Hawley Retirement Inc. Hawley Neglect Alleged After Resident Wanders and Falls
In a report dated January 9, 2017, The Minnesota Department of Health alleged that a client at Hawley Retirement Inc. Hawley was neglected when staff failed to provide adequate supervision. The client was found lying face down on the ground, not properly dressed, with multiple injuries to his/her face requiring surgery.
Hawley Retirement Inc. Hawley Neglect Substantiated After Facial Injuries From Fall
Based on a preponderance of the evidence, neglect occurred when the facility failed to ensure a client was adequately supervised. The client left the facility unsupervised and was found by police lying on the pavement approximately one block away. The client sustained facial lacerations and a fractured jaw from the fall.
The client received services from the home care provider. The client had cognitive deficits with significant memory impairment and a diagnosis of dementia. The client was mostly independent but required staff cures to complete all activities of daily living and ambulation. The client required staff assistance with meal preparation and medication management. The client had a history of wandering within the building. The client’s service plan directed staff to monitor the client whereabouts every one hour and to re-orient the client to his/her surroundings. The client was an elopement risk due to a history of frequent requests to go outdoors. The facilities intervention was for the client to wear a wander guard device that sounds a door alarm when the client was near an exit door that was opened. The wander guard was placed on the client’s wrist and, the alarms were mounted at every exit door. If an alarm sounded it required staff enter a code for deactivation.
During an interview, a witness stated s/he visited the building at least two times a week. Mid-morning, she heard the north exit door wander guard alarm sounding. The visitor knew the code and deactivated the alarm, the visitor told a staff person she had taken care of the alarm and left the area.
An interview with a staff person established she heard the alarm sounding for the north exit door and was on her way to the door when she met the visitor in the hallway. The staff person was aware the visitor had deactivated the alarm. When told by the visitor the alarm was taken care of, the staff person assumed the visitor had checked for clients locations that wore the wander guards. The staff person did not check outside the exit door for any clients. Approximately five to ten minutes after the alarm sounded, a police officer entered the building and told staff the client was found on the pavement approximately one block from the building. Prior to that, the staff was not aware the client left the building.
Family transported the client to a hospital and the client was admitted with a lip and chin lacerations and a dislocated fracture of the left jaw. The jaw fracture was managed conservatively with clear liquids and minimal use of lower jaw joint to allow for healing. Due to the client’s fragile status, the client was discharged from the hospital six days following the fall, to home with family under hospice care.
An interview with the director of nursing established only the home care provider employees should have the code to deactivate the wander guard alarm. Staff should check the location of the client to ensure safety. It could not be determined who provided the visitor with the code to deactivate the alarm.
Review of the client’s certificate of death revealed the client passed away fourteen days following the elopement and fall with the primary cause of death as decreased oral intake due to dementia and deconditioning.
Hawley Retirement Inc. Hawley – Report Suspected Abuse and Neglect
For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.
If you have concerns about financial exploitation or any other form of elder abuse or neglect contact Minnesota Elder Abuse Attorney Kenneth LaBore toll free at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.