consultation and information regarding the obligations of the facility and your rights as a resident or concerned family member. To contact Attorney Kenneth L. LaBore, directly please send an email to KLaBore@mnnursinghomeneglect.com, or call Ken at 612-743-9048 or call him at his direct toll free number 1-888-452-6589. This website is not intended to provide legal advice as each situation is different and specific factual information must be obtained before an attorney is able to assess the legal questions relevant to your situation.

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Wandering and Elopement

Lack of Supervision Resident Wandering and Elopement
Lack of Supervision Resident Wandering and Elopement

Nursing Homes Have a Duty to Prevent Residents from Wandering and Elopement

Many residents of nursing homes are suffering from a disability that affects their mental capacity, such as Alzheimer’s disease, dementia and delirium. Nursing homes need to have sufficient numbers of adequately trained staff to supervise, monitor and assess the residents to ensure they remain safe and are not at risk for wandering and elopement. Generally the terms “wander” and “elopement” are used when a resident leaves a part of the facility or the building itself without notifying staff. Senior nursing home residents that wander can get into dangerous situations such as traffic or encountering adverse weather conditions, such as extreme cold, leading to injuries ranging from frost bite to hypothermia and death. Often a senior that leaves the facility can be gone hours before anyone may even notice they are missing from the nursing home. Residents can become disorientated and are often unable find their back to the facility or seek assistance on their own. Before the development of electronic monitoring devices, such as tag alarms nursing home residents would have more restrictions in their activities to allow for supervision. It is important that the nursing home have enough well trained staff and the necessary monitoring equipment to allow the resident as much freedom as possible, without putting them at risk for injuries related to wandering and elopement. Generally elopement is used to describe a resident that actually leaves the facility without being observed. Often times a resident that wanders or elopes has orders from their doctor to be supervised and may even be required to wear electronic monitoring. Nursing homes may have insufficient staff to adequately monitor the residents allowing a person to exit the building unnoticed. The facility may have also failed to implement or respond to alarms and monitors designed to alert the staff when a resident leaves a designated area.

Residents Need Supervision to Prevent Wandering and Elopement.

According to federal regulation 42 CFR §483.25 (h), accidents. The facility must ensure that—

(1) The resident environment remains as free of accident hazards as is possible; and

(2) Each resident receives adequate supervision and assistance devices to prevent accidents. (this includes risks from wandering and elopement)

How can a Nursing Home Reduce the risk of Wandering and Elopement

• Use of tag alarm that clips on the shirt of resident and alerts when they get up from bed or a chair. • Use a electronic “wander guard bracelet” or “life alert system” to alert when the resident leaves the floor of the nursing home. • Make sure that there is adequate staffing levels in the nursing home, sufficient to attend to the needs of the residents. • Properly monitor the residents who are ambulatory and suffer from cognitive deficits.

Wandering and elopement occurs when a resident with compromised cognitive ability is able to depart the building or walk around unsupervised and undetected. All patients have the right to go where they have been determined to require supervision and monitoring to be kept safe. If wandering and elopement occurs, it is often because of the lack of care provided by the nursing home staff. It is the responsibility of the nursing home staff to ensure that all patients are accounted for and kept free from accident. If someone you love has been permitted to elope or wander and has suffered the consequences, then it is important you contact an experienced lawyer familiar with law pertaining to cases against nursing home facilities. After an incident is important to hold the facility accountable to ensure that the nursing home learns from the incident and implements necessary policies and procedures to keep their residents safe from accidents and injuries related to wandering or elopement. For a free consultation with Nursing Home Elder Abuse and Neglect Attorney Kenneth L. LaBore call 612-743-9048 or call him toll free at 1-888-452-6589 or send an email to: KLaBore@MNnursinghomeneglect.com. Disclaimer

Free Consultation on Issues of Elder Abuse and Neglect Serving all of Minnesota Toll Free 1-888-452-6589
Free Consultation on Issues of Elder Abuse and Neglect Serving all of Minnesota Toll Free 1-888-452-6589

Residents if Allowed Will Wander and Elope – Lack of Supervision

To discuss your concerns about a resident concerning any form of elder abuse including fall injuries, mechanical patient lift falls, sexual abuse or other issues call Ken at 612-743-9048.

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